Mumbai: Amid a surge in infection and deaths due to measles in Mumbai and the rest of Maharashtra, the union health ministry has asked the state government to strengthen an active fever and rash surveillance mechanism for early case identification and undertake a head count survey of all children aged 6 months to 5 years in the vulnerable outbreak areas to facilitate full MRCV coverage in an accelerated manner.
Mumbai on Wednesday recorded 13 new cases of measles and one death related to the infection, the Brihanmumbai Municipal Corporation (BMC) said.
As many as 30 new measles patients were admitted to civic or state-run hospitals in the city during the day while 22 patients were discharged, the BMC said in a release.
The union health department joint secretary D P Ashok Babu requested in a three-page letter to Maharashtra Public Health Principal Secretary Sanjay Khandare that he direct the concerned officials to initiate prompt action on preparedness and measles outbreak response activities.
Increase in measles cases has been reported
Recently, an increase in measles cases has been reported in certain districts of Maharashtra and other states. A rapid rise in the number of cases and some mortality have also been observed, specifically in the BMC jurisdiction and certain other districts.
This is of particular concern from a public health point of view. It is also clear that in all such geographies, the affected children were predominantly unvaccinated, and the average coverage of MRCV (measles- and rubella-containing vaccines) among the eligible beneficiaries is also significantly below the national average,’’ said Dr Babu.
Adequate availability of vaccines
‘’Adequate availability of vaccines across all blocks and districts may be ensured for the vaccination campaign. The state may communicate to the ministry of health and family welfare the need for additional vaccine requirements in order to conduct supplementary immunisation activities," Dr Babu said.
Furthermore, Dr Babu has requested the state government to activate the institutionalised mechanism of the District Task Force on Immunization, chaired by the District Collector, to review the measles situation on a daily or weekly basis and plan the response activities accordingly.
The disease is fatal among children with malnutrition
"The disease is known to be fatal among children with moderate and severe malnutrition. As a result, house-to-house search activities to identify such vulnerable children and provide preemotional care with nutritional and vitamin A supplementation are also required as part of case identification and management,'' he said.
Furthermore, the state has been asked to disseminate accurate and factual information about measles symptoms and treatment in general to the general public in order to facilitate the early identification and management of measles cases. All suspected cases of fever and a maculopapular rash must be reported and investigated.
Immediate isolation of laboratory-confirmed cases required
‘’Immediate isolation of laboratory-confirmed cases must be done for at least 7 days from the date of identification. Guidance for home-based cases must be issued with reference to age appropriate two doses of vitamin A supplementation with adequate support,’’ he said.
Caregivers must be made aware of the danger signs indicating that such children should be hospitalised immediately if they have persistent diarrhea, rapid breathing with chest indrawing (pneumonia), or ear discharge. ‘’State must embark wards and beds for effective caseload management of measles in dedicated health facilities for timely transfer and treatment of such cases."