by Henrylito D. Tacio
The dry season is now in full blast. It is the best time of the year to have fun and travel. But it is also the time to catch viruses like measles.
Filipinos better watch out. The Philippines has been cited by the World Health Organization (WHO) as one of the countries in Western Pacific “at risk of measles outbreaks.”
The Department of Health (DOH) recorded a total of 569 measles as of February 24, 2024. All regions, except for Bicol and Central Visayas, reported to have increasing cases in recent months.
In Bangsamoro Autonomous Region in Muslim Mindanao, the health ministry declared a measles outbreak last March 21, as the Muslim-majority region recorded 592 cases and three deaths.
According to the United Nations health agency, the likely outbreak of measles is due to “gaps in vaccination coverage and disease surveillance, and travel from people from countries experiencing outbreaks.”
“Anytime there’s measles in a community, it is a threat,” said Dr. Saia Ma’u Piukala, WHO Regional Director for the Western Pacific. “Even countries that have achieved elimination can’t relax. They have to maintain high coverage of measles vaccination and strong systems for picking up cases that get imported through international travel. Without this, measles transmission can become re-established.”
“No country is exempt from measles, and areas with low immunization encourages the virus to circulate, increasing the likelihood of outbreaks and putting all unvaccinated children at risk,” wrote Dalmacito Cordero, Jr. in a letter published in Human Vaccines and Immunotherapeutics journal.
Coronavirus pandemic
When the coronavirus disease-2019 hit the country, regular immunization was in peril. Many parents were afraid of going to health centers to have their children vaccinated, for fear of being infected with the dreaded virus, as vaccination at health centers and other healthcare institutions entails overcrowding.
Even then-President Rodrigo R. Duterte urged parents to have their children immunized during the national vaccination program. “I, therefore, call on parents [of children] under five years old, as well as the local government leaders and other community stakeholders to support the immunization activity,” he said in a video message posted over the health department’s Facebook page.
Very contagious disease
Measles – locally known as “tigdas” or “tipdas” – is a very contagious illness. It is easily spread when an infected person breathes, coughs, or sneezes, and the expelled air is inhaled by an uninfected person. A single person infected with measles can potentially infect 12 to 18 additional people.
“The virus remains active and contagious in the air or on infected surfaces for up to two hours,” the WHO said.
Measles is caused by a virus in the paramyxovirus family (which also causes mumps, German measles, and chicken pox). “The measles virus normally grows in the cells that line the back of the throat and lungs,” the WHO said. “Measles is a human disease and is not known to occur in animals.
Before widespread vaccination, measles was so common during childhood, that most people became sick with the disease by age 20.
“Not vaccinating children can lead to outbreaks of measles, mumps, and rubella – all of which are potentially serious diseases of childhood,” reminded Dr. Neil K. Kaneshiro, Clinical Assistant Professor of Pediatrics at the University of Washington School of Medicine.
Signs and symptoms
“The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts four to seven days,” the WHO informed. “A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage.
“After several days, a rash erupts, usually on the face and upper neck. Over about three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of seven to 18 days).”
Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of five, or adults over the age of 20. The most serious complications include blindness, encephalitis (an inflammation that causes brain swelling), severe diarrhea, and related dehydration, ear infections, or severe respiratory infections, such as pneumonia.
“As high as 10% of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care,” the WHO said. “Women infected while pregnant are also at risk of severe complications, and the pregnancy may end in miscarriage or preterm delivery.”
One good thing: People who recover from measles are immune for the rest of their lives.
Among those who are at risk of being infected with measles are unvaccinated young children; they are at highest risk of measles and its complications, including death. Unvaccinated pregnant women are also at risk. Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.
Vaccination and treatment
Although measles is a highly-contagious disease, it can be prevented through vaccination, Health Undersecretary Dr. Eric Tayag pointed out.
“Vaccination is the best way [to prevent it, or prevent spreading] it to others,” wrote Cordero, who is with the Department of Theology and Religious Education at De la Salle University. “The vaccine is safe and helps your body fight off the virus. Experts believed that these measles vaccines have a ‘high efficacy’ rate, which could provide up from 90% to 95% protection for children.”
Until now, there is still no specific treatment for measles.
Aside from vaccination, doctors usually give recommendations to relieve symptoms until the immune system defeats the virus.
“This is why it is essential to strengthen the immune system by maintaining proper hygiene, keeping your hands clean, covering our nose and mouth when coughing or sneezing, and, most of all, drinking enough water and eating healthy food,” Cordero wrote.
Severe complications from measles can be avoided though supportive care that ensures good nutrition, adequate fluid intake, and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhea or vomiting. Antibiotics are prescribed to treat eye and ear infections, and pneumonia.
According to the WHO, routine measles vaccination programs for children together with mass immunization campaigns are the key public health strategies to reduce global measles deaths. The measles vaccine has been in use for over 40 years. It is safe, effective, and inexpensive.
“Measles is incredibly resilient and our success is fragile. If we drop our guard, this disease will regain a foothold and spread like wildfire once again. We must stay vigilant,” Dr. Bonnie McElveen-Hunter, Chairman of the American Red Cross, said a decade ago. – ###
