Bidding measles goodbye in the Philippines

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Wednesday, January 29, 2014


THE government has commenced a massive vaccination program to about two million Filipino children to prevent the spread of measles.

The Department of Health (DOH), the World Health Organization (WHO) and other medical groups started the campaign called "Goodbye Tigdas" (Goodbye Measles) on January 21 in Metro Manila and seven provinces.

These areas have seen an increasing number of measles cases last year.

The vaccination program comes after the Health Department declared an outbreak of the disease in Metro Manila on the first week of January 2014 due to the significant increase in the number of cases.

The DOH reported early this month that for 2013, the number of measles cases rose from 1,536 to 1,724. At least 21 individuals died, some due to complications like pneumonia. Almost half of the cases were found in several cities in Metro Manila.

The WHO said more than 95 percent of measles deaths occur in low-income countries with weak health care infrastructure.

The National Measles Laboratory of the Research Institute for Tropical Medicine (RITM) recorded a surge in the number of specimens referrals that were confirmed positive for measles -- which may indicate an outbreak -- from June toward the end of 2013.

In an interview, Rex Centeno of the RITM Virology Unit said that as of the last week of January, they still have two weeks worth of backlogged specimens to confirm due to the sudden increase of measles infection.

An outbreak is declared when the number of cases exceeds the expected number for a disease in a particular time, said RITM Virology Unit head Dr. Amado Tandoc III.

Tandoc said outbreaks of vaccine-preventable diseases like measles occur because the virus is "an extremely infectious airborne pathogen" and the portion of the population immune to the infection may not be enough to protect the rest of the population, which are not immune.

"There are a lot of healthy but unimmunized individuals in the community despite having a functional immunization program. If an unimmunized person gets sick with the virus, all the unprotected individuals are at risk of getting sick," he said.

The WHO said at least 95 percent of the community should be vaccinated against the disease.

"Factors contributing to the increasing number of cases include gaps in routine measles vaccination coverage including that less than 50 percent of eligible children have received a 2nd dose of measles vaccine that reinforces protection against measles infection," it said.

Tandoc also said, "Having one shot at nine months is not enough. Two doses of the current vaccine for measles (MMR, which includes mumps and rubella), confer lifelong immunity to more than 99 percent of recipients."

The WHO also said increased travel within the country, both due to the recent emergencies such as Typhoon Yolanda -- and the past holiday season contributed to the surge of cases.

Measles is a highly contagious disease caused by a virus. The measles virus grows in the cells at the back of the throat and lungs.

It is one of the leading causes of death among young children all over the world, despite the availability of vaccine.

The symptoms of the virus include a high fever, which appears about 10 to 12 days after exposure and lasts for four to seven days. During this time the person may also have cough, runny nose, red and water eyes, and small white spots inside the cheek.

A rash also erupts on the face and upper part of the neck after several days and spreads to the hands and feet about three days after. It may persist for five to six days.

A 2003 study by the WHO in the Western Pacific region stated that the campaign to eliminate measles in the Philippines showed a high national coverage but lower in large urban slums. This gap in coverage leads to continued measles transmission and death.

The study also said, "The population of the National Capital Region (NCR), with large urban slum areas, was grossly underestimated, so the real coverage was considerably lower. Cases and deaths have decreased across the country, except in the NCR. For 2000, 68 percent of cases were unimmunized and 50 percent of cases and 88 percent of deaths occurred in the NCR."

Meanwhile, Philippine Medical Association president Dr. Leo Olarte said that the "lack of concern and gross neglect of mothers to have their kids vaccinated in the local health centers" also contributed to the outbreak.

The DOH has set a deadline for measles elimination by 2017.

Dr. Eric Tayag, spokesperson of the DOH and the head of the National Epidemiology Center, said that while it is difficult to completely eradicate measles as long as strains of viruses remained elsewhere in the world the Health Department are gunning for the timeline to eliminate measles in the Philippines within three years.

Since there was no known cure yet for measles, the only way to do this is via strengthening the vaccine campaign against the disease.

"We can make sure that all our children are adequately protected through immunization, that our health care services reach the target population and that these services are made readily accessible," Tandoc said.

For his part, Olarte said that the goal to make the Philippines measles-free by 2017 is achievable, provided that everyone, particularly the mothers, cooperate in the vaccine drive.

The Philippine Medical Association was also part of the information and dissemination campaign for the massive vaccine program. (Sunnex)

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