DO WE NEED TO GIVE MEASLES VACCINE TO CHILDREN EARLIER THAN THE CURRENTLY RECOMMENDED AGE?

Ammarah Jamal, Yousuf Yahya, Muhammad Tariq Karim

Abstract


Background: Measles is a leading cause of death among children. No specific drug has yet been discovered to treat measles but an available vaccine can effectively prevent the infection. In Pakistan children are vaccinated against measles by two doses given at age of nine months onward. The last few years have witnessed an increasing number of measles cases at age lower than nine months. Methods: Secondary data analysis of the records of Expanded Program on Immunization from all districts of Sindh was performed from January–April 2016. Data included all patients of any age or gender, fulfilling the World Health Organization case definition of measles, along with positive IgM antibodies for measles in their blood. Data was analysed using windows SPSS version 21.0. Results: Analysis of 658 confirmed measles cases showed an age range of 3 months to 336 months with a mean of 32.82. Most patients (41.4%) belonged to age group 10-24months. Some noteworthy18% of cases were ≤9 months old including 1.8% patients who were ≤6 months age. An unexpected 76 (11.6%) were >60 months of age. 50.6% of the cases were male while 49.4% were female. Most of the patients (73.9%) belonged to urban areas. Conclusion: We conclude that a sizeable number of children are infected by measles before reaching the age of first recommended inoculation against measles. It is affecting people at both extremes of life ranging from as young as three months up to 28 years of age.

Keywords: Measles; vaccination; child; immunity; infant; infection

Full Text:

PDF

References


Kliegman RM, Stanton B, Geme JS, Schor NF. Nelson Textbook of pediatrics. 20th ed. Philadelphia: Saunders Ltd, 2016; p.1542.

Mehta P. The Measles Vaccine. [Internet]. India: Mehta Childcare; 2016 [ cited 2017 Jan 22]. Available from: http://www.mehtachildcare.com/vaccines/measlesvaccine.htm

WHO. Measles. [Internet]. World Health Organization 2016 [cited 2017 Jan 22]. Available from: http://who.int/mediacentre/factsheets/fs286/en/

Rahim F, Rehman HU, Afridi JM. Measles- Demographic profile and complications in children. J Med Sci 2011;19(4):174–6.

Thalange N, Beach R, Booth D, Jackson L, editors. Essentials of Paediatrics. 2nd ed. Edinburgh: Elsevier, 2013; p.377.

Khan T, Qazi J. Measles outbreaks in pakistan: causes of the tragedy and future implications. Epidemiol Rep 2014;2:1.

WHO. Response to measles outbreaks in measles mortality reduction settings. [Internet]. 2009 [cited 2017 Jan 22]. Available from: http://apps.who.int/iris/bitstream/10665/70047/1/WHO_IVB_09.03_eng.pdf

Khan A, Ullah O, Ambreen, Ahmed I, Merajuddin. Measles in vaccinated children 1.5 to 3 years of age in rural community of district Peshawar, Paskistan. J Ayub Med Coll Abbottabad 2015;27(4):825–8.

WHO. IMCI (Integrated Management of Childhood Illness) Distance Learning Course Module 2 The Sick Young Infant, Switzerland; 2014.

Niazi A, Sadaf R. Measles Epidemic in Pakistan: In Search of Solutions. Ann Med Health Sci Res 2014;4(1):1–2.

CDC. Recommended Immunization Schedules for Persons Aged 0 Through 18 Years — United States, 2012. [Internet]. [cited 2017 Jan 22]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6105a5.htm

WHO. Global measles and rubella strategic plan: 2012-2020. Geneva: WHO; 2012. 2016.

Van Den Ent MM, Brown DW, Hoekstra EJ, Christie A, Cochi SL. Measles mortality reduction contributes substantially to reduction of all cause mortality among children less than five years of age, 1990–2008. J Infect Dis 2011;204(suppl 1):S18–23.

Simons E, Mort M, Dabbagh A, Strebel P, Wolfson L. Strategic Planning for Measles Control: Using Data to Inform Optimal Vaccination Strategies. J Infect Dis 2011;204(Suppl 1):S28–34.

WHO. Country Profile-Measles Elimination: Malaysia. [Internet]. [cited 2017 Jan 23]. Available from: http://www.wpro.who.int/immunization/documents/measles_country_profile_may2016_mys.pdf

Jani JV, Jani IV, Araujo C, Sahay S, Barreto J, Bjune G. Assessment of routine surveillance data as a tool to investigate measles outbreaks in Mozambique. BMC Infect Dis 2006;6:29.

Oyefolu AO, Oyero OG, Anjorin AA, Salu OB, Kabir OA, Omilabu SA. Measles morbidity and mortality trend in Nigeria: A 10-year hospital-based retrospective study in Lagos State, Nigeria. J Microbiol Infect Dis 2016;6(1):12–8.

Papania M, Baughman AL, Lee S, Cheek JE, Atkinson W, Redd SC, et al. Increased susceptibility to measles in infants in the United States. Pediatrics 1999;104(5):e59.

Lim GH, Deeks SL, Fediurek J, Gubbay J, Crowcroft NS. Documenting the elimination of measles, rubella and congenital rubella syndrome in Ontario: 2009-12. Can Commun Dis Rep 2014;40(8):143–51.

European Centre for Disease Prevention and Control. Measles and rubella monitoring- March 2013. [Internet]. [cited 2017 Jan 25]. Available from: http://ecdc.europa.eu/en/publications/Publications/measles-rubella-monitoring-report-march-2013.pdf

CDC. Measles and the Vaccine (Shot) to Prevent It. [Internet]. [cited 2017 Jan 25]. Available from: https://www.cdc.gov/vaccines/parents/diseases/child/measles.html

CDC. Recommended Adult Immunization Schedule for Adults Aged 19 Years or Older, by Vaccine and Age Group. [Internet]. [cited 2017 Jan 25]. Available from: https://www.cdc.gov/vaccines/schedules/hcp/imz/adult-shell.html#f7

Rota JS, Hickman CJ, Sowers SB, Rota PA, Mercader S, Bellini WJ. Two case studies of modified measles in vaccinated physicians exposed to primary measles cases: high risk of infection but low risk of transmission. J Infect Dis 2011;204(Suppl 1):S559–63.


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]