Amid an increase in the number of measles cases, the Centre has asked states to consider administering an additional dose of measles and rubella vaccines to all children aged nine months to five years, in vulnerable areas. Recently, increased numbers of measles cases were reported from certain districts of Bihar, Gujarat, Haryana, Jharkhand, Kerala and Maharashtra.
Areas under the Brihanmumbai Municipal Corporation (BMC) and some other districts in Maharashtra have reported a rapid rise in infections and around 10 mortalities caused by the measles virus. In a letter to the Principal Health Secretary of Maharashtra that was also marked to all states and Union territories, the Health Ministry said this surge is of particular concern from the 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 Measles and Rubella Containing Vaccine (MRCV) among the eligible beneficiaries is also significantly below the national average," Health Ministry Joint Secretary P Ashok Babu said.
In this context, he said a meeting of domain experts chaired by a member (health), NITI Aayog, was held on Wednesday. Based on inputs received from the meeting, the Centre said states and UTs are advised to consider administering an additional dose to all children of nine months to five years in vulnerable areas. "This dose would be in addition to the primary vaccination schedule of first dose at nine-12 months and second dose at 16-24 months," he said. The vulnerable areas are to be identified by the state government and UT administration in "Outbreak Response Immunisation" (ORI) mode.
A dose of MRCV is to be administered to all children aged six months and up to less than nine months in those areas where measles cases in the age group of less than nine months are above 10 per cent of the total cases, he said.
"Since this dose of MRCV is being given to this cohort in "Outbreak Response Immunisation" (ORI) mode, these children should also be covered by first and second dose of MRCV according to the primary (routine) Measles and Rubella vaccination schedule," he said.
As the disease is known to witness a surge in cases of numbers from November to March, annually, the health ministry said an active fever and rash surveillance mechanism needs to be strengthened for early case identification.
"Head count survey of all children aged six months to five years must be undertaken in the vulnerable outbreak areas to facilitate full MRCV coverage in an accelerated manner. The institutionalised mechanism of District Task Force on immunisation under the leadership of the district collector must be activated to review the measles situation on a daily and weekly basis and plan the response activities accordingly," he said.
The disease is known to be fatal among children with moderate and severe malnourishment, he said, underlining that as part of the case identification and management, house-to-house search activities to identify such vulnerable children and provide pre-emptive care with nutritional and Vitamin A supplementation is also necessary.
The Health Ministry said immediate isolation of laboratory-confirmed cases must be done for at least seven days from the date of identification.
The Centre also asked Maharashtra to earmark wards and beds for effective caseload management of measles in dedicated health facilities for timely transfer and treatment of such children.
The Centre has also deployed high-level teams to Ranchi (Jharkhand), Ahmedabad (Gujarat) and Malappuram (Kerala) to assess and manage the increase in the number of measles cases among children there.
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