HYDERABAD: The recent surge in measles cases in Hyderabad and its neighbouring areas is a cause for concern, as hundreds of children have been infected and several have even lost their lives in the last three months.
Despite medical experts and paediatricians in the city labelling it as an outbreak, health officials have attributed it to ‘rampant surveillance’ or over-reporting of cases of fever and/or rashes. In view of the ongoing prevalence of the outbreak, medical experts are calling for a statewide Measles-Rubella (MR) vaccination drive to be conducted as soon as possible.
The deadly disease of measles has spread across Mumbai, leading to the death of 15 children between October 2022 and January 2023. Medical experts in Hyderabad observed a similar trend, starting in late January. “We have never witnessed such a huge number of cases for such an extended period before. However, it was not reported anywhere, and there was no word from the government either,” said Dr Srikant Manda, an executive board member of the Indian Academy of Paediatrics (IAP).
He further stated that this was unusual as measles cases are typically reported in May, during peak summer. “Many paediatricians in the city, like myself, have observed this surge in measles cases. Each paediatrician is reporting around 4 to 5 cases daily,” Dr Manda mentioned.
In order to collect data, the government has assigned lab technicians to draw samples from positive cases. State public health officials are collaborating with paediatricians to monitor the cases and conduct Outbreak Response Immunisation (ORI) where more cases have been reported. “According to government data, there have been two deaths in the Mehdipatnam area. Whether officials acknowledge it or not, it is undoubtedly an outbreak,” emphasised Dr Manda.
More fatalities observed among kids with malnutrition: Doc
Dr T Usha Rani, the superintendent of Niloufer Hospital, confirmed that there is an outbreak of measles in the region, as the number of cases has been increasing since February-March of this year. Most of the cases are from Hyderabad and Rangareddy districts. “Normally, measles cases are referred to the Fever Hospital. However, since paediatric cases are being referred here, we have created an isolation ward in the hospital. Currently, we have an occupancy of 20 to 30 patients daily, with approximately 2-3 new cases coming in,” explained Dr Usha Rani told TNIE. She added that there have been fatalities among those with severe malnutrition.
Failed vaccination
The MR vaccination is a crucial component of the universal vaccination programme, and it must be administered to every child at the age of nine months, followed by a second dose after 16 months. Dr Usha Rani pointed out that the possible reason behind the surge in measles cases is that many children have missed out on their vaccinations during the Covid-19 pandemic.
The State government conducted an MR vaccination mass campaign in 2017 before the pandemic, which experts believe was ineffective. “During the MR campaign, the state claimed to have covered the entire population. However, there has been a significant surge in measles cases in the last two months,” stated Dr E Arjun, a senior paediatrician who played a leading role in the campaign.
To his surprise, even older children have been infected, indicating inadequate vaccination with some children receiving only one dose or no dose at all. Paediatricians are concerned that the government has not taken any steps to create awareness or caution among the public that many measles cases may go unreported.
They are worried that parents may mistake it for a viral fever and wait for it to subside, potentially using unnecessary antibiotics. Dr Arjun emphasised the need for a special vaccination drive to address the current outbreak.
Result of ‘rampant surveillance’?
“We do not refer to it as an outbreak,” stated a health official, who didn’t wish to be named. As part of the Measles Elimination Programme, the government is conducting extensive surveillance.
All fever cases with rashes are being considered as possible measles cases according to the guidelines issued by the Union government, the official said, adding that some cases have tested positive for measles, while others have only exhibited fever with rashes. The official also noted that some of the positive cases may be false positives.
According to officials, some of the children who died had underlying medical conditions such as heart ailments or were already infected with other viral illnesses. The committee responsible for handling these cases is reviewing them to determine if measles was the exclusive cause of the deaths. The officials stated that they were unable to provide data at this time. Additionally, some children who required ventilators were admitted and were later found to be positive for measles.