Wednesday, April 17, 2019

Measles, the New Pandemic

"It's my 6-year-old daughter who had measles first. She had a lot of fever."
"I called the doctor but it was Friday. He had already gone to town. I went to see another doctor who told me that my daughter had an allergy."
"This misdiagnosis was almost fatal."
Erika Hantriniaina, Ambalavao, Madagascar

"Vitamin A is given to children to increase their immunity. We try to reduce the fever. If there is a cough, we give antibiotics."
Dr. Boniface Maronko, World Health Organization

"The epidemic unfortunately continues to expand in size. Malnutrition is the bed of measles."
"But immunization is not the only strategy for the response to this epidemic. We still need resources for care, monitoring and social mobilization."
Dr. Dossou Vincent Sodjinou, WHO epidemiologist

"He has a fever. I think it's measles because there are these little pimples that have appeared on his face."
"I'm so scared for him because in the village everyone says it kills babies."
Nifaliana Razaijafisoa, Ambalavao, Madagascar
A volunteer nurse examines six-month-old Sarobidy, who is infected with measles, while her mother Nifaliana Razaijafisoa looks on at a healthcare centre in Larintsena, Madagascar. (Laetitia Bezain/Associated Press)

Madagascar has logged beyond 115,000 cases of the largest measles outbreak in its history. Misinformation and hesitation born of deliberate campaigns to turn people away from having their children inoculated have resulted in measles cases rising globally. It is a lack of resources in Madagascar, however, that has driven the rise of measles infections.

On Madagascar's main island only 58 percent of people have been vaccinated, representing a major feature in the spread of the outbreak. One of the most infectious diseases, immunization rates are required to be at least 90 to 95 percent, even higher, for the herd immunity effect to prevail in the prevention of measles outbreaks.

It is mostly children under age 15 that have died from the measles infections since the outbreak began in September, according to the World Health Organization. Close to fifty percent of Madagascar's child population is malnourished, complicating the outbreak. For rural dwellers, simply reaching a clinic for help can represent a challenge.

Health centres in the country are often understaffed or are staffed with poorly qualified workers and many people living in Madagascar cannot afford to see a doctor, or to buy medicine. Information on health issues can be lacking entirely or be unreliable.That vaccines are free in public health centres doesn't reach all parents.

There are no specific treatments for measles; instead the symptoms are treated. Highly infectious, the disease is spread by coughing, sneezing, close contact or infected surfaces. Should the disease fail to be treated in its early stages by antibiotics, complications including diarrhea, bronchitis, pneumonia and convulsions can manifest.

Free medications have been sent to regions most affected by the outbreak, by Madagascar's health ministry. Dr. Maronko supervises efforts to contain the outbreak, reminding heads of health centres in the Ambalavao region not to ask parents to pay, having seen some doctors asking them for money. WHO  began a third mass vaccination campaign with the goal of reaching 7.2 million children, six months of age to nine years, in Madagascar last month.

Mothers wait to have their babies vaccinated against measles, at a healthcare center in Larintsena, Madagascar.  Laetitia Bezain / AP

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