From 6 to 543: What is behind surge in reported measles cases in Delhi?

Along with this, eight deaths were reported due to the viral infection.

Measles is a highly contagious viral infection that causes fever, cough, rashes, and complications like encephalitis or swelling of the brain, which can lead to death. Measles is also linked with secondary infections like pneumonia and diarrhoea.

In 2019, a total of 25 cases were reported with zero fatality. In 2020, 15 cases were reported with two deaths. In 2021, six cases were reported with one death.

According to an official from the Directorate of Family Welfare, which comes under the state health department, the surveillance for measles was strengthened in 2022 before which, case detection took place only if a patient reported fever, rashes and cough, coryza, and conjunctivitis.

The official said that during Covid lockdown in 2020 and 2021, the infections were rising internally and the surveillance had weakened as the “entire machinery was busy in handling Covid pandemic.”

However, in 2022, any patient reporting fever and rashes was being tested for measles which resulted in a high positivity rate, said the official.

The official said that most of the cases were in four districts of Delhi– Shahdara, northeast, east, and south east where most of the children getting infected with the virus were between 5 to 15 years of age. He said that wherever there were clusters and people were found living in close proximity, the cases went up.

“In 2022 when we strengthened our surveillance, we found that these districts are attached to UP where there is a lot of migration population and the cases were on the higher side. When we spotted that the number of cases had increased by the end of 2022, we started providing additional vaccine doses of measles and rubella to all the children who are 15 and below,” he said.

Usually, two doses are given: one when a child is 9 months old, and the second at 16 months.

Earlier, only when five or more cases were reported from an area, it was flagged as epidemic-struck and officials would visit the spot.

“Now we are investigating each and every case. Case-based surveillance has strengthened and by December, we have to eliminate measles and we are in the final step. We are taking a no-leave policy and case-based surveillance is on,” the official said.

The measles campaign mandated by the central government which runs in schools had halted due to a court case on informed consent from parents. Before this, the health department used to vaccinate children against measles in school.

However, with increasing cases in 2022, the health department opted to vaccinate children only through its hospitals and dispensaries to circumvent the issue of informed consent.“We stopped the school activities and started our own campaign, giving an additional dose of the vaccine to the children from 9 months to 15 years of age,” said the official.

“If we see more cases in any area, we will conduct a core committee meeting and give additional doses to children between 9 months and 15 years,” the official added.

The health department started the additional dose campaign on February 6 amid the high number of cases and claimed to have covered 100 per cent of the target population. According to officials, a total of 11.07 lakh beneficiaries were covered.

The official quoted above said nutritional health also plays a vital role, adding if the child is weak and malnourished, they still catch the virus despite the vaccine.

“Most of the children go to faith healers or quacks before going to a doctor for measles,” he added.

According to Dr Jugal Kishore, Director Professor and Head of Community Medicine Department, Safdarjung Hospital, often parents forget or don’t want to vaccinate their children because of a lack of awareness.

He said that “even the most elite people” sometimes refuse to get the vaccine for their children.

“Possibility of the occurrence decreases with the help of vaccines. But, we all know that vaccination is not 100 per cent and many people don’t want to take it. Due to this, infections keep occurring and bouts of outbreak take place in congested areas,” said Dr Kishore.

He said due to lack of availability, Vitamin A, which is the first dose before the measles vaccine, is not provided resulting in malnourishment.

“Vitamin A and measles go hand in hand. Vitamin A is very crucial before the vaccine is provided to children,” he added.