IMMUNISATION WEEK: Has your baby received their measles vaccine?

Measles is a highly contagious disease caused by a virus. In Kenya, the Ministry of Health through the Kenya Expanded Programme Immunization Schedule, recommends that babies be vaccinated against measles at ages 9 months and 18 months.

However, your baby will be given the measles vaccine at 6 months in the event of a measles outbreak or if the baby has been exposed to HIV. This vaccine will be administered at a dosage of 0.5mls on the right upper arm. The Kenya Expanded Programme Immunization Schedule also states that if there has been no measles outbreak, your baby will get their first dose of 0.5mls of the measles vaccine at nine months and the second dose at eighteen months.

What is measles?

Measles is an acute viral respiratory illness characterised by extremely high fever, coughing, conjunctivitis (pink eye), general feeling of illness, and coryza (inflammation of the mucous membrane in the nose). According to the Ministry of Health, Kenya registered an active outbreak of measles in 22 counties between October 2019 and June 2021. Also, data from the National Vaccines and Immunization Programme at the Ministry of Health shows that in 2000, measles was the leading cause of vaccine-preventable deaths in children. It is currently the third after pneumococcal and rotavirus. At the same time, measles-rubella is the leading cause of congenital defects. Rubella is an acute contagious viral infection that causes a mild fever and rash in children and adults. Infection during pregnancy, especially during the first trimester, can result in miscarriage, foetal death, stillbirth, or infants with congenital malformations, which are known as congenital rubella syndrome.

Transmission and symptoms

This disease spreads through the air via respiratory droplets from coughing and sneezing by infected persons. In most cases, symptoms begin to show from the tenth to fourteenth day after exposure. A red, flat rash that usually starts on the face and then spreads to the rest of the body mainly begins three to five days after the start of symptoms. The World Health Organization says the first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days.

A runny nose, a cough, red and watery eyes, and spots inside the cheeks can also develop in the initial stage. “When the rash erupts, it usually shows on the face and upper neck. The rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days),” the WHO states. The virus that causes measles remains active and contagious in the air or on infected surfaces for up to 2 hours. “It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts,” the WHO says.

The risk

According to the WHO, children who have not been vaccinated against measles are at a high risk of getting infected and even dying from this disease. However, the WHO says the majority of deaths related to measles come out of the complications which are associated with the disease. “Serious complications are more common in children under the age of 5, or adults over the age of 30,” states the WHO. The global health body lists the most serious complications like blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and dehydration, ear infections, or severe respiratory infections such as pneumonia. “Severe measles is more likely to occur among poorly nourished young children, especially those with insufficient vitamin A, or those whose immune systems have been weakened by infections such as HIV/AIDS,” states WHO. Unvaccinated pregnant women are also at risk. “Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected with measles,” states WHO.

Treatment

According to the WHO, there is no specific antiviral treatment that currently exists for measles. However, severe complications from measles in a baby can be reduced through good nutrition, adequate fluid intake and treatment of dehydration, and antibiotics in the event of a pneumonia infection. This should be done in line with the recommendations of a licensed and qualified pediatrician or your general physician. “All children who have been diagnosed with measles should receive two doses of vitamin A supplements. These doses should be given 24 hours apart,” the WHO recommendations state.