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Momodou
Denmark
11787 Posts |
 Posted - 02 Nov 2007 : 17:34:36
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HEALTH AND NUTRITION BANTABA
What Is Measles?
By Yaya Bajo
(Courtesy of HEU)
Measles remains a leading cause of death among young children, despite the availability of a safe and effective vaccine for the past 40 years. An estimated 345,000 people, the majority of them children, died from measles in 2005 (the latest year for which figures are available).
Measles is one of the most contagious diseases known. Almost all non-immune children contract measles if exposed to the virus. Measles is an acute viral illness caused by a virus in the paramyxo-virus family. As a respiratory disease, measles virus normally grows in the cells that line the back of the throat and in the cells that line the lungs. Measles is a human disease with no known animal reservoir.
Vaccination had had a major impact on measles death. From 200 to 2005, more than 360 million children globally received measles vaccine through supplementary immunization activities. Moreover, improvements have been made routine immunization over this period. These accelerated activities have resulted in a significant reduction in estimated global measles deaths. Overall, global measles mortality decreased by 60% between 1999 and 2005. The largest gains occurred in Africa where measles causes and deaths decreased by nearly 75%.
Sings And Symptoms
The first sign of infection is usually high fever, which begins approximately 10 to 20 days after exposure and lasts one to seven days. During the initial stage, the patient may develop coryzer (running nose). Cough, red and watery eyes and small white spots inside the cheeks. After several days, a rash develops, usually on the face and upper neck. Over a period of about three days, the rash proceeds downward, eventually reaching the hands and feet. The rash lasts for five to six days, then fades. The rash occurs, on average, at day 14 after exposure to the virus, with a range of seven to 18 days.
Complications
Measles occur after an unpleasant mild or moderately severe illness. Severe measles is particularly likely in poorly nourished young children, especially those who do not receive sufficient vitamin A, or whose immune system have been weakened by HIV/AIDS or other disease.
Children usually do not die directly of measles, but from its complications. Complications are more common in children under the age of five or adults over the age of 20. The most serious complications include blindness, encephalitis (a dangerous infection of the brain causing inflammation), severe diarrhea (possibly leading to dehydration), ear infections and severe respiratory infections such as pneumonia, which is the most common cause of death associated with measles. Encephalitis is estimated to occur in 1/1000 case, while otitis media (middle ear infection) is reported in 5-15% of cases and pneumonia in 5-10% of causes. The case fatality rate in developing countries is generally in the range of 1 to 5%, but may be as high as 25% in populations with high levels of malnutrition and poor access to health care. People who recover from measles are immune for the rest of their lives.
People Most At Risk
Un-immunised persons, especially young children, are highest risk for measles and its complications, including death. Measles can also affect un-immunized older children, adolescents and young adults. All people who have not been immunized with vaccine or who have not acquired immunity through having experienced the disease can become infected.
Measles can be particularly deadly in countries experiencing or recovering from rates war, civil strife or natural disasters. Infection rates soar because damage to infrastructure and health services interrupts routine immunization and overcrowding in campus for refugees and internally displaced persons greatly increases the risk of infection.
Transmission
The highly contagious measles virus is spread by airborne droplets (circulating as a result of coughing and sneezing), close personal contact or direct contact with nasal or throat secretions of infected person. Consequently, measles tends to occur as epidemics which may cause many deaths especially among young malnourished children.
The virus remains active and contagious in the air or on infected surfaces for up to two hours. It can be transmitted by an infected individual from four days prior to the onset of the rash to four days after the onset. If one person has the disease, a high proportion of their susceptible close contacts will also become infected with the measles virus.
Treatment
Severe complications from measles can be avoided through proper clinical management General nutritional support and the treatment of dehydration with oral rehydration solution are necessary. Antibiotics should be prescribed for treating eye and ear infections and pneumonia. To improve survival, it is important that children with measles receive adequate nutrition and fluids.
All children in developing countries diagnosed with measles should receive two doses of vitamin A supplements given 24 hours apart. Given vitamin A at the time of diagnosis can help prevent eye damage and blindness. Moreover, vitamin A supplementation had been shown to reduce the number of deaths from measles by 50%.
Disease And Mortality Burden
While measles is now rare in many industrialized countries, it remains a common illness in many developing countries. More than 20 million people are infected each year by measles. In 2005, it was estimated that there was 345,000 measles deaths globally; this translate to about 945 measles deaths everyday. The over whelming majority (> 95%) of measles deaths occur in countries with per capita Gross National income of less than US $ 1000. The primary reason for continuing high childhood measles morbidity and mortality is the failure to deliver at least one dose of measles vaccine to all infants. In countries where measles has been largely eliminated cases imported from other countries remain an important source of infection.
Prevention: A Cost-Effective, Save Vaccine
Suffering, complications and health caused by measles can be easily prevented through immunization. The measles vaccine is safe, effective and inexpensive. It costs less than one US dollar (Consisting of vaccine, injection equipment and operational costs) to imminise a child against measles, making measles vaccination one of the most cost-effective public health interventions available for preventing death. Measles immunization carries the highest health return for the money spent saving more lives per unit cost. The vaccine, which had been available for more than 40 years, costs about US 50.33 per bundle dose. (vaccine plus safe injection equipment) if procured through the United Nations children Fund (UNICEF).
In many countries where the public health burden of rubella and/or mumps is considered to be important, measles vaccine is often incorporated with rubella and/or mumps vaccines as a combined, live, attenuated (weakened). Measles-Rubella (MR) or Measles-Mumps Rubella (MMR) vaccine. If procured through UNICEF, MR vaccine cost about US 5065 per bundled dose, and the price of MMR per bundled dose is in the range of $1.04-$1.50 depending on the manufacturer. Measles vaccine is equally effective whether in the monovalent or in the combined immunization coverage rates for measles vaccination vary significantly by region. WHO and UNICEF estimate that the global average for routine measles immunization coverage between 1999 and 2005 increased from 71% to 77%.
To be continued
Source: Foroyaa Newspaper Burning Issues
Issue No. 129/2007, 2 – 4 November 2007
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