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Published Date: 2010-07-14 15:56:54
Subject: PRO/EAFR> Measles - Africa (26): Zambia
Archive Number: 20100714.209169

MEASLES - AFRICA (26): ZAMBIA
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Date: Fri 9 Jul 2010
Source: The Post Online (Zambia) [edited]
http://www.postzambia.com/post-read_article.php?articleId=3D11347&highligh=
t=3Dmeasles

Zambia's measles outbreak hits 3000, leaves 62 dead
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Zambia has so far recorded 3000 cases of measles =

in the current outbreak with 62 deaths =

registered, health ministry permanent secretary =

Dr Peter Mwaba has confirmed. Dr Mwaba has =

disclosed that adults with weak immune systems =

like HIV patients are susceptible to measles. =

Speaking to journalists in Lusaka on Thursday [8 =

Jul 2010], Dr Mwaba said there were still =

sporadic cases of measles in the country though =

the situation was being contained.

"As of Monday [5 July 2010], we had over 62 =

mortalities and those infected are close to 3000. =

Those are already controlled, not infected and =

they have been discharged from most of the =

centres. From the time of the outbreak we have =

seen over 2000 cases out of which we have over 60 mortalities," Dr Mwaba sa=
id.

"The flooding obviously made some parts =

inaccessible, meaning that we could have lost out =

on immunizing some of these children but we have =

continued with our routine immunization. But now =

most of the centres have vaccines and we will mop =

up with child week where we hope to reach most of =

the children. We have doubled our efforts."

During the media briefing, Dr Mwaba also =

disclosed that adults with depressed immunity =

were also at risk of catching measles. "We have =

patients who are between 6 months and 9 months =

getting most of these attacks. But also =

interestingly, we have seen that among adults, =

those that are immune compromised are also =

affected, we are getting a few cases among them =

but the bulk is among children," Dr Mwaba said. =

"Those are usually the ones infected with =

HIV/AIDS and those whose immunities are low for one reason or the other."

Dr Mwaba said since the epidemic had spread in =

southern Africa, Zambia would ensure that it =

conducts immunizations even in border areas. "It =

is important that we put the epidemic in this =

context, it's ravaging around southern Africa. I =

think that even as we are doing our own measures =

of control here we also need to look at the =

border areas so that we immunize those that are =

in our areas, so the child week may go as far as =

mopping up bordering areas," Dr Mwaba said.

"This is an epidemic; you expect to have sporadic =

new cases. This, we will only be able to control =

once we have immunized every child and I think =

this is why it is important that the civil =

society and the public take advantage of the =

immunization that we do. We will also immunize =

against polio. If people don't take their =

children to immunization we lose out and we have =

an epidemic like what we have right now." He said =

the routine immunization exercise would help =

immunize many children and urged parents to take =

their children for immunization.

Health minister Kapembwa Simbao, had a fortnight =

ago sent an urgent appeals to donors and =

cooperating partners for urgent assistance to =

enable government carryout a comprehensive =

immunization programme against measles and save =

lives. Mazabuka Central member of parliament Gary =

Nkombo has added his voice to concerns on =

addressing the measles outbreak. Nkombo has since =

called on the Ministry of Health to be proactive =

in efforts against the spread of measles.

What is Measles?
----------------
Measles is an infection of the respiratory system =

caused by a virus, specifically a paramyxovirus =

of the genus Morbillivirus. Symptoms of measles =

include fever, cough, running nose, red eyes and =

a generalized erythematous rash.

Measles is spread through respiration (contact =

with fluids from an infected person's nose and =

mouth, either directly or through aerosol =

transmission), and is highly contagious: 90 =

percent of people without immunity sharing a =

house with an infected person will catch it.

The infection has an average incubation period of =

14 days (range 6=AD19 days) and infectivity lasts =

from 2=AD4 days prior, until 2=AD5 days following the onset of the rash

How to avoid getting Measles
----------------------------
Instructions:
The most important way to avoid getting the =

measles is to get vaccinated. This is the =

recommend schedule for vaccinating your child =

[Position paper reference: Weekly Epid. Record (2009, 84: 349-360)]

- Reaching all children with 2 doses of the =

measles containing vaccine (MCV) should be the =

standard for all national immunization programmes.

- Delivery of the 2nd dose (MCV2) may occur =

either at a scheduled age through routine =

services or periodically through mass campaigns, =

depending on which strategy achieves the higher =

coverage. An MCV2 dose may be added to the =

routine immunization schedule in countries that =

have achieved > 80 percent coverage of measles =

1st dose (MCV1) at the national level for 3 =

consecutive years as determined by the most =

accurate means available (e.g., survey or =

WHO/UNICEF estimates). In general, countries that =

do not meet this criterion should prioritize =

improving MCV1 coverage and conducting =

high-quality follow-up SIAs, rather than adding MCV2 to their routine sched=
ule.

- In countries with ongoing transmission in which =

the risk of measles mortality remains high, MCV1 =

should be given at age 9 months. MCV2 should be =

given between 12-18 months, as providing MCV2 in =

the 2nd year of life reduces the rate of =

accumulation of susceptible children and the risk of an outbreak.

- In countries with low rates of measles =

transmission (that is, those that are near =

elimination) and where there is a low risk of =

measles infection among infants, the 1st dose may =

be administered at age 12 months to take =

advantage of the higher seroconversion rates =

achieved at this age (>90 percent =

seroconversion). In these countries the optimal =

age for delivering a routine 2nd dose of measles =

is based on programmatic considerations that =

achieve the highest coverage and hence the =

highest population immunity. Administration of =

the second dose at age 15-18 months ensures early =

protection of the individual, slows accumulation =

of susceptible young children and may correspond =

with other routine immunizations (for example, =

DTP booster). If 1st dose coverage is high (>90 =

percent) and school enrollment is high (>95 =

percent), giving the 2nd dose at school entry may =

be an effective strategy for achieving high =

coverage and preventing outbreaks in schools.

- Combined vaccines (Measles and Rubella or =

Measles, Mumps and Rubella) may not be optimal =

for use in countries where vaccine coverage for =

measles vaccine of at least 80 percent cannot be achieved or maintained.

- In areas where there is a high incidence of =

both HIV infection and measles, MCV1 may be =

offered as early as age 6 months. 2 additional =

doses of measles vaccine should be administered =

to these children according to the national immunization schedule.

[Byline: Chibaula Silwamba and Florence Bupe]

--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>

[The current measles outbreaks in Southern Africa =

countries including Zambia have been attributed =

to low measles immunization coverage due to =

declining funding for the measles control =

strategy. The situation can only get worse if =

adequate funds are not mobilized to implement the =

measles immunization campaign to control the =

current outbreak. It is therefore imperative that =

the national authorities and partners mobilize =

the required resources to reverse the current measles trends.

A map showing the provinces of Zambia can be =

accessed at =

http://en.wikipedia.org/wiki/Provinces_of_Zambia, =

and the HealthMap/ProMED-mail interactive map of =

the country can be accessed at http://healthmap.org/r/017q. - Mod.JFW]

See Also