Context:

• Member Countries of WHO South-East Asia Region resolved to eliminate measles and rubella by 2023, to prevent deaths and disabilities caused by these highly infectious childhood killers’ diseases.

Background:

• The new target to eliminate both the diseases will leverage the existing momentum and strong political commitment which is being demonstrated through unprecedented efforts, progress and successes.
• A resolution to eliminate the two diseases was adopted at the Seventy Second Session of WHO Regional Committee for South-East Asia here in New Delhi.
• Measles elimination and rubella control has been a regional flagship priority since 2014.
• The Member countries adopted a “Strategic Plan for Measles and Rubella Elimination 2020-2024” that lays down the road map and focus areas to achieve the elimination targets in the Region.

Countries that Eliminated Measles and Rubella:

• Five countries have eliminated measles – Bhutan, DPR Korea, Maldives, Sri Lanka and Timor-Leste.
• Six countries have controlled rubella – Bangladesh, Bhutan, Maldives, Nepal, Sri Lanka and Timor-Leste.

What will be done Eliminate Measles and Rubella?

• To achieve the new targets, the Member countries resolved to strengthen immunization systems for increasing and sustaining high level of population immunity against measles and rubella at both national and sub-national levels.
• The resolution calls for ensuring a highly sensitive laboratory supported case-based surveillance system – better evidence for appropriate planning and response. It also emphasizes on preparedness for outbreak response activities for measles and rubella.
• All countries pledged to mobilize political, societal and financial support to ensure interruption of transmission of indigenous measles and rubella virus by 2023.

Current Status:

• There has been a 23% decline in mortality due to measles in the 2014-17 period. Nearly 366 million children have been reached through mass vaccination campaigns with measles-rubella (MR) containing vaccines in the Region since January 2017.
• Children in all 11 Member countries have access to 2 doses of measles containing vaccine (MCV) and ten countries have access to rubella-containing vaccine.
• India ranks 4th among 194 countries in measles cases, according to WHO data.
• The latest Global Measles and Rubella Update, which lists provisional data received in June and covering the period between May 2018 and April 2019, says India reported 47,056 measles cases and 1,263 rubella cases during these 12 months.

Measles:

• Measles is a highly contagious viral disease.
• It remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine.
• Measles is transmitted via droplets from the nose, mouth or throat of infected persons. Initial symptoms, which usually appear 10–12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.

Vaccine:

• Measles can be prevented with MMR vaccine. The vaccine protects against three diseases: measles, mumps, and rubella.
• CDC recommends children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age.
• Teens and adults should also be up to date on their MMR vaccination.

Rubella:

• Rubella is a contagious, generally mild viral infection that occurs most often in children and young adults.
• Rubella is the leading vaccine-preventable cause of birth defects. Rubella infection in pregnant women may cause fatal death or congenital defects known as congenital rubella syndrome.
• There is no specific treatment for rubella but the disease is preventable by vaccination.

Vaccine:

• The rubella vaccine is a live attenuated strain, and a single dose gives more than 95% long-lasting immunity, which is similar to that induced by natural infection.
• The rubella vaccine is a live attenuated strain, and a single dose gives more than 95% long-lasting immunity, which is similar to that induced by natural infection.

Indian Government Initiatives:

Measles-Rubella (MR) Vaccination Campaign:

• Ministry of Health & Family Welfare has initiated measles-rubella (MR) vaccination campaign in the age group of 9 months to less than 15 years in a phased manner across the nation. The campaign aims to cover approximately 41 crore children.
• The vaccination campaign is being held to protect children against measles and rubella which are highly contagious viral diseases. While measles kills nearly 49,000 children in the country every year, rubella causes irreversible birth defects.
• There is no treatment for measles and rubella, but both diseases can be prevented by vaccination.
• By vaccinating all children in the age group of 9 months to 15 years, India aims to eliminate both measles and rubella.

Benefits:

• Measles immunization directly contributes to the reduction of under-five child mortality, and in combination with rubella vaccine, it will control rubella and prevent CRS.

How Sri Lanka Eliminated Measles:

• Sri Lanka’s success follows its persistent efforts to ensure maximum coverage with two doses of measles and rubella vaccines being provided in the childhood immunisation programme.
• The vaccination coverage in the country has been consistently high – over 95% with both the first and second doses provided to children under the routine immunisation programme. nAdditionally, mass vaccination campaigns with a measles-rubella vaccine have been held periodically to plug immunisation gaps, the last one in 2014.
• The country has a strong surveillance system and all vaccine-preventable diseases are an integral part of the communicable disease surveillance system.
• Measles is a notifiable disease in the country.