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| MEASLES |
Disease
Measles is a highly contagious infection; before vaccines became available, this disease affected most people by the time of adolescence. In 2005, measles still affected nearly 21 million persons, and the number of global measles deaths was estimated to be 345 000. Common complications include middle-ear infection and pneumonia. Transmission, which is primarily by large respiratory droplets, increases during the late winter and early spring in temperate climates, and after the rainy season in tropical climates.
Occurrence
Measles occurs worldwide in a seasonal pattern. However, following the introduction of large-scale measles immunization, far fewer cases now occur where measles immunization is the part of immunization schedule. Epidemics may still occur every 2 or 3 years in areas where there is low vaccine coverage.
In countries where measles has been largely eliminated, cases imported from other countries remain an important continuing source of infection.
Risk for travellers
Travellers who are not fully immunized against measles are at risk when visiting
countries or areas where vaccine coverage is incomplete.
Vaccine
Though measles/mumps/rubella (MMR) or measles/rubella (MR) is being given in many countries instead of monovalent vaccine but in many developing countries monovalent measles vaccine is being advocated. Measles vaccination is usually given after the age of 9 months, preferably between 12-15 months. In developing countries measles vaccination is being given at the age of 9 months. To ensure optimum population immunization it is being advocated now that a second dose of measles vaccine may be given at the school entry (between 4-6 years). However in cases of outbreak the vaccine can be given to infants as young as six months old with a recommendation of second dose at 12-15 months. In our country due to high incidence of measles first dose is given at the age of 9 months and second dose between 16-18 months. Vaccination of susceptible adults within 72 hours of exposure to active case of measles is protective .
Special attention must be paid to all children and adolescent travellers who have not been vaccinated against measles at the appropriate time. While traveling to measles endemic areas, the aforementioned children and adolescent should be immunized properly. |
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