Health · Public Health & Disease · 23 hrs ago
Measles outbreaks in Keralam prompt calls to review vaccination protection
Measles outbreaks are affecting several districts in Keralam, especially Kozhikode, Malappuram and Palakkad.
As of November 6, the state had recorded 824 confirmed and 1,681 probable cases, with five related deaths reported and one confirmed.
The disease, once mainly seen in young children, is now affecting people of different ages, including vaccinated people and infants under nine months.
India’s routine programme gives measles vaccine doses at nine and 18 months, but experts say the changing pattern raises questions about protection.
A study of vaccinated children in Keralam and Tamil Nadu found some had antibody levels below the protective range, though antibody results alone do not show whether someone will develop measles.
Keralam’s first-dose coverage is around 95%, while second-dose coverage is lower, at about 85% to 88%.
Experts want the state’s immunisation advisory group to consider studies of antibody levels and a possible additional dose; the WHO has said evidence is not yet enough to change the routine first-dose recommendation.
Keralam had 824 confirmed and 1,681 probable measles cases reported by November 6, alongside five related deaths, one of which was confirmed.
Outbreaks have been reported across districts, particularly Kozhikode, Malappuram and Palakkad.
Experts say measles is affecting a wider range of ages, including vaccinated people and infants below nine months.
A former paediatrics professor has called for consideration of an additional vaccine dose and studies of antibody levels among adolescents and young women.
A study of vaccinated children from Keralam and Tamil Nadu found that 8.5% lacked antibody levels classified as protective.
- Who
- People affected by measles outbreaks in Keralam, including infants, children and older adults.
- What
- Outbreaks have prompted experts to call for reassessment of measles epidemiology and vaccination protection.
- When
- As of November 6, the State had reported 824 confirmed and 1,681 probable cases. The year is not stated.
- Where
- Keralam, particularly Kozhikode, Malappuram and Palakkad.
- Why
- Cases among different age groups, including vaccinated people and infants below nine months, have raised questions about current protection.
K.K. Purushothaman and proponents of reviewing protection
WHO consultation experts
Additional vaccine dose
K.K. Purushothaman and proponents of reviewing protection
Purushothaman says Keralam should consider an additional dose during adolescence or for women before marriage.
WHO consultation experts
The consultation found evidence insufficient to change the existing recommendation for the first routine dose at 9–15 months.
Measles vaccination was introduced into India’s Universal Immunisation Programme with a single dose at nine months.
A second dose at 18 months was introduced.
Keralam experienced its last major surge in measles cases.
More than 31% of reported measles cases in Mumbai’s major outbreaks were among infants below nine months.
A study of vaccinated children from Keralam and Tamil Nadu was published in JAMA Network Open.
Keralam’s Integrated Disease Surveillance Programme had reported 824 confirmed and 1,681 probable cases.
- Confirmed cases
- 824 as of November 6
- Probable cases
- 1,681 as of November 6
- Deaths
- Five measles-related deaths reported; one confirmed
- Districts
- Kozhikode, Malappuram and Palakkad particularly affected
- Vaccine coverage
- First MR dose around 95%; second dose around 85-88%
- Study participants
- 684 children aged four to 18 from Keralam and Tamil Nadu
What people are saying
In recent epidemics, we have seen a good number of infants developing measles before nine months, potentially because mothers of the present generation have lower levels of measles antibodies. We also have a chunk of cases among older adults.