Measles outbreak in Mumbai: What is the disease and how is the city fighting to contain it?

An outbreak of measles has hit Maharashtra’s Mumbai, with at least one confirmed death due to the disease. On Wednesday (9 November), the Brihanmumbai Municipal Corporation (BMC), the Mumbai civic body, said an 18-month-old boy in Govandi had died due to measles in the city in October, Mid-Day reported. Notably, the last measles death in Mumbai was reported in 2019, as per Times of India. According to the civic body, at least three more children are suspected to have had measles-related death. As many as 84 cases of the disease have been reported in the financial capital of India, with Govandi being the worst affected, reports Indian Express. What is measles and what are its symptoms? What is happening in Mumbai? How to keep children protected from the disease? We explain. What is measles? Measles is a highly contagious disease caused by a virus in the paramyxovirus family. The disease spreads through direct contact and the air. The virus first infects the respiratory tract and then advances through the rest of the body. The first sign of measles is visible around 10 to 12 days after a person is exposed to the virus and it can last for four to seven days. The World Health Organization (WHO) says a runny nose, cough, red and watery eyes, and small white spots inside the cheeks are some of the initial symptoms experienced by those affected by measles. The rash, usually on the face and upper neck, appears about 14 days after a person is affected by the virus. [caption id=“attachment_11613861” align=“alignnone” width=“640”] The rash usually emerges 14 days after a person is exposed to the virus. Firstpost (Representational Image)[/caption] “Over about three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of seven to 18 days),” says the WHO website. “The rashes look like small red spots which remain slightly raised and give the skin a splotchy red appearance. The face of the rash breaks out first. Within days, it spreads to the rest of the body,” Dr Mangala Gomare, executive health officer of the BMC, told Indian Express.

The death caused by measles is due to complications linked with the disease.

The most severe complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. As per the WHO, “Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.” The grave complications are mostly seen in children below five years or adults over the age of 30. The United Nations health agency notes that unvaccinated young children are at the highest risk of contracting measles and suffering from its complications, including death. Dr Ajit Gajendragadkar, consultant, paediatrics, PD Hinduja Hospital told Indian Express, “Children who are not vaccinated are at a high risk of contracting the disease, which in some cases can be fatal or cause significant morbidity.” What’s happening in Mumbai? Three children – Hasnain (five-year-old), Noorain (three-and-a-half-year-old) and Fazal Khan (13-month-old) – who lived at Rafi Nagar in Govandi’s M East ward and likely had measles, lost their lives between 26 and 27 October. The families of the children said they had a fever and developed rashes, reports Mid-Day. With an upsurge in cases, the BMC has started conducting door-to-door surveillance to identify suspected cases of measles. A BMC official told Mid-Day, “On 14 October, a suspected case of measles was detected at Rafi Nagar and till now, six cases have been confirmed there. On Tuesday, the BMC surveyed 914 houses and screened 4,086 people out of which 13 suspects who have a fever and a rash have been identified. After the incident, we have written a letter to all health posts, local practitioners and a private hospital to report measles cases to their respective health officers.” Gomare informed that measles cases have been logged from F-North, H-East, L, M-East and P-South in the city since January, with Govandi accounting for 23 infections so far. The Centre has also jumped to action and dispatched a three-member high-level multi-disciplinary team to the city comprising experts from the National Centre for Disease Control (NCDC), New Delhi, Lady Hardinge Medical College, New Delhi, and the Regional Office for Health and Family Welfare, Pune, Maharashtra. As per PTI, the Union health ministry said the central team will carry out “field visits to investigate the outbreak and assist the state health departments in terms of public health measures, management guidelines and protocols to manage the increasing cases of measles being reported in Mumbai”. [caption id=“attachment_11613881” align=“alignnone” width=“640”] The Mumbai civic body has urged children in the 9-16 age group to get vaccinated against measles. AFP (Representational Image)[/caption] A special ward at Kasturba Hospital at Chinchpokli has been dedicated to the treatment of children infected with measles, with around 35 patients admitted there, a civic official told PTI. Vaccine hesitancy in some areas Healthcare workers say they face vaccination hesitancy in the slums, especially in Govandi. According to Indian Express, Fatima Ahmed Khan, an ASHA worker, said there is a mostly migrant population in the slum with large families. “Even after a lot of persuasion, they don’t let their children get vaccinated. Due to repeated pregnancies, the mothers also fall sick whose priority changes into feeding so many children rather than vaccination,” she said. How to protect children against measles? The BMC has found that around 10 per cent of the children infected with measles and rubella had incomplete vaccination while 25 per cent were not inoculated at all. The civic body officials have urged parents to get children in the 9-16 age group vaccinated against the disease. Dr Tanu Singhal, consultant, paediatrics and infectious diseases, Kokilaben Dhirubhai Ambani Hospital, told Mid-Day, “To prevent measles, vaccination is important. One has to take the first dose of MMR (measles-mumps-rubella) at nine months and then at 15 months.” Under the Universal Immunisation Programme, India administers the first dose of the measles vaccine at 9-12 months of age and the next shot at 16-24 months of age. “Measles cannot be eliminated unless at least 95 percent of the kids are immunised against it in every village, every district and every community,” Dr Jacob John, a senior virologist, was quoted as saying by Moneycontrol. With inputs from agencies Read all the  Latest News ,  Trending News ,  Cricket News ,  Bollywood News , India News  and  Entertainment News  here. Follow us on  Facebook,  Twitter and  Instagram.