In my time, a period that covers my childhood and the years when my children were themselves quite young, diseases like measles, mumps and chicken pox were considered ?common childhood diseases.? Parents held quite benign views about them, considering these diseases ?natural,? or even an expected rite of passage that every child had to go through because a bout with each of them conferred natural immunity.
Dr. Eric Tayag, head of the Department of Health-National Epidemiology Center and president of the Philippine Foundation for Vaccination, says that to a certain extent such a view may still be true. But, he says, these days ?the equation has changed,? and the increase in population and the emergence of new viral strains mean that ?there are more chances of complications and even death? in the wake of these ?common childhood diseases.? Some of the complications arising from measles are: encephalitis, pneumonia, diarrhea, deafness and even blindness.
Measles is back in the news these days because of the astounding number of new cases, leading to speculations that an outbreak has taken place. There have been a total of 742 confirmed cases from January to March this year, compared to just 222 in the same period last year. Of these, 471 have occurred in Metro Manila, compared to just 62 last year. So far, four infants (one of them eight months old) have died from the disease.
Measles is a highly infectious disease, warns Tayag. While a person infected with the influenza virus can transmit the virus to two-three people on average, he says, a person infected with measles, which is transmitted through airborne droplets, can infect up to 12 to 13 more people. Most people think the appearance of measles? most common manifestation: the appearance of small, itchy postules on the skin, signals the ?onset? of the disease. But, says Dr. Tayag, a person sick with measles is infectious up to four days before the appearance of the rash, and remains so up to four days after the disappearance of the rash.
* * *
WHY are we experiencing an upsurge in measles these days?
Measles?along with mumps, German measles and chicken pox?are caused by the same family of viruses. They commonly make an appearance during cold weather months, says Dr. Tayag, but are usually ?noticed? during the summer months ?because by this time, the number of cases would have increased and attracted public notice.?
But the spread of these diseases is also an indication of failings or gaps in the public health system. In 1998, shares Tayag, the Department of Health embarked on a program that aimed to eliminate measles by 2008. And indeed, the country saw a drastic drop in the number of measles cases, especially after the launch of the ?Ligtas Tigdas (Safe from Measles)? campaign in 2004. Between 2004 and mid-2006, there were no measles deaths reported. But, notes Tayag, the number of measles cases has steadily risen since 2007.
Every year, Tayag reports, ?from five to 10 percent of the target population doesn?t get vaccinated,? which is why every three to five years the DOH embarks on a campaign to re-vaccinate all children up to five years old in an effort to provide protection for the ?overlooked? children. ?There is no danger of overexposure or of getting an overdose? of the vaccine, he adds.
* * *
WHOSE responsibility is it to ensure that children are protected against measles and other diseases in the same family?
First, says Tayag, it is the responsibility of the DOH because it is the department that receives the supply of vaccines and distributes it to the different local governments. Second, it is the responsibility of local governments which are charged with implementing the immunization program, including making an accurate count of children so it can access the correct amount of vaccines. And last, it is the responsibility of parents to bring their children to health centers or rural health units to receive not just their measles shots, but all other vaccines covered by the expanded program on immunization (EPI), which is offered free.
At this time when local governments are conducting house-to-house immunization, Tayag says the stay-at-home parent could also make sure to stay home so that when the immunization team comes calling, the parent can make sure the child is immunized.
Kristel Guce, associate product manager for vaccines of GSK, which sponsored the press conference on measles, also appealed to mothers, or women of childbearing age, to make sure that they themselves are vaccinated before they get pregnant. A mother confers immunity against many diseases to her newborn, for a few months and especially if she breastfeeds the infant. More important, an immunized mother is protected against a disease like German measles, which if contracted during a woman?s first trimester can cause congenital defects, including deafness, blindness and heart disease.
* * *
AT PRESENT, all Filipino children are covered by the EPI, which provides protection against the most common diseases in the country: TB, DPT, Hepatitis B, polio and measles. If parents bring their children to a private physician, they can avail themselves of the EPI for a minimal charge, plus other vaccines not covered by the program. These include vaccines against flu, pneumonia, rotavirus (diarrhea), hepatitis A, and the human papillomavirus (cervical cancer). GSK also provides a vaccine against mumps, measles and rubella, and even a ?4-in-1? vaccine against MMR and varicella or chicken pox.
These vaccines are not cheap (they cost a few thousand pesos, depending on the doctor or hospital), but as we all know, prevention is a much cheaper option than treatment or hospitalization?or death.
