Lack Of Vaccination, Big Family Sizes Behind Mumbai Measles Outbreak: Officials

Even as the COVID-19 cases are going down steadily in Mumbai, it is struggling to control the outbreak of measles among children as eight deaths and 184 confirmed cases have been so far been reported in the city, as per civic officials.

Poor living conditions, big family sizes, lack of proper health services, sanitation facilities and nutrition, poor immunity, missed vaccine doses and reluctance for the inoculation are some of the major reasons for the outbreak of the disease in the city, they told PTI.

Mumbai has seen a multi-fold rise in the cases of measles this year as against 25 cases recorded in 2020 and nine last year, as per civic data.

The metropolis has witnessed the outbreak of the disease when the government has targeted to eradicate it by 2023 end.

Earlier, Mumbai had reported three deaths due to measles in 2019, one death each was recorded in Nagpur, Chandrapur and Akola in 2020, while Thane and Mumbai had reported one death each in 2021, as per a state bulletin.

If there are five suspected cases of an infection in a week, of which more than two have been confirmed in laboratory testing, then it is termed as an outbreak, Maharashtra health surveillance officer Pradip Awate told PTI.

Measles is one of the leading causes of diarrhoea, pneumonia and lowering of immunity, among other conditions, and leads to children getting stuck in the vicious cycle of various diseases and malnutrition, according to health experts.

As per the state bulletin, the health department is conducting house-to-house surveillance for measles and special vaccination sessions are being arranged on a campaign mode.

This year Maharashtra reported 503 cases of measles till November 17, compared to 153 in 2019, 193 in 2020 and 92 cases last year, according to the bulletin.

Outside Mumbai too, the outbreak of the viral disease has been witnessed in a few places like Bhiwandi town in neighbouring Thane district with seven cases and Malegaon in Nashik district reporting five cases, it said.

A Brihanmumbai Municipal Corporation (BMC) official said due to the pandemic in 2020 and 2021, the regular inoculation programmes were affected and as a result, the vaccination against measles was also hampered. Hence a large number of children either missed the first or second doses.

“We have now undertaken a three-point programme to control the measles outbreak,” BMC's executive health officer Dr Mangala Gomare said.

This includes search of the suspected cases of measles, speedy immunisation of children who have missed a vaccine shot or not taken any dose and spreading awareness about the inoculation, she said.

“In a household survey of 0 to 2 years old children, it was found that about 20,000 children have missed either their first or second dose of the vaccine. We are organising additional sessions for them,” Dr Gomare said.

She said they would arrange 100-150 extra sessions of inoculation camps for the children who have missed the measles doses.

The official said they have already inoculated 10,000 children in the 0 to 2 years of age group and targeted to complete within a week's time the vaccination of the remaining 10,000 kids in that age bracket group and 40,000 children up to 5 years of age, who have missed the vaccine doses for any reason.

This year, the cases suddenly started rising from the last week of September and the situation has now become alarming, BMC officials said.

The civic-run Kasturba Hospital added a special isolation ward following the outbreak in September.

The viral disease has spread to 17 localities in eight wards out of the total 24 civic in the city, BMC officials, adding that a few of the patients are on ventilator support.

The maximum spread of the infection is in M-east ward which includes areas like Govandi and Deonar, followed by L-ward comprising Kurla and Chunabhatti areas, they said.

The BMC has so far detected 2,900 suspected cases of measles with patients having common symptoms like fever and rashes.

“All the deaths are from the Muslim community and the areas where they were living are also dominated by the community," a civic official said.

The reasons behind the measles outbreak in the slum-dominated M-east ward are poor living conditions and services, lack of sanitation facilities, poor immunity and nutritious value, said a civic doctor who has worked there.

There are also many fake doctors in the area who do not provide the right treatment to the patients, worsening the health issues, the health official said.

Mumbai's biggest dumping ground is located in the M-east ward where most of the people are from the poor financial background. They are engaged in informal occupations and the living conditions are not good, according to activists working in the area.

Srushti Jaitely, a therapist who also works for an NGO, said as per a 2009 report, the human development index of the area is 0.05 per cent, which she claimed is equivalent to the sub-Saharan countries.

"There is extreme poverty and a lot of vulnerability as the ward is situated on the periphery of the city. When the city was developing, the ward was accommodating dumping grounds, scrap yards and with time, people also came to settle in the area. A lot of people have been relocated there in the name of rehabilitation. Hence, the largest number of R and R (relocation and rehabilitation) colonies are in this ward," Jaitely said.

After the outbreak of the disease, the BMC along with the Maharashtra and central governments swung into action and took multiple steps to contain the spread of the viral disease to other parts of the city.

The Union Health Ministry immediately sent a high-level multi-disciplinary team to Mumbai to take stock of the upsurge of measles cases in the city.

On November 17, Chief Minister Eknath Shinde also reviewed the measles outbreak situation and directed the BMC and the state health department officials to take help of religious leaders in spreading awareness about vaccination against the disease.

He also visited the Kasturba Hospital to take stock of the situation.

Acting on the high level team's suggestion, the civic body has already called meetings with religious and community leaders as well as prominent people from the affected areas for spreading awareness about the disease and the immunisation, officials said.

The civic body is also giving two doses of vitamin A to suspected patients and they are being admitted to hospital or referred to a paediatrician, if necessary, they said.

Awate said the health department will take a weekly review of the situation in the state on Monday, and it has already undertaken necessary steps to contain the spread of the diseases including social mobilisation. PTI KK GK GK