A meeting of domain knowledge technical experts was held on Wednesday under the Dr VK Paul, chairpersonship of member (Health), NlTl Aayog to review the situation.
P. Ashok Babu, Joint Secretary, in a letter directed the state/UT government to initiate prompt action on preparedness and measles outbreak response activities.
“Adequate availability of vaccines across all blocks and districts may be ensured for the vaccination campaign. States/UTs may communicate the demand for additional vaccine requirement to the health ministry for conducting supplementary immunization activities," Babu said.
The union health ministry has further directed to identify cases of measles and conduct “outbreak response immunization" (ORl) mode. This dose would be in addition to the primary vaccination schedule of first dose at 9-12 months and second dose at 16-24 months.
“One dose of MRCV to be administered to all children aged 6 months and up to less than 9 months in those areas where the Measles cases in the age group of less than 9 months are above 10% of the total measles cases, to be identified by the State Govt / UT Administration. Since this dose of MRCV is being given to this cohort in “outbreak response immunization" (ORl) mode, therefore, these children should also be covered by first and second dose of MRCV as per the primary (routine) Measles and Rubella vaccination schedule," the official said.
According to the health ministry, the disease is known to witness a surge in case numbers during the period of November to March, annually. Hence, an active fever and rash surveillance mechanism needs to be strengthened for early case identification.
“Head count survey of all children aged 6 months to 5 years must be undertaken in the vulnerable outbreak areas to facilitate full MRCV coverage in an accelerated manner. The institutionalized mechanism of district task force on immunization under the chairmanship of the district collector must be activated to review the measles situation on a daily/weekly basis and plan the response activities accordingly.
The disease is known to be fatal among children with moderate and severe malnourishment. Therefore, health ministry has also directed for house-to-house search activities to identify such vulnerable children and provide pre-emptive care with nutritional and vitamin A supplementation along with early identification and prompt management of measles cases.
Furthermore, states are also directed for immediate isolation of laboratory confirmed cases must be done for at least 7 days from the date of identification.
“Guidance for home-based care of such cases must be issued with reference to age-appropriate two doses of vitamin A supplementation with adequate nutritional support. Caregivers must be made aware regarding identification of danger signs for immediate hospitalization of such children, i.e., persistent diarrhoea, rapid breathing with chest indrawing (pneumonia), and ear discharge," informed the health ministry.
State must earmark wards and beds for effective caseload management of measles in dedicated health facilities for timely transfer and treatment of such children and sensitize people about the disease. Meanwhile earlier in the day, the Centre has deployed high level teams to Jharkhand, Gujarat & Kerala to manage Measles outbreak.
