Measles outbreak in Mumbai indicates that country lowered guard against other pathogens while fighting Covid

A measles outbreak in Mumbai has raised concerns amongst the country’s public health authorities. The city has reported more than 200 cases in the past two months and at least 13 children have lost their lives. This is a big jump from the last few years — 10 cases and one death in 2021; 29 cases and no death in 2020; and 37 cases and three deaths in 2019. Other areas in Maharashtra, including Nashik and Yavatmal, have also been affected. By all accounts, the outbreak seems to have been precipitated by a backslide in the universal immunisation programme during the pandemic. According to the state government data, only 41 per cent of the eligible children have been inoculated against measles in Mumbai. Overworked public health professionals, including ASHA workers, have also had to combat vaccine hesitancy. Parents, reportedly, are showing a disinclination to continue the inoculation regime for their children after they developed fever on being administered the first jab. Such after-effects are par for the course. In the past, health departments in most parts of the country would anticipate the worries of parents and find ways to reassure them. The Mumbai outbreak indicates that the pandemic may have disrupted such efforts.

In recent years, the Centre’s Mission Indradhanush project has improved vaccine coverage and reduced delays between shots. But WHO and UNICEF studies have shown that immunisation programmes — especially those focusing on DPT (diphtheria, pertussis and tetanus) and measles — have taken a hit in low and mid-income countries, including India, in the past two years. Early in the pandemic, the National Health Mission’s information system reported that at least 100,000 children missed their shots because of the restrictions on movement. Anecdotal reports do indicate that India’s universal inoculation programme picked up during the later part of the pandemic. But measles is a highly contagious disease. Experts had cautioned that even a 5 per cent fall in the vaccination rate can disrupt herd immunity and precipitate an outbreak. The surge of the disease in Mumbai indicates that their fears are coming true.

In the past week, a rise in measles cases has also been reported from Ranchi, Ahmedabad and Malappuram. The Centre has reportedly sent teams to help state health authorities frame control and containment measures. It has also rightly asked states to consider administering an extra dose of vaccines to children, aged five to nine, in vulnerable areas. But the time has also come to look beyond emergency measures and provide the country’s public health services its long-overdue boost. The gains of the Universal Immunisation Programme should not be overturned by health emergencies.

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