Located in southern India, Kerala is experiencing a substantial increase in measles cases since January 2019. This upsurge is in line with the world’s current comeback of measles.
Current Measles Statistics
Kerala reports over 600 measles cases annually. However, this year took a serious turn when the same number of cases were reported in the initial four months alone. Traditionally, measles has been an illness impacting mostly children. The recent shift toward affecting an older population carries new public health concerns due to increased disease severity, particularly among vulnerable communities such as expectant mothers and immunocompromised patients. These individuals are unable to receive the live attenuated measles vaccine.
Vaccination Measures and Challenges
When universal routine vaccination improves in childhood and the virus persists in circulation, the disease tends to shift towards those who may not have been vaccinated or whose vaccine-driven immunity has started to wane. The maternal antibodies transferred in utero are believed to protect a child until nine months of age, which is why this period has been established as the initial vaccination age for measles.
In order to enhance immune protection, a compulsory second dose was introduced in 2010 at the age of 15-18 months as part of the national measles elimination strategy. It’s relatively apparent that those currently within the 18-40 years age group may not have received the second dose, which could be one of the reasons for the increased cases in this demographic. Conversely, there have also been incidents where infants younger than nine months died from measles, as young mothers might not have adequate antibody protection.
| Age Group | Measles Cases |
|---|---|
| Below 9 months | Unknown |
| 9 months – 18 months | Increasing |
| 18 years – 40 years | Significantly Increased |
Considerations and Questions for Future Measles Control
The evolving epidemiology of measles has not only revealed several unknowns but also incited crucial queries on whether adult immunization should be a policy, the effectiveness of the vaccine, the adequacy of the vaccine immune response, and the consideration of a third dose of MMR (mumps-measles-rubella). These concerns are instrumental in devising strategies to combat the increasing incidences of measles.
Last Modified: February 6, 2024