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Efforts continue to protect children against measles

A child being immunized against measles in a tented camp

Muzaffarabad, December 6: In an emergency situation, the threat of a measles outbreak needs to be addressed as the single highest health priority for children. In previous emergency situations assessments tell us that up to 25 percent of under-5 children who died, died from measles.

In the aftermath of the October 8 Pakistan earthquake an immediate plan to vaccinate vulnerable children was set in place. This plan means that by June 2006 UNICEF, working with WHO, the Ministry of Health and NGO partners, aims to have reached 4 million children aged 6 months to 15 years with measles vaccination.

This overall long term plan is for a catchment area extending beyond the critically affected earthquake areas of NWFP and Pakistan administered Kashmir, as an additional safety net at a time when significant population movement is taking place, and given that this disruption may affect the comprehensive reach of the campaign.

For all those under 5 years the plan is that they receive Vitamin A supplementation as well, as this can reduce under-5 child mortality from all causes, including a 23 percent reduction of respiratory infection mortality and up to 50 percent reduction of mortality from measles

To date (end November) 731,330 children have been reached by the campaign in the two affected areas.

In Pakistan administered Kashmir over 502,433 children have now been vaccinated (178,482 receiving Vitamin A supplementation). This accelerated effort by UNICEF working with WHO, the Ministry of Health and local partners aimed to reach a target of 800,000 children under 15 years of age for immunization against measles, and to provide all under 5’s with Vitamin A supplementation as well.

Launched on November 12, the two week campaign covered the whole of Pakistan administered Kashmir (PAK), with a focus on children in communities high up in the remote valleys where access remains difficult, and the threat of their being entirely closed down by the winter snowfalls increases with every passing day.

The campaign involved the deployment of 582 two-person teams of vaccinators. The Pakistani military undertook to drop the teams in the valleys by helicopter, leaving them to walk between isolated hamlets, and then arranged to pick them from a forward location after a few days.

UNICEF support covered vaccine procurement, cold chain management and the provision of vaccine carriers and syringes. Along with the measles vaccination, the dose of vitamin-A and an extra dose of oral polio vaccine (OPV) was administered to all under-5 children. The OPV is in order to reinforce Pakistan’s polio eradication campaign, since the year’s last of the regular National Immunization Day was just about to take place at that time.

In NWFP measles vaccination coverage as of end November is 228,897 (125,626 receiving Vitamin A supplementation.)

In recent days Pakistan administered Kashmir measles cases have been confirmed. The continuation of the vaccination efforts is therefore needed. The congested camps in Muzaffarabad are a particular cause of concern, since the crowding, inadequate sanitation and poor conditions in the “spontaneous” camps impact on children’s health, already weakened by chronic undernutrition and the quake-caused trauma.

Further “mop up” activities in these camps are being put in place to reach the remaining children not yet vaccinated, along with renewed measures for outlying communities. The establishment of fixed points for immunization (routine immunization, too as part of EPI) in the field hospitals and Basic Health Units now set up in the camps, and in some urban and rural locations, will help to achieve comprehensive coverage, beyond that possible with the mobile teams who arrive and then have to leave to move on.

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