Measles – An Advisory from ROJoson

Trigger:

The Department of Health (DOH) on Wednesday (February 6, 2019) declared measles outbreak in Metro Manila and Central Luzon – 547% increase compared to previous year.

DOH is now more actively campaigning for more immunization against measles in the Philippines.

ROJoson – in support of the public programs conducted by the Department of Health (DOH), I am encouraging the Filipino citizenry to be vaccinated against measles when
appropriate to control the outbreak of measles and to prevent unnecessary deaths.

The vaccine is given for free in health centers / government hospitals and in private hospitals with corporate social responsibility programs that support the DOH campaign to control the measles outbreak.



Diagnosis or Recognition of Measles

Fever

Cough, coryza (colds), conjunctivitis (red eyes)

Koplik’s spots – rashes inside the lining of the mouth (buccal mucosa, opposite the upper 1st and 2nd molars) [before appearance of rashes on the body]

Then, maculopapular rashes starting from the face going down to the neck, chest, abdomen, and extremities.



Persons at Risk 

People not vaccinated against measles and exposed to patients with measles



Below is a message of the Philippine Pediatric Society and the Philippine Infectious Disease Society of the Philippines on immunization against measles.

Their recommendations on immunization are as follows:

  • Provide the first dose of measles-containing vaccine (monovalent measles,
    MR, MMR) to infants starting at age 6 months instead of the usual 9 months of
    age, as recommended in the Childhood Immunization Schedule.
  • For children who received their first dose of measles-containing vaccine at age
    younger than 12 months: provide two additional doses of MR or MMR, minimum
    of 4 weeks apart, beginning at 1 year of age.
  • For any individual older than 12 months of age without a history of measles
    disease, not pregnant or not planning to become pregnant in 4 weeks, with no
    immunocompromising conditions or allergic reaction to a previous dose of
    measles-containing vaccine: a dose of monovalent measles, MR or MMR may be
    given. A second dose of measles-containing vaccine may be given to complete
    the 2-dose schedule.

Below is also an advisory from the Philippine Society for Microbiology and Infectious Diseases (PSMID).

With the measles outbreak in Metro Manila, the Philippine Society for Microbiology and Infectious Diseases (PSMID) has shared with the public four ways to prevent the spread of the contagious disease.

The organization advised the public to keep vaccinations up-to-date, and more specifically to opt for the measles, mumps, rubella (MMR) vaccine for those who can receive live virus vaccines.

The PSMID, however, noted that pregnant women and patients with low immunity must consult their doctors for vaccinations as they cannot receive live virus vaccination such as the MMR vaccine.

The organization also urged frequent hand washing with soap and water or an alcohol-based hand rub.

It likewise instructed the public to practice “good cough etiquette” by covering the mouth with a handkerchief or shirtsleeve or by wearing a protective mask.

Lastly, the PSMID advised sick people to stay home.

Meanwhile, the agency warned that measles may create complications such as pneumonia and diarrhea, especially in children, persons with low immunity, and pregnant women.

If you develop symptoms similar to measles (fever, rash, cough, conjunctivitis), you may be contagious just by speaking or coughing.

It would be best for you to stay home. If you must see a doctor, please wear a mask at all times.

Read more: https://newsinfo.inquirer.net/1082930/psmid-shares-four-ways-to-prevent-measles#ixzz5euHyatso



An Urgent Plea from the
PHILIPPINE PEDIATRIC SOCIETY and the
PEDIATRIC INFECTIOUS DISEASE SOCIETY OF THE PHILIPPINES
Immunize Eligible Children Against Vaccine-Preventable Diseases

06 February 2019

Dear Colleagues:
The ongoing increase in measles cases in the Philippines is alarming. A recent
Department of Health Philippine Integrated Disease Surveillance and Response (PIDSR)
report showed that out of almost 22,000 cases of clinical measles-rubella reported
between Jan-Dec 2018, there were 5,120 confirmed measles cases. Among these
cases, about 200 deaths were reported, among which 59 were confirmed measles
deaths. This reflects a staggering 547% increase in cases compared to the previous
year (791 cases and 17 deaths in 2017). Of note, 70% of cases and 88% of deaths due
to measles had not been vaccinated. All regions in the country have been affected by
this crisis.1

Measles is a highly communicable disease, having an attack rate of 90% among
susceptible exposed individuals. More than 95% of a given population needs to be
protected to interrupt ongoing transmission.2

The World Health Organization aims to “achieve at least 95% coverage with both the first and second routine doses of measles vaccine (or measles-rubella-containing vaccine as appropriate) in each district and nationally” as part of the Global Measles and Rubella Strategic Plan 2012-2020.3

Unfortunately, the National Demographic and Health Survey revealed a decreasing trend
in the number of vaccinated children, from 80% in 2008 to 70% in 2017.4

Recent news articles have quoted DOH officials confirming a further decline in vaccination coverage to about 60% last year.5

We, as healthcare providers, have the responsibility of educating our patients about the
importance of disease prevention through immunization. We should take every
opportunity to convince and reinforce the message that the vaccines available to prevent
diseases are safe and highly effective, and that vaccination remains the main
intervention in reducing morbidity and mortality against infectious diseases.

In addition to the above, some activities that we can embark on include:
1. As individual clinicians:
a. Ensure up-to-date immunization of all our patients.
b. Provide the first dose of measles-containing vaccine (monovalent measles,
MR, MMR) to infants starting at age 6 months instead of the usual 9 months of
age, as recommended in the Childhood Immunization Schedule.
c. For children who received their first dose of measles-containing vaccine at age
younger than 12 months: provide two additional doses of MR or MMR, minimum
of 4 weeks apart, beginning at 1 year of age.
d. For any individual older than 12 months of age without a history of measles
disease, not pregnant or not planning to become pregnant in 4 weeks, with no
immunocompromising conditions or allergic reaction to a previous dose of
measles-containing vaccine: a dose of monovalent measles, MR or MMR may be
given. A second dose of measles-containing vaccine may be given to complete
the 2-dose schedule.
e. Support public programs conducted by your local government health unit, by
encouraging your patients to be vaccinated through these programs when
appropriate.

2. As officers / members of local medical societies:
a. Collaborate with the City, Municipal or Provincial Health Office, in organizing
community-based regular Vaccine Mission activities.
b. Spread the word in your community, and increase awareness about measles
and other vaccine-preventable diseases.

3. As a hospital-based clinician or hospital administrator:
a. Collaborate with the City, Municipal or Provincial Health Office in organizing a
hospital-based Vaccination Desk, and offer free measles and other available
vaccines to qualified children, adolescents and even adults
b. Provide measles-containing vaccine to your in-patients once they are ready
for discharge.
Although this unprecedented crisis has challenged our national health system, we
believe there is hope as long as we all work together. Let’s each do our part and make a
difference!

1 Department of Health. Philippine Integrated Disease Surveillance and Response. Morbidity week No. 52. Epidemiology Bureaus Public Health Surveillance Division. January 1-December 31, 2018

2 American Academy of Pediatrics. Measles. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book Report of the Committee on Infectious Diseases. 31st ed. Itasca IL.: AAP; 2018: 537-550

3 World Health Organization. Global Measles and Rubella Strategic Plan 2012-2020. Available at https://www.who.int/immunization/diseases/measles/en/. Accessed 31 Jan 2019.

4 Philippine Statistics Authority (PSA) and ICF. 2018. Key Findings from the Philippines National Demographic and Health Survey 2017. Quezon City, Philippines, and Rockville, Maryland, USA: PSA and ICF.

5 S. Tomacruz. “A year after Dengvaxia: Immunization drops, measles outbreak soar.” Published Dec 1, 2018. Available at https://www.rappler.com/newsbreak/in-depth/217912-dengvaxia-one-year-after-outbreaks-series-part-1
PPS-PIDSP-PLEA-TO-IMMUNIZE




With the measles outbreak in Metro Manila, the Philippine Society for Microbiology and Infectious Diseases (PSMID) has shared with the public four ways to prevent the spread of the contagious disease.

The organization advised the public to keep vaccinations up-to-date, and more specifically to opt for the measles, mumps, rubella (MMR) vaccine for those who can receive live virus vaccines.

The PSMID, however, noted that pregnant women and patients with low immunity must consult their doctors for vaccinations as they cannot receive live virus vaccination such as the MMR vaccine.

The organization also urged frequent hand washing with soap and water or an alcohol-based hand rub.

It likewise instructed the public to practice “good cough etiquette” by covering the mouth with a handkerchief or shirtsleeve or by wearing a protective mask.

Lastly, the PSMID advised sick people to stay home.

Meanwhile, the agency warned that measles may create complications such as pneumonia and diarrhea, especially in children, persons with low immunity, and pregnant women.

If you develop symptoms similar to measles (fever, rash, cough, conjunctivitis), you may be contagious just by speaking or coughing.

It would be best for you to stay home. If you must see a doctor, please wear a mask at all times.

Read more: https://newsinfo.inquirer.net/1082930/psmid-shares-four-ways-to-prevent-measles#ixzz5euHyatso


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ROJ@19feb8

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