Opinion

TOPICS: Measles in Nepal

TOPICS: Measles in Nepal

By Dr. Dipak Devkota

Browsing the internet, I came across some figures for Nepal like that from 1994-2002 in Nepal, there were an estimated average of 90,000 cases of measles per year. If we take the population to be roughly 28 million in these years, 0.32 per cent of the population was affected each year in this country by a very contagious viral infection that can have numerous complications like pneumonia, ear infections, hepatitis, pancreatitis, diarrhea and also encephalitis of various types. I hope you do your own research on the internet as there seem to be conflicting statistics for Nepal. In Nepal, most of the patients affected are children. There might be some overlap or underestimation in the figures with similar viral infections causing a rash, as many cases might not be proved measles by laboratory methods.Anyway, this sounds like an incidence of 321 cases in every lakh of the population. Measles is said to be endemic in Nepal. From 2008 to 2011, there was an epidemic of measles in France infecting about 22,178 people. The epidemic was studied and it seems most of the people who died from the disease were immune compromised, meaning there was some factor which prevented their immune system from attacking the virus effectively, like some defects one is born with, or certain other coincident diseases, or medicines, like cancer treating drugs that suppress the immune system. Only ten deaths are reported. Be assured, the mortality in Nepal is higher with people not immune compromised also succumbing to this viral infection. Administering vitamin A which helps with epithelial regeneration has helped fight measles complications and deaths in developing countries like Nepal. In the nineteen eighties and nineties, we saw a lot of measles in malnourished children who would be immune compromised at Kanti Children’s Hospital. Measles vaccination seems to have started in Nepal in three districts from around 1979 and became more widespread from the eighties of the last century. Leaving aside the erudite statistics, it seems to me that the immune system should be investigated more deeply in children severely ill from measles. Taking this a step further, the siblings of children known to be severely affected from measles should also be investigated for any defects in their immune system. Can we apply such an approach to a country plagued by multitudinous health problems of a more immediate urgency?