Sunday, 11 May 2014

Spike in measles cases in Singapore

Jabs urged as this year's figure exceeds 2012-13 total
By Salma Khalik, The Straits Times, 10 May 2014

MORE people here have been infected with measles this year than over the past two years.

Although every child has to be protected against measles by the age of 18 months - close to half of the 99 people infected since January were children.

Last week alone, seven people were diagnosed. Four were children - two were too young to get the vaccination and the other two had missed theirs.

There were 46 cases of measles in total last year and 38 in 2012.

KK Women's and Children's Hospital revealed that it has hospitalised about 35 children for measles this year.

Dr Thoon Koh Cheng, its head of infectious diseases for children, said: "We strongly urge all parents with children who are above the age of one and who have yet to get the measles vaccine to do so as soon as possible, especially if they intend to travel."

Measles is one of two compulsory immunisations, without which children cannot be enrolled into Primary 1. The other is the vaccine against diphtheria. Both are free for citizens at polyclinics.

By the age of two, 95 per cent of children have been protected against measles and 97 against diphtheria. It goes up to 97 per cent and 98 per cent respectively by the time they are six years old.

Ms Estella Young, 36, who is expecting her second child next month, would like to see more public education on vaccination.

The housewife knows of parents who refuse to vaccinate their children, either because they think it is dangerous or they believe the risk of their child getting the disease is low, since the majority is already vaccinated.

They do not see the point of the child suffering the mild side effects, such as fever or pain at the injection site, that sometimes accompany vaccination.

Dr Thoon agrees every child should be vaccinated. He said: "Parents must be made aware that if the unvaccinated child is exposed to a case of measles, the risk of developing measles could be as high as 90 per cent. While most children in Singapore do not die from measles, the risk of complications remains."

A Ministry of Health spokesman told The Straits Times: "It is compulsory for parents and guardians to have their child vaccinated against measles and diphtheria. The penalty for non-compliance is a fine of up to $500 for the first offence and up to $1,000 for the second or subsequent offence."

Ms Young believes the law should be rigorously enforced to make sure unvaccinated children, unless they are medically exempted, cannot enrol in Primary 1.

The World Health Organisation (WHO) says measles is a leading cause of death among young children, especially those under the age of five years.

The outbreak of measles in Vietnam this year has killed more than 110 people, and underscores the importance of immunisation.

In 2012, 330 people worldwide died from measles each day, WHO said. This accounts for about 5 per cent of deaths that are preventable through vaccination.

The WHO lists 25 infectious agents that can be immunised against. Singapore recommends that children get vaccinated against half of these diseases.

Other vaccines, such as the one for anthrax, are not commercially available, while some, such as the vaccine against tick-borne encephalitis, have little relevance for people in Singapore, unless they plan on going to rural areas in central Europe.

But there are other optional ones which can protect adults and children alike against much suffering and death.

What you need to know about measles
The Straits Times, 10 May 2014

About a month ago, an outbreak of measles occurred in the Philippines and infected 23 Singaporeans who had travelled there.

The most serious complications from measles include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and dehydration, ear infections, or severe respiratory infections such as pneumonia.

Complications are more common in children under the age of five, or adults over the age of 20.

Here are some key facts from the World Health Organization about the disease.

About measles:
- Measles is a highly contagious and serious disease that is caused by a virus.
- Measles is one of the leading causes of death among young children, even though a safe and cost-effective vaccine is available.
- In 2012, there were 122,000 deaths caused by measles globally. This means about 330 deaths every day, or 14 deaths every hour.
- Measles vaccination helped reduce the number of deaths caused by measles by 78 per cent between 2000 and 2012 worldwide.
- In 2012, about 84 per cent of the world's children received one dose of measles vaccine by their first birthday through routine health services - up from 72 per cent in 2000.
- Since 2000, more than 1 billion children in high-risk countries were vaccinated against the disease through mass vaccination campaigns. About 145 million of them received vaccination in 2012.

- High fever for four to seven days
- Runny nose
- Cough
- Red and watery eyes
- Small white spots inside the cheeks
- After a few days, a rash usually appears on the face and upper neck. Three days later, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days before fading.

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