Measles is an infectious disease transmitted through the airway (droplets, saliva droplets when coughing, sneezing, talking, or through nasal discharge), caused by the measles virus. In general, prevention of measles includes clean and healthy living behaviors and no contact with patients. However, the main prevention is measles immunization.
Measles is highly contagious. Children and adults who have never been immunized against measles or have never experienced measles are at high risk of contracting measles. Symptoms of measles include fever, cough and runny nose, watery eyes, and reddish spots on the skin that usually appear 2 to 4 days after the initial symptoms. Measles will be very dangerous if complications occur. It can cause serious complications such as diarrhea, pneumonia, encephalitis, blindness, and even death. In 2000, more than ½ million children worldwide died from complications of measles.
In general, measles prevention includes clean and healthy living behaviors and staying out of contact with patients. However, the main prevention is measles immunization, which is the administration of the MR vaccine [a combination of measles (M) and rubella (R)] that can prevent measles and rubella. The MR vaccine is 95% effective in preventing measles and rubella. It is safe and has been used in more than 141 countries worldwide.
MR immunization is given to all children starting at 9 months of age. Mild fever, red rash, mild swelling, and pain at the injection site after immunization are normal reactions that will disappear within 2-3 days. Serious post-immunization adverse events are very rare. Immunization must be done as scheduled to protect children from measles.
The situation in Indonesia in the last 2 years or almost 3 years since being affected by the COVID-19 pandemic has had unfavorable implications for immunization coverage, one of which is measles immunization. In Indonesia throughout 2022 there have been 12 provinces that have issued statements of extraordinary events (KLB) of measles. An area is called an outbreak if there are at least 2 measles cases in the area that have been laboratory confirmed and these cases have an epidemiologic relationship. The number of cases was obtained over a period of 1 year from January to December 2022. When compared to 2021, there is a significant increase of approximately 32 times. The reason is that for 2 consecutive years, Indonesia could not reach the target for routine immunization services, so many children were not routinely immunized due to COVID-19.
The government is targeting measles and rubella elimination by 2023. Elimination is a situation where we can reduce the morbidity of measles to such an extent that it is no longer a public health problem.
Measles outbreaks occur all over the world, including in the United States. A measles outbreak is declared when the number of reported cases in an area is higher than the expected number of cases. Measles can enter the United States through infected travelers entering or traveling to the US as well as through infected US travelers returning from other countries.
The Centers for Disease Control and Prevention (CDC) works with partners and Ministries of Health to prevent, detect, and stop global measles outbreaks. CDC provides support for:
- Finding measles quickly to stop outbreaks
- Analyze data and information to support decision-making
- Planning and implementing outbreak response immunization campaigns
- Help find and move resources to where they are most needed
- Conduct laboratory analysis
CDC focuses on countries with large measles outbreaks and countries with weak health systems, low immunization rates, or coverage gaps that make outbreaks more likely.
Image: Illustration (Source: onlyyouqj - www.freepik.com)
References:
1. Ministry of Health. Be aware, measles is a complication that causes severe illness [Internet]. 2023 Jan 20 [cited 2023 Jan 23]. Available from: https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20230120/1642247/waspada-campak-jadi-komplikasi-sebabkan-penyakit-berat/
2. Ministry of Health. Measles & rubella (MR) immunization campaign guidelines for teachers and cadres.
3. Centers for Disease Control and Prevention. Global measles outbreaks [Internet]. 2023 Jan 13 [cited 2023 Jan 23]. Available from: https://www.cdc.gov/globalhealth/measles/data/global-measles-outbreaks.html
