Wednesday, May 29, 2013

Fighting measles in Punjab: Province-wide vaccination must wait four more weeks

The Express Tribune
Four months after measles cases started surfacing in the Punjab, the Health Department is yet to launch an immunisation campaign in districts other than Lahore. According to official figures, 117 children in the province have died of the disease since January. 73 of them were from Lahore. A total of 14,300 cases have been reported from the province so far. Maryam, a five-year old, died of measles in Lahore on Tuesday. “Health officials thought that the epidemic would die down with the increase in temperature. That has not been the case,” said a senior paediatrician at the Children’s Hospital. The vaccination campaign has been limited to Lahore so that children in other districts are still at great risk, he said. The Health Department, at the onset of the epidemic in January, identified 12 high-risk districts in the province: Gujranwala, Sheikhupura, Faisalabad, Okara, Kasur, Mianwali, Bhakkar, Muzaffargarh, Layyah, DG Khan, Rajanpur and Rahim Yar Khan. “Measles is a droplet infection. You cannot contain it if you don’t vaccinate the children at risk,” a senior doctor at Mayo Hospital said. The epidemic here started in Sindh. Had the government taken pre-emptive measures and vaccinated children in the province, many lives could have been saved, he said. The government is unfortunately repeating the mistake by not vaccinating children in districts other than Lahore. “Many families travel from high-risk districts to Lahore and many leave the city for these districts,” said the doctor. This increased the risk of contracting measles. The Health Department thought it would die down with time, but that hasn’t happened, he said. Young Doctors Association (YDA) leader Dr Salman Kazmi said it was criminal negligence on the Health Department’s part. “This is height of mismanagement. It should have acted promptly,” he said. The health secretary and expanded programme on immunisation (EPI) director should be held responsible, said Kazmi. EPI Director Dr Tanveer Ahmed told The Express Tribune that the department did not have enough vaccine to carry out an immunisation campaign in all high-risk districts. “We will receive a shipment of vaccine on June 15 and launch a province-wide immunisation campaign from June 24 to July 4,” he said, “We cannot get the vaccine earlier than that.” He said the government was spending Rs458 million on the vaccine. A health department spokesman said that the department had a cold chain system to store the vaccine so they would not have a problem storing the vaccine imported for the campaign. The spokesman said, in a statement issued on Tuesday, that in addition to 10 cold rooms in Lahore, there were 22 cold rooms in other districts. He also said that there was a need to improve the cold storages. The Health Department had approached the government to procure additional cold rooms. He said that the existing system had the capacity to store measles vaccine for the coming vaccination campaign. However, the department had prepared a proposal (PC-1) to purchase new cold rooms at a cost of Rs3.6 million for a 40 cubic metre cold room, (a 10-cubic metre cold room will cost Rs2.7 million). The spokesman hoped that the next government will approve the proposal.

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