ISLAMABAD: Over 65pc of the total measles cases reported in the eastern Mediterranean region, consisting of 22 countries, were reported from Pakistan in 2017.

According to a World Health Organisation report, a total of 6,494 measles cases were reported in 2017, which is more than double those reported in 2016.

Health experts say the actual number of cases may be higher as many cases in Pakistan are not reported, mostly due to the weak surveillance system.

However, Ministry of National Health Services (NHS) Director General Dr Asad Hafeez said a measles outbreak is observed every eight to 10 years and that the ministry has decided to give 35 million doses of measles vaccines to children who are under the age of five in September this year.

Measles are a contagious respiratory infection caused by a virus. It causes rashes on the whole body and flu-like symptoms including fever, cough and a runny nose. The virus spreads through the air via coughing and sneezing and can be fatal for children.

The WHO report, which is available with Dawn, says that 10,540 tests for measles were conducted in Pakistan in 2017 while 5,871 laboratory tests were conducted in 2016. It shows that 6,494 cases were confirmed last year and 2,845 were confirmed in 2016.

The report also shows that more than 65pc of cases reported in the eastern Mediterranean region were from Pakistan while the second highest number of cases was reported from Afghanistan at 1,511 and the third most from Syria at 513 cases.

There were 402 diagnosed cases of measles in Saudi Arabia, 146 in Somalia, 166 in Yemen, 87 in UAE, 40 in Iran and 21 in Iraq. Not a single case was reported in Jordan and Bahrain while Djibouti did not report for 2016 and 2017.

A health expert from the National Institute of Health said the increasing number of measles cases is an indicator of the weak routine immunisation system in the country.

“The country experienced a measles outbreak some eight years ago during which over 10,000 cases were reported and 150 children had died. The year 2018 can be worse and the number of cases may increase further,” he said.

The official explained that countries which have a less than 90pc rate of routine immunisation are more exposed to measles and that the vaccine coverage in Pakistan is around 50pc. He said a large number of cases are never reported in Pakistan due to the weak surveillance system and that the actual number of measles cases will therefore be much higher.

“We should have done an intervention at the start of 2017 but no one bothered to do so. The chances of an outbreak will increase after April as the virus becomes more active in the warmer temperatures,” he said.

NHS DG Dr Hafeez said five to six million children are born every year in Pakistan and that vaccines for the virus are administered at nine months which means a large number of children are not covered for nine months, which is in addition to the children who are not administered the vaccines at all.

“We conduct campaigns in the village where a case is reported from but [the way to mitigate the risk] is to vaccinate all children at once across the country for which $25 million to $30 million are required. On the other hand, vaccines are prepared on special order. We have arranged for funds with the support of WHO, Global Alliance for Vaccines and Immunisation and the federal and provincial ministries in order to purchase 35 million doses of the vaccine,” he said. He added that because an anti-measles campaign cannot be started in the warmer season, it has been decided to start the campaign in September this year after which Pakistan will be safe from an outbreak for another eight to 10 years.

“Efforts are also being made to improve the immunisation rate in order to ensure the country is rid of measles for good,” he said.

Published in Dawn, February 26th, 2018