LARKANA: Measles is spreading fast in Larkana and its surroundings, confirmed health experts working in Chandka Medical College Hospital’s (CMCH) children units to Dawn on Tuesday.

The number of cases continued to swell and the graph was constantly rising, said the Child Life Foundation (CLF) which runs a separate emergency unit adjacent to the CMCH Children Hospital. Foundation administrator Abdullah Khan Asar said that since the fresh episode which started in January 2021, and till date, 184 measles patients were admitted in the emergency unit where six deaths were recorded.

Two patients were in critical condition when this correspondent visited the unit on Monday. The situation direly needed a separate intensive care unit (ICU) under the obtaining conditions. The relatives of a boy were seen maintaining oxygen manually to save his life.

The administrator said the patients’ graph was depicting an upward trend and majority of children were arriving at the terminal stage from Larkana, Qambar-Shahdadkot, Jacobabad and the adjoining parts of Balochistan.

In the wake of the sensitivity of the issue, the 90-bed CMC Children Hospital had established a separate ward along with an isolation unit to treat measles cases, said Prof Dr Shanti Lal working in Unit-III.

Currently, he said, five children hailing from Larkana city, Qambar and Shahdadkot were getting treatment in the separate ward while four with critical condition were admitted in the isolation ward, he said.

A WhatsApp group of the Pakistan Medical Association (PMA) was receiving reports of rise in measles cases from Nawabshah and Sukkur, Dr Shanti said.

He disclosed to this reporter that 99 per cent patients received in Unit-III of the hospital during the period under reference belonged to Nazar Mohalla, Allahabad and Murad Wahan [Larkana city] had severe complications like pneumonia, encephalitis, sub-coetaneous emphysema, otitis media and febrile fits. Unfortunately, they were unvaccinated, he said. The patients were coming from Usta Mohammed, Qambar, Shahdadkot, Kashmore-Kandhkot, Shikarpur, Dokri, Bakrani and other areas, he said.

A group of doctors doing their post-graduation undertook a study of 100 patients suffering from measles in the CMC Children Hospital. Of them complications were seen in 80pc children, said Dr Fayyaz Hussain Shahani.

Majority of the patients were in the age bracket of nine months to three years and among them 70pc were malnourished, 20pc of them severely. The study further revealed that among all 80pc were unvaccinated, 20pc vaccinated, 30pc on breastfeeding and 70pc non-breastfeeding, he said in the presence of co-authors of the study. Among complications, pneumonia was 52pc followed by encephalitis (20pc), he said.

Describing measles as more dangerous than Covid-19, Prof Dr Saifullah Jamro labelled the present outbreak as ‘epidemics’ which badly needed initiating mass vaccination campaign throughout Sindh.

Peeping into the past, he said two or three years ago, they had encountered an identical situation and immediate remedy was to launch a mass vaccination drive in the province.

Measles cases were presently reported from Sindh and Balochistan and they demanded the government to immediately launch a massive vaccination campaign against the outbreak to contain its spread, he said. He also urged ensuring intensifying routine immunization.

Citing a variety of reasons, doctors said mothers often on one pretext or the other left their children unvaccinated. The parents also in routine concealed the fact behind refusal of immunization, they said.

A doctor on the condition of anonymity said a child was admitted as a diagnosed case of measles when he did not respond to treatment. It turned out to be a registered HIV/AIDS case, he said. The parents kept mum over the fact, he said.

He said mortality could be brought down if children were provided two consecutive doses of vitamin A paired with massive immunization. Unfortunately vitamin A was not available in stores. The children hospital got vitamin A from the district health office only, said Prof Dr Shanti.

Associate Prof Dr Jan Mughiri working in Paeds Unit-I said that of 38 patients, whom the ward received on Friday, nine cases were diagnosed as that of measles.

Doctors believed that due to Covid-19 and polio, the routine vaccination percentage had come down. The myths knitted with this health disorder have also played a role as parents more often keep their kids at homes. This practice aggravated the intensity leading to developing serious complications which could only be avoided through awareness along with stressing on enhancing routine immunization, the doctors said.

Sources in the district health office connected with surveillance admitted the rise in measles cases, saying that so far 70 confirmed cases were reported along with 150 suspected ones. As soon the outbreak was reported, experts had proposed for initiating a massive vaccination drive in the province to overcome the situation, the sources said. This was an epidemic, they said, adding that a campaign would likely be launched after Eidul Fitr.

The big tertiary children hospital was in dire need of establishing an ICU to tackle emergency situation, the doctors said.

The additional medical superintendent of the CMC Children Hospital was also worried about the measles outbreak, saying that coordinated efforts were required to meet the situation.

A group of final-year MBBS students posted in different wards of the children hospital told this reporter that element of undernourishment was found as one of the key components in the affected children.

Published in Dawn, April 28th, 2021