EDITORIAL - Measles on the rise

The numbers are nowhere near the levels during the epidemic from 2017 to 2019. Still, the Department of Health has sounded the alarm on a spike in measles cases. In just the first month of 2023, the DOH has recorded 59 measles cases nationwide – a jump from just eight in January last year. Central Luzon posted the biggest increase followed by the Ilocos Region, Northern Mindanao and Davao Region.

At least there have been no measles deaths so far. The DOH noted that measles outbreaks usually occur every four to five years. The latest one was recorded in the final months of 2018 until early 2019. For the entire 2019, the country recorded 47,871 measles cases with 632 deaths, or a case fatality rate of 2.6 percent, according to DOH surveillance data and the 2020 epidemiological overview prepared by the World Health Organization.

WHO records showed that in the Western Pacific, the largest measles outbreak in the region during that period occurred in the Philippines. This was attributed to the plunge in first-dose measles vaccine coverage in the country by 75 percent in 2018; the decline continued through 2020, at 72 percent. A report in peer-reviewed medical journal The Lancet noted that the highest deaths were reported among children aged less than nine months, and that no deaths occurred among vaccinated children.

In 2017, there were 2,428 recorded measles cases in the Philippines. The figure jumped to 20,827 in 2018 and surged to 48,525 during the 2019 outbreak. At the height of the epidemic in the first half of 2019, special measles care units had to be set up as hospitals became overwhelmed. In 2020 amid the COVID-19 lockdowns, the cases plummeted to 3,832.

The first-dose vaccine for measles, mumps and rubella was introduced in the country in 1983 for children aged nine months. The second dose, for children at 12-15 months, was added to the schedule in 2009. After a peak of 92 percent from 2004 to 2008, measles vaccine coverage slowed down to 80 percent in 2016 and further to 75 percent in 2018.

A scandal over the Dengvaxia anti-dengue vaccine, with hysterical accusations that the shot caused the death of hundreds of children, affected the government’s general immunization campaign. This was aggravated by the strict quarantine of children throughout the COVID pandemic.

The general immunization program has yet to return to levels before the Dengvaxia controversy. Low immunization coverage has resulted in even polio making a comeback in September 2019 after 20 years of the country being polio-free. As measles cases spike, a more aggressive effort is needed in the overall immunization program, to protect children from debilitation and death.