Managing Measles: Understanding, Treating, and Preventing the Viral Threat
By Tonny Abet
tonnyabet@gmail.com
Measles, a highly contagious viral infection, manifests with a characteristic widespread skin rash and fever. This vaccine-preventable illness, caused by the measles virus, remains a significant cause of childhood mortality globally. The virus spreads through airborne droplets expelled during coughing or sneezing and through direct contact with an infected individual.
Dr. Michael Baganizi, head of the Ministry of Health's immunisation programme, has highlighted the persistent challenge measles poses in Uganda. Recent outbreaks have been severe enough to necessitate the reopening of the measles ward at Mulago Hospital, a stark indicator of the disease's resurgence.
"The measles ward at Mulago [Hospital] is full. Those wards had been closed but now they have reopened and they are full," Dr. Baganizi stated, underscoring the gravity of the situation. He further commented on the link between vaccination gaps and outbreaks: "That is what happens when vaccination breaks down. We hope that with this intervention it will be curtailed."
Data from the Ministry of Health reveals a concerning trend: the number of districts reporting measles outbreaks surged from approximately 20 in 2023 to 40 by the end of 2024.
Medical experts explain that measles typically begins with a high fever accompanied by symptoms such as a runny nose, a distinctive barking cough, and conjunctivitis, commonly known as "red/pink eye," which can lead to blindness if untreated. Patients may also experience vomiting and diarrhoea before the appearance of the generalised skin rash.
The Ministry of Health's 2023 clinical guidelines provide clear instructions for managing measles cases, advocating for the isolation of patients "at home or health centre" to prevent further transmission. Symptomatic treatment focuses on managing the fever with painkillers and addressing eye problems with prescribed ointments, always under the guidance of a qualified healthcare professional.
Crucially, the Ministry emphasises the need to increase fluid and nutritional intake for measles patients due to the high risk of malnutrition and dehydration, which can be life-threatening.
Under the care of healthcare workers, patients may also receive vitamin A supplementation and prompt treatment for any secondary bacterial infections with appropriate antibiotics. The guidelines stress that individuals isolated at home or in lower-level health facilities should be referred to a hospital immediately if any complications arise.
Prevention remains the most effective strategy against measles. Key preventive measures include widespread measles vaccination, avoiding contact between infected and uninfected individuals, and dispelling harmful local myths. One such myth, the belief that measles patients should avoid meat and fish, is actively being countered through public education.
Dr. Jane Ruth Aceng, the Minister of Health, has affirmed the Ministry's commitment to increasing vaccination uptake to curb outbreaks.
“I appeal to all the districts to support the efforts –Measles- Rubella (MR) vaccinations which will also be part of the integrated child health days. We need to put an end to this measles outbreak before it spreads to avoid reopening the measles wards because this will be another added burden and yet we have preventive tools with us,” the Minister urged.
Dr. Aceng attributed the current outbreaks to low vaccination coverage and appealed to the public to rely on scientific evidence rather than misinformation.
“I also want to appeal to all of us to embrace vaccination and stop listening to anti-vaxxers (those who are opposed to vaccinations) because focusing on the WhatsApp scientists and anti-vaxxers is what has brought us today. If we had focused on vaccination and reached out to the zero-dose children, we would not be having a measles outbreak,” she stressed.
In response to the escalating outbreaks, Dr. Baganizi highlighted a proactive measure: the "Big Catchup" vaccination campaign aimed at reaching children who have missed their scheduled vaccinations.
"We had over 1.5 million children we had targeted to give the second dose of measles vaccine. The 45 affected districts include Kampala. And if we don’t vaccinate enough children, this outbreaks will continue because they keep finding unvaccinated children or weak immunity as the virus keeps rotating around," he explained.
Dr. Baganizi emphasized the critical importance of vaccination in halting the spread of the disease: “This vaccination was meant to put that to a halt. If this doesn’t happen more and more districts will continue experiencing outbreaks. Unfortunately, measles kills. It is not a simple disease.”
Concerning statistics from the Ministry of Health indicate a worrying trend of increasing numbers of "zero-dose" children – those who have not received essential vaccines against preventable diseases. An assessment report by researchers from the Gavi Zero Dose Learning Hub in Uganda revealed that this number nearly doubled in just two years, rising from 55,000 in 2021 to 96,000 in 2023. This growing pool of unvaccinated children creates a fertile ground for measles outbreaks to thrive, underscoring the urgent need for increased vaccination efforts and public health education.
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Keywords: measles, vaccination, immunization, treatment, disease, prevention, uganda
