Missed jabs led to more measles cases

December 10, 2012

SINGAPORE – The number of measles cases trebled last year, largely due to incidents of young children not being vaccinated, the Ministry of Health (MOH) has revealed.

The infection rate had declined rapidly since the introduction of compulsory vaccinations in 1985.

But last year, some 148 people came down with the condition, compared with 49 reported cases in 2010.

Most were children under four years old.

Children are given the measles, mumps and rubella (MMR) vaccine in two doses.

Last December, the MOH brought forward the date of the first jab from one to two years old to when the child is a year old.

The second was brought forward from six or seven years old to 15 to 18 months old.

An MOH spokesman told The Straits Times that the upward trend had raised “some concern” and that the changes sought to “address the rising trend of measles among unvaccinated young children”.

The figures were published in the MOH’s annual report on communicable diseases.

Dr Chan Poh Chong, who heads the division of ambulatory and adolescent paediatrics at the National University Hospital, said there were more measles cases in other developed countries such as Britain and the United States in the last two years.

The MOH said the resurgence of measles was largely due to single sporadic cases among under-fives, most of whom were unvaccinated.

The ministry’s report showed that eight children already had at least one dose of the MMR vaccine before they got sick last year.

Some sufferers could have contracted the disease overseas or were too unwell to receive the injections.

A number of parents may have inadvertently forgotten to take their children for the vaccination as well, added Dr Chan.

Five per cent of toddlers here did not get the first jab by the age of two and about 7 per cent of schoolchildren missed the second one, the MOH report said.

The ministry expects that the recent changes made to the immunisation schedule will “help to reduce the incidents of measles over the next few years”.

So far this year, only 31 cases have been confirmed, added its spokesman.

Meanwhile, a predicted rise in dengue fever cases never materialised as figures for last year showed a slight drop from 2010 numbers.

There were 5,330 infections and six deaths in 2011 compared with 5,363 and six deaths in 2010.

This marks a change in the pattern of dengue transmission here since the last cycle, which ended in 2005 with more than 14,000 cases and 25 deaths.

The National Environment Agency (NEA) said the pattern of dengue infection had followed a cycle that lasts five to seven years, with infections peaking in the final year of this period.

In the ensuing “inter-epidemic” year, the rate dies down before cases pick up again the following year as the cycle begins anew.

But now that cycle is changing, with several consecutive drops in infections observed in recent years instead of the typical year-on-year rise.

For example, the 8,826 infections in 2007 also went down the following year, to 7,031.

The decline of 2,534 cases from 2008 to 2009 was the “biggest drop on record”, said the NEA.

An NEA spokesman said: “The years since 2005 have shown significant changes in the pattern.”

Efforts to curb the spread of the mosquito-borne disease might have influenced this pattern.

The agency said that last year, for every 10,000 inspections of homes and public areas such as construction sites, mosquito breeding was found at only 32 places, down from 115 in 2005.

“This would have an impact on transmission potential although the exact impact cannot be quantified,” said an NEA spokesman.

Associate Professor Leo Yee Sin, who heads the Communicable Disease Centre, agreed that preventive efforts might be a factor.

Climate change might have played a part too, although this remains uncertain, she said.

Source: The Straits Times

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