3.4.3 Measles and immunisation
Throughout the world, measles is still one of the leading causes of childhood mortality. It is a highly contagious disease and can be associated with high mortality, severe complications and an increased vulnerability to other infections, which can subsequently lead to malnutrition. When vaccinations are not promptly distributed, populations are vulnerable to outbreaks.
Prevention of measles is thus a high priority, particularly when the population is living in refugee camps or displaced person situations. Measles immunisation campaigns should be prioritised, along with immunisation for pertussis and diphtheria when determined through surveillance. Surveillance should be used to determine when it is appropriate for other vaccine programmes to be integrated into health services.
During a humanitarian response CARE will focus on strengthening or introducing SRHR services, either through collaboration with local ministries of health, or in partnership with other non-governmental organization implementing partners. However, CARE has an important role to play, where feasible, in assisting the local and national governments in contributing to reducing maternal, newborn, infant and under-five mortality and morbidity through programs introduced by the public sector of the concerned government. In the absence of a functioning government health system, CARE will assist, where feasible, with multilateral organizations to support life-saving interventions to reduce excessive maternal and newborn, including infant and under-five morbidity and mortality.
To ensure prevention and detection of measles in an emergency, the following points should be adhered to:
- At the outset of an emergency, an estimation of measles vaccination of all individuals aged nine months to 15 years of age should be made.
- If coverage is estimated to be less than 90%, then a mass vaccination campaign should be initiated in coordination with local and national health authorities, as well as partner organisations.
- Upon completion of the measles campaign, at least 95% of the population aged six months to 15 years of age must have received the measles vaccine.
- During this time, at least 95% of children six to 59 months of age should also receive an appropriate dose of vitamin A.
- Routine follow-up with another measles vaccination dose nine months later should be in place with children six to nine months of age.
- Fixed vaccination points should be immediately integrated into the health system with the collaboration of local and national health authorities.
- At least 95% of all newcomers into the host area should be vaccinated.
- All suspect cases for measles should be assessed immediately.
In addition to mass measles vaccinations, standardised case management protocols, such as the IMCI for diagnosis and treatment, should be used. Outreach activities and community education messages should be widely disseminated to ensure that individuals affected by the emergency are aware of when they should seek treatment or care.