Why measles cases in SP raise alert for all of Brazil

Two other states are investigating cases of the disease; each infected person can pass the virus to about 10 others.

Two measles cases were confirmed in the State of São Paulo in 2022, one in the capital and the other in the municipality of São Vicente, located in the metropolitan region of Baixada Santista. Previously, the case had been notified by Cubatão, but the notification takes into account the patient’s municipality of residence, as registered in the official system by the municipalities.

The age of those infected was not revealed by Organs responsible bodies. In the capital, according to the Municipal Health Department, 24 other cases are being analyzed.

The contaminations confirmed in São Paulo are autochthonous, that is, people contracted the virus within Brazilian territory, and not while traveling. “This means that the virus is among us, and if adherence to vaccination coverage does not improve, cases can increase rapidly”, explains Melissa Valentini, an infectious disease specialist at Grupo Pardini and a master’s degree in Infectology and Tropical Medicine from UFMG (Federal University of Minas Gerais). ).

Measles is an infectious disease caused by a virus called Morbillivirus. The disease is one of the main responsible for infant mortality in Third World countries. Transmission occurs directly from person to person, through secretions from the nose and mouth expelled when coughing, breathing, talking or breathing (check out the symptoms of the disease below).

Measles is spread through the air, and has the highest transmission rate of any viral disease.

“If we take into account the ‘R0’, the mathematical measure that quantifies the number of transmissions, the estimate is that each person with measles passes the disease to more than 10. The R0 of covid-19 is between 1.5 and 3 , depending on the variant. Therefore, the measles vaccine coverage target must be above 95%, to be able to stop the disease”, explains José Cerbino Neto, researcher at INI/Fiocruz (National Institute of Infectious Diseases).

The report contacted the secretariats of all Brazilian states. As of press time, in addition to São Paulo, only the following state health agencies have responded: Paraná (2 cases under investigation) and Bahia (28 cases under investigation). Among the federative units that did not register suspicions or have already discarded them, are Pernambuco, Goiás, Pará, Distrito Federal, Ceará and Espírito Santo.

At the current moment, with fewer restrictions imposed by covid-19 and more people traveling, Neto points out that the risk of a new measles outbreak is even greater. “The lack of distance and mask ends up impacting other respiratory diseases as well. Associated with low vaccine coverage, it is the perfect recipe for dissemination.”

Measles vaccination decline

In 2016, Brazil received the measles-free country certificate by the (Pan American Health Organization), but lost it in 2019, after confirmation of a case of the disease in Pará.

The MMR vaccine (against measles, mumps and rubella) has had insufficient coverage numbers since 2017. The first dose had a drop in coverage from 93.12% in 2019 to 70.52% in 2021. The second dose, however, was required to complete the immunization, it dropped from 81.55% to 49.31% in the same period.

“As we have had fewer cases of the disease in recent years and people no longer see children dying or people suffering from measles, the perception of risk decreases and, consequently, the search for a vaccine. a fear of going to health centers and being infected by the coronavirus”, says the researcher from Fiocruz.

The country’s objective now is to resume certification by improving immunization rates. “As we saw recently with covid-19, the vaccine changes the trajectory of a disease, so it’s important that we don’t lose what we were already doing so well”, highlights Valentini.

New campaign targets children

Vaccination officially starts when the child turns one year old, and has a booster dose when he turns 15 months old. With these two steps, immunization is considered sufficient for life.

However, due to the low adherence to immunization and the greater risk of the disease in children, the current campaign recommends that an additional “dose 0” be given from 6 months of age. Children who are now up to 5 years old and have already taken both doses can also receive the booster during the campaign, until June 3rd.

In addition to them, until May 2, health professionals without proof of doses (for having, for example, lost their vaccination card) can also receive a new immunization.

Measles symptoms and treatment

For children, measles can be more serious. “As the natural immune system is not yet complete in the first years of life, symptoms can evolve intensely. After the disease cycle, with even lower immunity, secondary infections such as pneumonia can appear”, says Valentini.

In general, the signs of measles in the body are:

  • Cough
  • coryza
  • High fever
  • general malaise
  • Spots in the mouth and on the skin
  • Conjunctivitis
  • Nausea
  • Sore throat

Is there no specific treatment to fight the virus after infection? only drugs that can relieve symptoms.

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