This January, the Ministry of Health and Social Protection insisted on strengthening coordination and vigilance at the local level between the departments concerned, in order to converge efforts to combat the spread of measles. An update of the Epidemic Surveillance and Response Manual also underlines that “all regions, provinces and prefectures are now affected and must act accordingly”.
In addition to increased epidemiological surveillance, the manual insists that “all regional public health emergency operations centers (CROUSP) and all provincial rapid intervention teams must be activated and on alert,” in addition to holding weekly meetings and “close coordination with local authorities and other stakeholders.”
Since October 2023, Morocco has had at least 19,515 cases of measles and 107 deaths linked to the virus. On December 30, the Minister of Health and Social Protection, Amine Tahraoui, announced that infections represented 52.2 cases per 100,000 inhabitants and deaths 0.55%. Children under the age of 12 account for almost half of the deaths.
Beyond monitoring cases of infection, one of the pillars of the response to the spread of the epidemic remains prevention, starting with the intensification of the vaccination campaign. Contacted by Yabiladi, the director of the Virology Laboratory at Hassan II University in Casablanca, Moulay Mustapha Ennaji, insists on vaccination catch-up and on keeping children’s vaccinations against childhood diseases up to date. “This is the only effective way to fight measles,” insisted the higher education professor.
“The cause and effect link is intrinsic in both directions: if vaccination coverage is declining, it is because there is increasing reluctance towards vaccination. More and more parents are hesitant to take their children to health centers to receive their injections, which is a mistake, and this exposes more and more people to the risk of contracting the virus and spreading it.
Pr. Moulay Mustapha Ennaji
Vaccine hesitancy is not the solution
In accordance with the recommendations of the World Health Organization (WHO), the proportion of the population vaccinated against measles compared to that targeted overall must exceed 95%, in order to effectively contain the disease. Otherwise, it can become widespread and cause victims, especially among young children. This is what happened particularly in Morocco, where national strategies implemented since the 1980s made it possible, in the long term, to overcome the epidemic at the end of the 2010s. But since the health crisis of 2020 linked to Covid-19, this rate has fallen below the minimum recommendation.
“Until now, vaccination coverage has effectively protected children. Reluctance to vaccinate is widely debated across the world, but vaccination remains the only way to prevent and eradicate measles. This vaccine has also proven itself over the decades and the figures tell us this indisputably,” added Professor Ennaji to our editorial staff.
Director of the Department of Epidemiology and Disease Control at the Ministry of Health and Social Protection, Dr. Mohamed Lyoubi reiterated the WHO recommendations last week. Thus, he recalled that “the solution to fight the epidemic is to reach the level of vaccination coverage where we were before” the health crisis. “Since September 2023, cases [au Maroc, ndlr] were recorded mainly in children aged 18 months to 12 years. These are people who are supposed to have benefited from the vaccine,” he told the 2M channel.
According to Professor Ennaji, whatever the motivations and reasons for hesitancy to be vaccinated, “coverage declines accordingly and the results are there”. To strengthen this rate, the virologist highlights catch-up campaigns. In this regard, he emphasizes that given the current situation, any vaccination of anyone who has never received their double dose can help curb the spread of the epidemic.
“Children aged 18 months to 12 years are mainly concerned by the campaign because they are the most exposed to the virus, but if young adults are not yet vaccinated, they can go to health centers and receive their injections.”
-Pr. Moulay Mustapha Ennaji
In case of doubt, a PCR test can confirm the infection, following which quarantine measures remain imperative. “We must isolate the patient to avoid contagion to his environment, then have him treated by administering antivirals prescribed by the treating doctors,” indicates Professor Ennaji, who places particular emphasis on upstream prevention.
“The services of the Ministry of Health are working hard at the local level, with the various stakeholders concerned, to raise awareness, implement vaccination campaigns and provide care in the event of infection in health structures. », Tells us the professor, who reports serious cases and a significant mortality rate among children under 12 years old.
In this sense, the virologist recalls that vaccination against measles remains free in public health structures and as part of the campaign led by the supervisory department.
Characteristics of measles and vaccination
The World Health Organization (WHO) classifies measles as a highly contagious and serious viral disease that is transmitted through the air. Indeed, the virus can cause “severe complications”, leading to the death of younger patients. But the solution exists: the UN body underlines that vaccination “helped prevent more than 60 million deaths between 2000 and 2023”.
Despite this safe vaccine, the number of deaths from the virus across the world is estimated at 107,500 in 2023. A large part of these deaths are mainly among unvaccinated or under-vaccinated children under five, ‘where the imperative is to catch up with the second vaccine dose, for complete effectiveness.
Confirming the overall observation of decline in vaccination coverage across the world, the WHO notes that “the proportion of children having received a first dose of measles vaccine was 83% in 2023, well below the 86% recorded in 2019 “.
The world organization describes a virus that affects the respiratory system, “then spreads throughout the body”. It manifests itself as “high fever, cough, runny nose, and rash all over the body.” In this sense, the WHO emphasizes vaccination as “the best way to avoid contracting or transmitting measles”.
In figures, before the introduction of the measles vaccine throughout the world from 1963, “we recorded major epidemics every two or three years which could cause around 2.6 million deaths each year”.
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