Cameroon: Health Officials Step Up Fight against Measles and Rubella

By Boris Esono Nwenfor

BUEA, July 6, 2023 – Cameroon has begun a mass vaccination program to combat the measles epidemic, as health officials said the outbreak is getting worse because parents are failing to have their children vaccinated against the preventable disease.

Health officials plan on vaccinating about 5.5 million children aged 9-59 months. Each child will receive a shot of the vaccine on the shoulder in hospitals and public places in all ten regions of the country.

Measles and rubella are highly contagious diseases that can cause serious health complications, including death. Measles can lead to pneumonia, encephalitis, and blindness, while rubella can cause birth defects in unborn babies.

“Measles and rubella are two deadly viruses and the importance of this vaccination campaign is to reduce the infection rate of these viruses,” said Dr Eko Eko Filbert, South West Regional Delegate of Public Health. "As of now, the two, especially measles, is the deadliest vaccine-preventable disease. If the children are all vaccinated, then we will reduce the prevalence of measles-infected children, not only in the region but in the country."

Since the start of the year, there have been recurrent outbreaks of Measles epidemics affecting about 3000 children, according to officials of the Expanded Program on Immunization (EPI). So far, 100 of the country’s 200 health districts have reported Measles cases, with 18 deaths on record.

Most children who have been infected have reportedly not been vaccinated. The vaccination coverage in the country has been affected by the vaccine hesitancy witnessed during the COVID-19 pandemic.

Out of Cameroon's 200 health districts, 99 have reported cases of measles affecting children below 10 years old, said Shalom Ndoula, permanent secretary of the Expanded Immunization Program in the Ministry of Public Health.

"In Cameroon, the disease has affected more than 4,000 children with 18 deaths so far and that is a worrying situation," Ndoula told reporters in the capital city of Yaounde.

"It is a nationwide campaign, but the targeted children are children from nine months to five years that are the most affected by the measles outbreak," he added. According to the program, about 5.5 million children will be vaccinated in Cameroon.

Measles remains a threat in many African settings due to suboptimal routine immunisation and catch up campaigns. In Cameroon, a measles-rubella vaccination campaign was organised in 2019 to reduce the cohort of susceptible children. However, in 2020, eleven suspected cases of measles were notified in the Sa’a Health District and five were confirmed.

In Cameroon, like many other countries, the measles vaccine is provided to children through routine immunisation services delivered by the Expanded Programme on Immunisation (EPI). The EPI in Cameroon targets 0-15 months old children. The measles immunisation programme began in Cameroon in 1965 and by 1974 the vaccine was administered only to 9-month-old children as a single dose. Since 2015 the vaccine has been administered as a combined Measles-Rubella (MR) vaccine with the first dose at 9 months of age.

"We should understand that the prime project of the Ministry of Public Health, and the government of Cameroon is the Universal Health Coverage Phase 1. One of the major packages of this project

About Measles

According to the World Health Organization, WHO, measles is an acute, highly infectious viral disease caused by a Morbillivirus and for which humans are the only reservoirs. Transmission is primarily person-to-person via aerosolized droplets or by direct contact with the nasal and throat secretions of infected persons. When the measles virus is introduced to a non-immune population, nearly 100% of individuals will become infected and develop clinical illness. The incubation period of measles is about 10 to 12 days (range 7-18 days). Malnourished children are at higher risk of developing complications and mortality from measles infection.

The differential diagnosis of measles are illnesses with fever, rash, and a variety of nonspecific symptoms. When examining for measles, it is important to consider rubella, scarlet fever, exanthema subitum (roseola), dengue fever, the early stages of chickenpox, and infectious mononucleosis in the differential diagnosis. Moreover, other conditions may present in a similar form, including enterovirus or adenovirus infections, toxic shock syndrome, rickettsial diseases and drug hypersensitivity reactions.