Dr. Athula Liyanapathirana, Consultant Epidemiologist from the Ministry of Health (Centre) speaking at a press conference held at the Sri Lanka Medical Association briefs media representatives about the resurgence of Measles and a Special Measles Rubella Immunization week to be held from November  9 to December 7 (Pix by Waruna Wanniarachchi)

• A resurgence of over 1000 cases of Measles has been reported since May 2023
• A Special Measles Rubella Immunization, declared by the Ministry of Health, will be held from November 9 to December 7
• Infants under 9 months have also been affected and pregnant women are at risk of infection
• If the variant is suspected to be new, samples are sent to global testing facilities for further investigation

Measles, a highly contagious disease, was believed to have been eradicated in 2019 in keeping with an announcement made by the World Health Organization (WHO). However, a resurgence of over 1000 cases of Measles has been reported since May 2023, primarily affecting youth aged 20 to 30 years and infants under 9 months. With this rising concern, a Special Measles Rubella Immunization week has been declared by the Ministry of Health. 

Sri Lanka Medical Association (SLMA) has collaborated with the Epidemiology unit, Ministry of Health to organise a Special Measles Rubella (MR) Immunization campaign which will be held from November 9 to December 7. 

Around 1,100 cases reported

Speaking at a media briefing, Dr. Athula Liyanapathirana, Consultant Epidemiologist from the Ministry of Health said that around 40 to 45 years ago, Measles was a common disease that affected countless households, but the number of cases decreased with the introduction of the measles vaccine to Sri Lanka in 1984. The health authorities realised that one dose was insufficient, so they decided to administer a second dose in 2001. As a result, cases dropped significantly and by 2019, the WHO recognised Sri Lanka as a Measles-free country. “Subsequently with the COVID-19 outbreak, many immunization programmes globally experienced a slight setback and Measles resurfaced once again in many countries including our own in 2023” he added. Around 1,100 cases were reported since May 2023 and in response, the Measles vaccine was administered to infants and to children who missed the respective doses; resulting in the decline of cases once again. Dr. Liyanapathirana said, “Around 50 new cases of Measles reappeared in August this year and the most important fact about this cluster was that the majority of reported cases were at two nursing training colleges.

 Over 50% of cases fall within the 20 to 30 age range and the reason for this is that some individuals only received the first dose. Thus, we have chosen this age group as our primary target for vaccination coverage. In addition, Infants under 9 months have also been affected and pregnant women are at risk of infection.” 

He further stated that Measles is not mere a condition that causes fever and rashes and it can lead to severe health complications. “We have chosen ‘Windawanne Nathuwa Widaganna’ (get vaccinated without suffering) as the theme for this programme and identified 12 high risk districts (Colombo, Jaffna, Puttalam, Kurunegala, Gampaha, Kalutara, Galle, Matara, Kandy, Ampara, Batticaloa and Kalmunai). Some may question the safety of these vaccines, yet we can assure you that all vaccines used in National immunization programs are prequalified by the WHO and proven to be highly effective” the doctor said.

SLMA President Elect Dr. Surantha Perera explained in detail the spread of Measles, its symptoms and complications. Dr. Perera said “Measles is a highly contagious airborne virus and its symptoms include fever, a red rash, diarrhea and white spots inside the mouth. Measles can cause dehydration, lung infections such as pneumonia, ear infections and brain infections such as encephalitis. Immunization is the best way to prevent such complications.” Dr. Perera underscored that the Measles Mumps Rubella (MMR) vaccine is given at 9 months and again at 3 years of age. “We do not administer this vaccine to children with weakened immunity, cancer patients and pregnant women, but it is crucial that women who expect to become pregnant, get vaccinated. We have not observed any serious side effects from the vaccine, apart from slight swelling and redness where the shot has been given” said Dr. Perera.

We do not administer this vaccine to children with weakened immunity, cancer patients and pregnant women, but it is crucial that women who expect to become pregnant, get vaccinated. We have not observed any serious side effects from the vaccine, apart from slight swelling and redness where the shot has been given” 
- Dr. Surantha Perera, 
SLMA President Elect 

Dr. Janaki Abeynayake, a Consultant Virologist representing the Medical Research Institute emphasised the role laboratory testing plays in this programme. She stated “The special laboratory established by the epidemiology unit at the Medical Research Institute operates 24 hours a day free of charge for anyone who wants to get tested for measles or needs guidance. In the event of an outbreak, laboratory testing helps identify crucial information such as the magnitude of the outbreak and locations at risk, allowing relevant authorities to take appropriate action.” 
Dr. Abeynayake further explained that upon confirmation, genetic testing is necessary to determine the exact variant of measles. If the variant is suspected to be new, samples are sent to global testing facilities for further investigation.

Dr. Hasitha Tissera, Chief Epidemiologist from the Ministry of Health explained the current state of Measles in the region, ongoing activities and plans for prevention. Dr. Tissera said “There are countries in South Asia where Measles is still endemic and if an infected individual visits Sri Lanka, it can spread and those who are not vaccinated remain at risk. To address this concern, WHO has implemented several measures to eradicate Measles and Rubella completely in South Asia by 2026,” 

The special laboratory established by the epidemiology unit at the Medical Research Institute operates 24 hours a day free of charge for anyone who wants to get tested for measles or needs guidance”
- Dr. Janaki Abeynayake, 
Consultant Virologist, Medical Research Institute

SLMA President Dr. Ananda Wijewickrama

Dr. Tissera added, “Since November 4, we have conducted 80,000 house-to-house visits to identify those who aren’t fully vaccinated. Health workers are also visiting workplaces and higher educational institutions to identify those who missed the prescribed vaccine doses and such individuals will be directed to special clinics.” He stated that if anyone missed the vaccination on November 9, the clinics will be open for them on four consecutive Saturdays up until December 7. The Epidemiology unit has introduced a hotline – 070 456 5656 if further information is required.

SLMA President Dr. Ananda Wijewickrama concluded the press conference by emphasising on the importance of getting both doses of the vaccine for complete immunization and to prevent the spread of Measles, leading to a complete eradication of the disease.

“There are countries in South Asia where Measles is still endemic and if an infected individual visits Sri Lanka, it can spread and those who are not vaccinated remain at risk. To address this concern, WHO has implemented several measures to eradicate Measles and Rubella completely in South Asia by 2026”
-  Dr. Hasitha Tissera
Chief Epidemiologist, Ministry of Health