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Measles Pakistan

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  • Dr. Rana Jawad Asghar
    Dr. Rana Jawad Asghar [4] Pakistan (Sindh) Date: Mon 7 Jan 2013 Source: The Express Tribune [edite]
    Message 1 of 3 , Jan 14, 2013
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      Dr. Rana Jawad Asghar
      [4] Pakistan (Sindh)
      Date: Mon 7 Jan 2013
      Source: The Express Tribune [edite]

      Measles claims 10 more lives in rural Sindh
      - ------------------------------------
      As the measles outbreak slithers on, the epidemic took lives of 10
      more children in rural Sindh on Sunday [6 Jan 2013], taking the death
      toll to at least 50 since the beginning of January [2013].

      Four children passed away in Badin and Thatta districts. A 4-year-old
      child from Pir Sikandar Shah village in Badin's Tando Bhago taluka
      died after suffering from the disease for over a week. The child's
      father, told The Express Tribune that he also lost his 2-year-old
      daughter a week ago due to the illness. "A local doctor was treating
      my children. I brought my children late for treatment," their father
      said, adding that his children had not been inoculated [previously]. A
      2-year-old child died in Tando Bhago's Ward No 2 area, another
      2-year-old died in Badin's Nindo town, and a 4-year-old died in Adam
      Lashari village of Thatta.

      Six children have died of measles in different parts of upper Sindh. A
      3-year-old and a 4-year-old died in Hafiz Suleman Dahar village near
      taluka Daharki of Ghotki. A 4-year-old Sudheer Sundarni died in Jurio
      Sundrani village near taluka Qadirpur in Ghotki, while a 3-year-old
      died in Akbar Khan Lashari village near taluka Thull in Jacobabad

      In Kashmore district, a 2-year-old died in Mohammad Ali Samejo village
      near taluka Ghouspur and a 5-year old died in village Nasrullah
      Nandvani near taluka Tanrwani.

      In Dadu, a district-wide measles immunisation campaign was supposed to
      start, after Deputy Commissioner Nasir Abbass Soomro issued directives
      to the health department. However, despite the passage of 4 days, the
      campaign has not yet begun. Soomro had asked the health team to
      vaccinate children in the district's schools besides initiating a
      door-to-door campaign.

      While the death toll climbs in parts of southern Sindh, the health
      department appears to be oblivious to this development. Dr Aqeel
      Qureshi, the focal person for measles, refused to officially confirm
      any deaths in Hyderabad division. He said only a few dozen children
      had been brought to public sector hospitals and they had all been
      cured. "Health teams are carrying out [a] vaccination drive in
      villages in rural Sindh where measles cases have been reported," he

      [Byline: Z Ali / Sarfaraz]

      - --
      Communicated by:
      ProMED-mail from HealthMap alerts

      [Another report highlighting the a lack of coordination in masses
      vaccination in Pakistan. A map of Sindh province can be accessed at:
      <http://www.sindh.gov.pk/dpt/maps/images/7.gif>. - Mod.CP]

      [5] Pakistan (Islamabad)
      Date: Wed 9 Jan 2013
      Source: The Express Tribune [edited]

      Curbing measles: Strategies adopted to combat outbreak
      - ------------------------------------------------
      Health experts and officials of the capital administration at a
      meeting held at the Pakistan Institute of Medical Sciences (PIMA) on
      Tuesday [8 Jan 2013] devised short and long term strategies to prevent
      blowing up of measles into an epidemic.

      So far, in January this year [2013], 21 cases of measles have been
      confirmed in the capital, the majority of which are reported from
      katchi abadis and rural areas where the coverage of routine
      immunisation is low, according to the officials affiliated with
      Expanded Programme on Immunisation (EPI). [Mass migration from rural
      areas to cities has resulted in the proliferation of 'katchi abadis'
      or unplanned settlements in all of Pakistan's cities. - Mod.CP].
      Tabish Hazir, head of Paediatrics Department at Children Hospital,
      told The Express Tribune that 2 strategies were chalked out, one for
      the short term to tackle the outbreak before it attains epidemic
      proportions and the other for the long term.

      Under a short-term strategy, a liaison through a hotline service will
      be established between hospitals and the EPI for ensuring a quick
      response to a case reported from the twin cities. CDA and ICT have
      been asked to identify high-risk zones in their jurisdiction so that
      mop-up campaigns can be carried out under which all the children below
      the age of 15 will be vaccinated against measles, he said. All the
      hospitals will be given a reminder to strictly follow the guidelines
      meant for the treatment of patients suffering from measles.

      CDA Health Services Director Dr Hassan Urooj expressed concern of a
      vaccine shortage in the capital if every child under the age of 15
      [were to be] be vaccinated against the disease. He also said there was
      an acute shortage of vaccinators in his directorate. There are only 12
      vaccinators in the capital which means one for 10 000 to 12 000
      children which is insufficient especially during a crisis. When
      contacted, EPI National Programme Manager Dr Zahid Larik said at
      present there was no vaccine shortage in the country. "Currently,
      there is no vaccine shortage in any of the provinces or in the
      capital. There is a misconception about the measles outbreak in the
      country that is caused due to the shortage of vaccines which is
      completely wrong. It happens due to low coverage of routine
      immunisation and underreporting of cases," he said.

      A core group comprising officials from all concerned departments will
      plan a mass awareness media campaign on measles and will ensure 100%
      coverage of routine immunisation in their areas under the long-term

      The meeting was attended by the heads of the public and private
      hospitals, officials of Islamabad Capital Territory (ICT), CDA and

      - --
      Communicated by:
      ProMED-mail from HealthMap alerts

      [6] Pakistan (Hyerabad)
      Date: Thu, 10 Jan 2013
      Source: The International Tribune [edited]

      Measles epidemic: Officials play blame game over outbreak
      - --------------------------------------------------
      As another 6 children died from measles during the last 24 hours, the
      Pakistan Medical Association (Sindh chapter) demanded that an inquiry
      commission be set up to fix responsibility for the unabated spread of
      the disease in the province. A total of 2475 cases were detected in
      Sindh [provnce] in December [2012] alone, according to Health Minister
      Dr Sagheer Ahmed. At a press conference on Tuesday [8 Jan 2013] night,
      Dr Sagheer said district health officers and vaccinators, the key
      players in the Expanded Program for Immunisation (EPI) and Peoples
      Primary Healthcare Initiative (PPHI), were responsible for the measles
      outbreak in upper Sindh. "They are accusing each other but they are
      all responsible for the situation," said Dr Sagheer, while avoiding to
      say what official action will be taken against them. While one of the
      reasons that routine immunisation has been weakened is a dispute over
      jurisdiction between the EPI and PPHI, district health departments
      are also blamed for not responding immediately to the health crisis
      while it was developing.

      Dr Sagheer said that the virus has spread to Hyderabad and Mirpurkhas
      divisions, where health departments have been ordered to set up
      centres for vaccination and to send teams to affected areas. The
      minister said 1.5 million more doses [of vaccine] have been procured
      from Islamabad. According to him, measles claimed 210 lives in 2012,
      including 93 in December [2012]. However, these figures are considered
      to be an underestimation by many. "If the health officials are putting
      the total at 300, the actual figure will be more than double of what
      they tell," said the chief minister's relief adviser, Haleem Adil
      Shaikh. The adviser asserted at a press conference that the health
      departments are not even maintaining a proper record of the cases and
      deaths reported. He pointed out that, "A belated response came after
      improper routine immunisation, and it let the virus [disease]
      exacerbate". "Shifting accusations from one department to another will
      not do. We demand official action against those responsible," said PMA
      Sindh General Secretary Dr Pir Manzoor Ali.

      [Byline: Z Ali]

      - --
      Communicated by:
      ProMED-mail from HealthMap alerts
      < promed@...>

      [7] Pakistan (Karachi)
      Date: Sat 12 Jann 12 2013
      Source: The International News [abridged & edited]

      Karachi: 11 measles deaths in 2013, admits Health Minister
      - --------------------------------------------------
      Sindh Health Minister Dr. Sagheer Ahmed on Friday [11 Jan 2013]
      admitted that at least 11 children had died so far due to measles in
      Sindh since 1 Jan 2013, while around 1537 new positive cases were
      reported over the last 10 days. "As many as 2.9 [?] children in 8 of
      the worst affected districts of Sindh were vaccinated. There were 425
      fixed vaccination centers and 997 mobile teams working round-the-clock
      in these areas," the Minister told a meeting that was convened to
      review the measles outbreak. Dr. Sagheer Ahmed said that since the
      outbreak in the province during 2012, over 15 000 measles cases were
      reported, while deaths related to the disease were 11 in 2013. He
      maintained that the large-scale campaign was causing a vaccine
      shortage and said that the federal government, the World Health
      Organisation (WHO) and UNICEF had been requested to provide more
      vials. The minister told the meeting that federal health authorities
      and international organisations were informed that in order to achieve
      the 95 percent vaccination ratio, an adequate quantity of the measles
      vaccine was required.

      [Byline: M. Waqar Bhatti]

      - --
      Communicated by:
      ProMED-mail from HealthMap alerts

      [8] Pakistan (Karachi)
      Date: Sat 12 Jan 2013
      Source: Daily Times, Pakistan [edited]

      The World Health Organisation (WHO) reports that more than 300
      children have died from measles in Pakistan in 2012, a 5-fold increase
      from 2011. More than three quarters of death reported were in the
      province of Sindh. One hundred children died in the month of December
      [2012] alone, a SPCDPM statement said here Friday [11 Jan 2013].

      The routine immunisation exercise across Pakistan reflects uneven
      coverage among provinces, districts and cities, with only certain
      important cities of Punjab recording a decent performance. The low
      coverage of the routine immunisation was an easily avoidable condition
      that has led to a measles outbreak in the northern Sindh and risks
      spreading in other parts of Pakistan. The figures for coverage are
      dismal; interior Sindh's coverage stood at 22-25 percent, while
      Karachi's coverage also remained at a low of 55 percent.

      Official figures place coverage for Sindh at 80 percent, a blatant
      case of exaggeration and misleading reporting. Just recently,
      newspapers reported the discovery of 800 previously unreported cases
      of measles in Punjab.

      There is strong interlink between the rain affected areas and the
      outbreak of measles as majority of the measles cases have been
      reported from the flood-affected areas of Ghotki, Shikarpur,
      Jacobabad, Sukkur, Larkana, Qambar-Shahdadkot, Khairpur and
      Kashmore-Kandhkot that still have rain water standing since the
      devastating monsoon rains in September 2012 which caused floods.
      SPCDPM has urged the provincial and federal governments to take an
      urgent, serious and concerted effort to enhance the administration of
      anti-measles vaccination, and in preventing malnourishment, which
      currently affects children across Sindh and the rest of the country
      and makes them susceptible to contracting measles.

      Pakistan Pediatricians Association has claimed the measles had taken
      lives of over 300 children in the province. Huge difference of routine
      Immunisation coverage between provinces, districts and cities is at
      the root of the current measles outbreaks.

      - --
      Communicated by:
      ProMED-mail from HealthMap alerts

      [ProMED-mail does not normally post reports critical of governmental
      and admnstrtive deficiencies, but in this instance it seem
      appropriate. - Mod.CP]

      [see also:
      Measles update (01): Africa, Asia 20130106.148430
    • Dr. Rana Jawad Asghar
      [7] Pakistan (Khyber Pakhtunkhwa) Date: Sat 14 Jun 2014 Source: Dawn Newspaper [abbreviated Mod.CP, edited]
      Message 2 of 3 , Jun 15, 2014
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        [7] Pakistan (Khyber Pakhtunkhwa)
        Date: Sat 14 Jun 2014
        Source: Dawn Newspaper [abbreviated Mod.CP, edited]

        The Khyber Pakhtunkhwa health department on Friday [13 Jun 2014]
        announced it would book 3 of its technicians for intentional murder
        over 4 deaths during the recent anti-measles campaign in the province.
        It also announced suspension of 10 doctors and health technicians from
        Peshawar hospitals for negligence in this case. The suspension had
        been ordered in the light of a high-level inquiry into the deaths of 4
        children and hospitalisation of dozens in Peshawar after their
        vaccination against measles during the 12-day campaign, which began
        across the province on 19 May 2014. The inquiry committee reported
        that the accused wrongly administered anti-measles vaccine to children
        causing their deaths, an action ranked as intentional murder under the
        Pakistan Penal Code.

        The minister said technicians didn't administer vaccine properly, and
        officials said around 9.6 million children were vaccinated during the
        campaign and that the federal government had purchased anti-measles
        vaccines used in it from India. There followed formation of an inquiry
        committee headed by Peshawar deputy commissioner Zaheerul Islam and
        consisting of senior doctors and a representative of WHO.

        "The committee found that 3 technicians didn't inject vaccines
        properly to children, thus causing their deaths. In this light, the 3
        have been suspended forthwith, and a case against them will be
        registered under Section 302 of the PPC," said Shahram Tarakai, who
        was accompanied by information minister Shah Farman. The minister said
        the government had zero tolerance for medical negligence and that
        action would be taken against the culpable ones under the law. He said
        the health department had ordered suspension of the provincial
        Expanded Programme for Immunisation coordinator Dr Janbaz Afridi and
        that Rs 500 000 [USD 5000] would be paid to the family of every child
        who had died of improper administration of vaccination as
        compensation. Earlier, information minister Shah Farman said the
        anti-corruption department had either arrested or issued orders for
        the arrest of 144 government employees for corruption during the
        ongoing campaign. He said Rs 13.9 million [USD 142 000] in ill-gotten
        money had been recovered from the said employees.

        communicated by:
        ProMED-mail from HealthMap Alerts

        [Unfortunately we are left in the dark regarding the precise nature of
        the deficiencies in administration of the vaccine justifying the
        accusation of "intentional murder". Further information is awaited. -

        A ProMED-mail HealthMap is available at
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