Nihal Koshie
08/09/2002

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HYDERABAD: The perceived measles outbreak in Warangal district last month, which led to health department administering 38,000 vaccines in 195 villages, has baffled officials.

This is because none of the victims showed measles symptoms and results of initial tests are now pointing to anything but a typical measles as the causative factor. According to health department sources, none of the victims showed any symptoms of measles like running nose, high fever, breathing problems and most importantly, rashes. Further, all the 31 deaths occurred within eight hours of the first symptom, unlike measles where deaths occur only after a week. Moreover, measles outbreaks are usually in clusters.

But in the Warangal epidemic, of the 56 villages from where cases were reported, 49 had only one case and three villages only two cases, sources said. Even the elisa blood sample tests promptly carried out by the National Institute of Communicable Diseases (NICB), New Delhi, was only 70 per cent positive for any measles antibody. World Health Organisation officials and NICB officials who visited the villages diagnosed the epidemic as possible enteroviral encephalitis. But blood tests carried out on samples collected from the villages have ruled out encephalitis.

Admitting that the virus has baffled doctors and health officials, commisionerate of family welfare and Bill & Melinda Gates Foundation special officer J Laxminarayana said that the department had to ensure measles vaccination was administered promptly in the affected villages as this was the best option to contain the epidemic. However, World Health Organisation guidelines do not allow this, unless there is community or government pressure. Further, Laxminarayana said the epidemic was now under control and no fresh cases have been reported since the past one week, even as the vaccination campaign that commenced on July 18 has been completed.

However, whether the vaccination was wholly responsible for controlling the epidemic cannot be determined, as it is now believed that the virus could be a new and mutated strain of the measles virus. Tests on blood samples to isolate and culture the virus are being undertaken at the NICB.

Similar outbreaks were reported in Warangal district in 1998 and also in some parts of Uttar Pradesh this year.

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