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Query: UMLS:C0014070 (encephalomyelitis)
 13,017 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of measles are relatively mild in well-nourished children, but are associated with high mortality in those who are malnourished and in those who have other diseases. Complications may include bacterial pneumonia, bronchitis, otitis media, gastroenteritis, myocarditis, hepatitis, and encephalomyelitis. The Expanded Program on Immunization was introduced to India in 1978, but measles immunization did not commence until 1985 under the Universal Immunization Program. Total district coverage was achieved in 1990, followed by a peak immunization coverage figure of 90.9% in 1991. Coverage rates declined, however, to 85.8% in 1992-93. Impressive though they may be, these coverage rates obfuscate the reality that measles remains a major cause of morbidity and childhood mortality in India. Coverage levels remain under 50% in many tribal and remote areas, with 49,453 notified cases at the time of printing. Overall case fatality rates for the country are in the range of 2-15% due to a synergistic relationship between malnutrition and infection. One must therefore not rest in the fight against measles. Sudden outbreaks should be reported immediately and vitamin A supplements and immunization supplies readied in anticipation of epidemic. The many reasons why vaccine coverage rates remain low in some areas include the failure of many parents, health personnel, and some doctors to regard measles as a serious disease; restrictive vaccine administration directives requiring the presence of a physician; physician reticence to open a 10-dose vial for 1-2 patients; and parental and physician reluctance to immunize children who are slightly ill or where minor adverse side reactions such as fever and rash may be anticipated.
Indian Med Trib 1994 Mar 15
PMID:Measles is down but not out. 1217 72