Measles: The forgotten virus in the house

High temperatures, fussiness, fatigue and inability to eat properly.

Gertrude Anyango looks at her 10-month-old son, who was frail and crying unstoppably on the couch.

She did not know what or where the problem was coming from. Her son, Otieno Otieno, was turning and tossing while crying.

"I was scheduled to go for well-baby clinic the next day, but I had to postpone it. My baby was not feeling well and it was making me sick as well," she tells the Star.

Seated in her sitting room in Westlands area, Nairobi, Anyango, 35, quickly took the baby to Gertrude’s Hospital at Junction mall.

"When I arrived, I told them my baby was having a high fever, and so they immediately checked and found that his temperature had risen to 38.5 degrees," she says. 

"They inserted paracetamol medication in his anus. This was because Otieno was afraid of taking oral medicine."

The nurses measured his weight and height and did more tests. The doctors also did urine and blood tests on Otieno.

"My baby had no infection but he had some rashes on his face, particularly the cheeks and the forehead," Anyango said.

"Since he has eczema, the paediatrician said he should apply a unisten cream to clear the rash. I was told to apply this for 14 days and they would clear."

Anyango says when they arrived home, the boy was fine until it reached night time.

"Otieno was burning hot. Since I sleep with him in the bed, all his body seemed to be on fire. I quickly undressed him and only left him with diaper but he was still running a fever of about 39.5 degrees,” she says.

"I got really scared. We were given paracetamol, which I gave him but why the fever? I woke up at 2am and gave him the medication again as we monitored how he was faring."

Anyango said even as she went back to sleep, her mind was not at ease as her baby kept stretching and tossing and crying tirelessly.

"My husband was there with me during this time. As much as I was worried, he was, too. I could not sleep at all," she says.

“It’s like life stopped for some time. I felt like crying but what could I do? The baby was uncomfortable and I could not close my eyes," she says.

THE PROBLEM

Measles is caused by infection with the rubeola virus. The virus lives in the mucus of the nose and throat of an infected child or adult. It is transmitted via droplets from the nose, mouth or throat of infected persons.

Initial symptoms, which usually appear 10–12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth.

Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.

Anyango said she sat waiting for her son to feel better but this reprieve never came to pass.

“Otieno kept waking up every single hour. So when it reached morning at around 7am, I woke up and gave the baby paracetamol again," she says.

But now the rashes were becoming intense. This went beyond the cheeks and the forehead. "It was now on his neck and his hands," she says, adding that the baby began coughing and sneezing.

"I immediately called my cousin, who is a doctor at Nairobi Hospital and explained to him what was happening. From our conversation, I realised my baby had measles. He was also having a running stomach." 

HIGHLY CONTAGIOUS

Measles is a highly contagious airborne infection causing fever, coughing and rashes. It can be prevented through a two-dose vaccine, which has been available since the 1960s.

According to the World Health Organisation, about 86 per cent of the world's children received one dose of measles vaccine by their first birthday through routine health services in 2018 — up from 72 per cent in 2000.

As a result, the number of measles deaths across the globe decreased by about 80 per cent between 2000 and 2017.

The number of measles cases reported in the country went up from 63 in 2017 to 822 cases in 2018.

From 2017 to 2018, the number of children who received the first dose of measles vaccination reduced from 97 per cent in 2016 and stagnated at 90 per cent in 2017 and 2018.

Paediatrician Edith Kimani tells the Star measles must be found when blood tests are done, but notes that it is not as rampant as it used to be.

“You could say this is a measles rash, whereby the child will have just a few rashes but with medication, it will go away,” she tells the Star on the phone.

But Gertrude is not alone. Teresa Njoki, a businesswoman in Kisumu, has had a similar ordeal.

Njoki, 40, who we met at the Kenyatta National Hospital, says her child, who is 15 months old, has been grappling with measles.

"It started one morning. She complained of having headaches and when you touched her, she was running a fever,” she says.

Njoki, who stays in Kibera while on business in Nairobi, said after giving her baby Panadol, the next day the rashes crept in.

"But there were not so many rashes. After a day, the rashes disappeared. She now had a swollen stomach and could not eat," she told the Star.

“I then consulted and was told to wash the baby using a beverage soda, particularly Stoney. I used this to wash her for three days." 

The rash started diminishing but the baby’s stomach was still swollen, with the baby unable to pass stool.

"My grandmother explained to me the baby had measles and they were refusing to manifest itself through rashes," Njoki said.

"She then told me to use some herbs on her, which helped her with stool. Right now, we are here for the medics to check if there is any underlying disease."

After a day, I decided to call Njoki again and she confirmed that her baby had measles rash.

RAISING THE ALARM

As I sit down to write something about this forgotten disease, I hear a pop sound on my WhatsApp account. It's from a mothers' group.

"Hi, mums. My little baby has measles. She has been vomiting and has lost her appetite, and yet she will be vaccinated a week from now. What do I do? I am really scared," *Jael Jane said.

Many responses did not assure her that all will be well. All they kept saying was that once the baby is vaccinated, all should be well.

Her worries gave me a sense of wanting to put this out here. Even though she received a lot of assurance from her friends, it is important to highlight that measles is here with us.

Even as we fight this Covid-19 global pandemic, it is imperative that other illnesses are not overlooked.

In Kenya, according to the United Nations Children’s Fund, one in three children aged below five years is at risk of diseases that can be prevented through vaccination.

Imran Khares, a paediatrician at Gertrude's Children's Hospital, says it is rare for Kenyan children to contract measles.

"With the vaccinations put in place, cases have gone down,” he says.

Khares says once a child has been vaccinated, it is not a sure bet that he or she will not get measles.

"Measles is like any viral infection. You can still get the disease but it will not be full-blown. It can just be like a rash but will disappear quite fast," he said.

"With the vaccination, your body now knows how to keep the disease at bay. And in most cases, you will not get any complications."