Measles outbreak in Koinadugu Sierra Leone needs concerted response

Dr. Fawzia Thomas: Sierra Leone Telegraph: 18th June 2018:

It is quite worrying that an outbreak of measles virus was confirmed in the Koinadugu District of Sierra Leone four days ago.

The press release from the Ministry of Health and Sanitation says that in June 2018, there were 19 confirmed cases in the Sulima and Mongo chiefdoms.

Measles is mainly a childhood illness which can spread very easily especially in overcrowded areas, though such outbreaks are now getting quite rare, due to successful worldwide vaccination (MARKLATE) in communities.

However, if children are not vaccinated at 9 months and 15 months, then they are prone to developing measles.

Adults who missed their vaccinations could also become infected. These may be college or university students, travellers and other adults who were not given vaccinations as children.

Measles is caused by a virus. When a child is infected with the virus, it stays in the nose and throat and saliva of the child. It then spreads whenever the child sneezes, coughs, and even speaks close enough to another person.

In addition, the virus that has been coughed out can stay in the air and on surfaces for several hours. If an unvaccinated person is in that vicinity, then they can contract the disease.

So, it is highly contagious and can spread very quickly if measures are not put in place.

It is important to be able to recognise the symptoms of measles, such as high temperature which causes aches and pains; the child would become very miserable, crying and irritable; and refusing to eat or drink due to a sore throat. They have runny nose and red eyes, and sometimes light irritates their eyes.

The symptoms may resemble a very bad cold, but measles can be identified by looking for typical small white spots in the inner cheeks, toward the back teeth.

The spots look more like grains of salt against a red background. The other defining feature of measles is a rash on the skin, which may appear about 48 – 72 hours after the spots and can last for seven days. It is a flat rash which spreads from the head downwards and can be itchy.

Measles can be life threatening and may lead to death. So, parents need to see a doctor urgently if their child has these symptoms.

Measles can be treated mainly with Paracetamol to bring down the temperature and reducing the aches and pains. They will need plenty of rest and drink lots of water to keep hydrated. Some parents use Vicks or Mentholatum to rub lightly on the chest and forehead to ease the runny nose and sore throat.

The symptoms improve considerably after 3 to 5 days, and the virus and all symptoms should completely disappear after 2 to 3 weeks.

Although measles is a completely avoidable disease once the patient is vaccinated, some parents are reluctant for their children to have the injection.

They seem to think that the measles vaccine which is given in combination with mumps and rubella vaccine (MMR), causes autism and seizures in their children.

In the UK the MMR vaccine is given twice – at 11 months and at 3 years 4 months. Unfortunately, some parents refuse to have their children vaccinated and hence outbreaks from time to time. No evidence has been found to link the MMR to autism or seizures.

There is a lot of movement across the border to Sulima and Mongo, and so it is possible that parents forget to vaccinate their children or are not aware of the importance of taking the child to the health centre for vaccination.

There is a risk that some children will miss their vaccination dates and so are unprotected.

It is vital for public health officials and other community teams to identify these unvaccinated children and immunise them immediately to prevent further outbreaks elsewhere in the country.

It is important to have both vaccinations at 9 months and 15 months in Sierra Leone to be fully immunised against the measles virus. Having only on injection does not give full immunisation.

As mentioned above, adults who were not vaccinated could be at risk of contracting the disease and so should look out for these symptoms especially if they are in the outbreak area. They must be vaccinated as soon as possible.

Radio announcements will also be beneficial in alerting communities to the risk of contracting measles if not vaccinated.

Marklate is everyone’s business.  So traditional midwives, Child health visitors, traditional societies and the public in general must be sensitised and reminded regularly of the importance of childhood vaccination and pass the message unto parents.

See below the public health statement from the Ministry of Health and Sanitation:



  1. I am really happy to see that the government has taken immediate action against the illness. this is what Sierra Leone needs. Thanks very much Sir for caring for our children and people as a whole.

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