Measles epidemic launches passionate vaccination debate

Controversy over Portugal’s measles ‘epidemic’ (more cases confirmed since January than in the last eight years) has ratcheted up exponentially since 17-year-old Inês Sampaio died in hospital in Lisbon last week of bilateral pneumonia – one of the deadly complications of the disease. European Commissioner for Health Vytenis Andriukaitis has come out and said, in his opinion, measles is one childhood vaccine that should be made obligatory.

Parliament was due to discuss the issue as we went to press – and national news programmes have already had panels of experts arguing for and against the efficacy and safety of vaccines generally.

But national tabloid Correio da Manhã reports that health bosses are not interested in making the national programme obligatory.

Health minister Adalberto Campos Ferreira has “discounted the possibility”, says the paper, revealing instead that “alterations to make the system of vaccination more safe” will be announced on June 1 – the International Day of the Child.

Campos Ferreira’s actual words were: “On the government’s initiative we will present some alterations that will guarantee and propitiate greater compliance and security over what is the correct behaviour by all of us as a society, and the obligation we have in the name of our children and grandchildren.

“It does not involve obligation but a better articulation between the educative community and health services.”

The scare, meantime, has been put into context.

The population is still covered against measles to a level of “around 96%”, said health director Francisco George last week, while only 24 have been ‘confirmed’ up and down the country as measles – though at least 15 others are still ‘under analysis’.

Of the confirmed cases, 57% were in non-vaccinated children and adults (two health professionals at Cascais hospital) and seven have been in the Algarve, reported CM earlier this week.

George also stressed that the country has abundant stocks (200,000 doses) of the MMR triple vaccine that includes measles, with “even firefighters at national airports” having supplies.

Whether this is a precursor to the pharmaceutical industry developing a vaccine targeted at measles alone (the current triple vaccine is aimed at measles, mumps and rubella) is the question now left hanging.

Certainly uptake of the triple vaccine has been less than exemplary elsewhere in Europe where cases of measles are now up to 7,500 in 23 countries.

The most number of cases have been recorded in Romania, where purportedly 96% of the country’s children have not been vaccinated.

The percentage is the same as the number of children in Portugal who have been vaccinated, hence health chiefs’ trust in the disease having little ground here for propagation.

From the point of view of confirmed spread, only seven cases have been reported in the Algarve, with the majority reported in the Lisbon and Vale do Tejo health district.

“The majority of cases occurred in adults over the age of 20,” reports CM – stressing that in the first four months of 2017, the country has seen more cases of measles than in the last decade.

A CM box story recalls that Portugal suffered a measles’ outbreak in 1993/94, in which 3,000 cases were registered, with no deaths.

The last recorded measles deaths in Portugal – before 17-year-old Inês Sampaio last week – came in 1987 when 30 people died, claims CM.

Público suggests the last measles’ death only goes back 23 years. But with the virus now active in so many countries, criticism has been flying towards the so-called ‘anti-vaccine’ camp: people whose trust in the components that make up the vaccines lead them to seek alternative forms of cover for their children.

There has been confusion too over the efficacy of the ‘measles’ vaccine (as mentioned previously, a triple shot that is not geared simply to fight measles).

When Inês Sampaio lost her battle for life, media reports insisted her other siblings had been vaccinated.

Inês’ younger sister Beatriz was then admitted to hospital, with suspected measles, and the story changed to suggest Beatriz had only very recently been vaccinated.

As to other people who have caught the disease despite previous inoculation, health boss Francisco George has stressed it is still much better to be vaccinated, as anyone catching measles subsequent to vaccination will suffer the disease in a “lighter form”.

Another less publicised side to Inês’ tragedy is that the teen was already in hospital when she contracted measles, thus – as national tabloid Correio da Manhã explains – she was “suffering from a weakened immune system”.

This aspect of ‘healthy immune systems’ has been echoed by health boss Francisco George, who told journalists that he doubted measles would ever develop into a “large scale epidemic” in Portugal, not simply because most of the country is immunised against it, but because the disease “only exists in people who are sick”.

“To circulate, it needs to find favourable territory, and we do not have favourable territory,” he said.

Baby in Portimão misdiagnosed with “virus”

The parents of nine-month-old Maxi Borhidan are reported to have presented a complaint to Portimão hospital over the way measles was not detected in their baby as far back as March 11.

Maxi was taken to hospital with a high fever, reports CM, a rash all over his body, a swollen mouth and conjunctivitis – but the doctor who saw him failed to diagnose measles, as did the specialist who saw him days later in Faro, for the simple reason that doctors then believed Portugal was measles free.

This is another aspect of the outbreak that has been worrying health bosses. George told reporters early on that one of the biggest problems was that many doctors today “have not even seen measles”, due to its wane as a result of national vaccination programmes.

In Maxi’s case, the child is a cardiac patient, and is believed to have contracted the disease during one of his regular check-ups at Faro hospital.

The good news in this case is that Maxi has been released from hospital and is now fully recovered from the virus.

Being nine-months old, he was not due his triple vaccine protecting against measles for another three months.

By NATASHA DONN [email protected]

Photo: Health minister Adalberto Campos Ferreira (left) and director-general of health Francisco George during a press conference about the measles ‘epidemic’ on April 19 at the health ministry building in Lisbon