Five months after the alert for the first cases of measles in Guatemalathe Ministry of Health counts 22 Guatemalans died from the disease: 16 children under seven years old and six adults.
The cumulative number of cases from January 9, when the first case emerged, to June 5 amounts to 16 thousand 840and four out of 10 have been confirmed by laboratory tests. The rest have been identified by clinical signs and by having had contact with infected people.
According to the Health report, among the deceased there are three children who were not yet old enough to receive the zero dose of measles vaccine, implemented to protect minors between six and 11 months, since the first dose of the regular schedule is applied at 12 months and the second at 18 months.
One of the babies was seven days old and another was 17 days old; both were infected by their motherswho tested positive for the disease. In the third case, the child was two months old, had difficulty breathing and developed a serious infection.
How likely is it that a person will die from measles? The official report indicates that The mortality rate in children under one year of age is 2.82 per 100,000 children of that age.. It is 26 times higher than that of the general population, whose rate is 0.12 per 100 thousand inhabitants.
Among the deceased are six adults aged 21, 23, 27, 29, 33 and 42 years old. The most common diagnosis in this group is respiratory complications, although there are also cases in which the immune system was weakened.
The case of the 29-year-old person corresponds to a woman with 21 weeks pregnantwho was hospitalized a day after the appearance of hives on her body, one of the symptoms of the disease. Additionally, he developed pneumonia. The complications caused his death.
Regarding deaths, Health points out that it is important to maintain complete and timely vaccination schedules to prevent diseases that may cause complications.
Behavior of infections
Since the first cases of measles were identified in Guatemala, in Santiago Atitlán, Sololá, 6,903 people have been infected, registered as confirmed cases because they underwent a laboratory test that tested positive for the virus. However, there are 9,937 people who were not tested, but whose symptoms led to the conclusion that they had the disease.
He 94.1% of those infected have recoveredaccording to Health. In 72.6% of cases, the illness passed without problems; however, a 17.3% required hospitalizationand the most serious symptoms occurred in minors and people with previous conditions.
The cases registered per week have been decreasing. The highest peak was observed in March, when, on average, 775 weekly infections were reported. Starting in May, the number decreased to 216 per week.
Mario Melgar, pediatric infectious disease specialist and member of the National Council of Immunization Practices (Conapi), points out that the decrease in cases is “predictable” in outbreaks such as the one that occurred in the country.
However, this reduction is observed in laboratory-confirmed cases, since confirmatory tests were no longer performed on patients. According to the Health protocol, if a person presents symptoms or has had contact with a positive case, it is no longer necessary to test them.
“We don’t know how much (cases) are going down; what it seems is that the outbreak is stabilizing. There is always underreporting, since not all cases are reported, which is to be expected,” says Melgar.
In relation to deaths from measles, the infectious disease specialist mentions that the number reported is high and that the children who have died are young or have malnutrition, which is “worrying.”
The doctor adds that the risk of serious illness and death from measles at the ends of life is the most predictable. The death of young adults indicates, first, the presence of risk factors and, second, that even people without these factors can develop serious illnesses and die.
The capital, epicenter
The measles outbreak began on January 9 with five cases identified in Santiago Atitlán, Sololá, prompting the Ministry of Health to declare institutional red alert. For four weeks, that department was the epicenter of the disease.
Starting in the first week of February, cases began to increase in the department of Guatemala. The trend has continued and, to date, concentrates 45.3% of patients confirmed in the country. However, the infections have been concentrated in Guatemala City, where they are counted 2 thousand 117 people infected.
Sololá is the third with the most cases (369) while Quiché occupies the second (398) according to the official report.
The Ministry of Health’s measles information board indicates that 871,488 doses have been applied of the MMR vaccine (protects against measles, mumps and rubella) during the outbreak of the disease. Of these, 5% were administered to children between six and 11 months.
According to the Guatemalan News Agency (AGN), The mass vaccination strategy against measles was extended to Chimaltenango, Quiché, Sololá and Totonicapánsince it initially focused on the municipalities of Guatemala, Mixco and San Juan Sacatepéquez, as they concentrated the largest number of positive cases.
The Ministry of Health was consulted about the reported deaths and the extent of measles vaccination in the population; However, at the time of this publication he had not responded.
Editor’s note: This story was updated at 5:00 p.m. with the most recent data published by the Ministry of Health.
