Nationwide measles campaign begins

A major effort to immunise some 3 million people against measles began in Tajikistan on Monday, the largest nationwide immunisation campaign since the former Soviet republic gained independence in 1991. "Almost 3 million people, about half the country's population, will be covered," Sokhibnazar Turkov, deputy director-general of the Centre for Immuno-Prophylaxis, told IRIN from the Tajik capital, Dushanbe. The US $2.6 million government initiative, with extensive support from the US Center for Disease Control (CDC) in Atlanta, the UN Children's Fund (UNICEF), the World Health Organization (WHO) and the Japanese government among others, is being administered through schools, health centres and mobile teams throughout the impoverished nation. With 750,000 children dying of measles worldwide each year, according to UNICEF, Tajikistan remains particularly vulnerable to outbreaks of the disease. Immunisation coverage inside the country varies from 50 to 100 percent, depending on the district. And while, officially, the overall rate of vaccination for measles was 84 percent, a Multiple Indicator Cluster Survey sponsored by UNICEF in 2000 showed a lower coverage rate of 61 percent. "This situation poses a very real possibility for serious outbreaks, which continue to occur at five-year intervals," Niloufar Pourzand, a programme coordinator for UNICEF in Dushanbe, told IRIN. According to the Tajik Republican Centre for Immuno-Prophylaxis, there were 3,000 recorded cases of measles in 2003. But the centre, along with other assessors, feels that the number of cases that go unrecorded might be much higher. Employing some 4,500 health workers nationwide, the two-week campaign covers all children aged 1 to 18, health workers aged between 19 and 29, as well as security personnel and university students in the country's northern Sogd region. Meanwhile, religious leaders, teachers, health staff and volunteers are working nonstop to mobilise millions of children and their parents. "In short, this campaign touches nearly every home in the country," Pourzand explained, noting that a team of international observers would be monitoring its implementation. The task of immunising so many children over so short a period is daunting. Supplies are being pooled from as far away as Copenhagen and India, while getting vaccines to all the children in a country that is 93 percent mountainous has proven a challenge. "During the delivery and vaccination process, vaccines have to be kept continuously cold with ice packs and refrigerators, regardless of long distances and power outages," the UNICEF official said. Street children also form a difficult target group. "Fortunately, vaccination posts will be situated at street bazaars and street children's centres as well," Pourzand added. Measles, also known as rubella, is a common disease caused by a virus of the genus Morbillivirus. An acute and highly contagious viral disease marked by distinct red spots followed by a rash, it occurs primarily in children. Measles is spread through respiration (contact with fluids from an infected person's nose and mouth, either directly or through aerosol transmission), and is highly contagious - 90 percent of people without immunity sharing a house with an infected person will catch it. Devastated by five years of civil war, Tajikistan, hopes to eradicate the disease by 2010.