“Children with cancer were significantly impacted by measles.”

Mumbai: According to research by the Tata Memorial Centre (TMC), children who were battling cancer at the time suffered greatly as a result of the measles epidemic that raced over Mumbai in 2022. The results have highlighted the significance of more than 95% vaccination coverage in the community to protect immunocompromised children, since only five out of eighteen (27%) who came with measles at the blood cancer treatment unit could fight it.

Pediatric experts at TMC’s hemato-oncology section faced a bewildering scenario in December 2022 when a surge of youngsters with leukemia, ages 2 to 18, showed up with seizures, balance issues, and unexplainable spasms. Since measles doesn’t exhibit typical symptoms like fever or rashes, diagnosis was initially challenging.

Many patients needed intubation and ventilatory support despite extensive treatment regimes that included antiviral medicine, antiepileptic medications, immunoglobulin therapy, and, in certain cases, corticosteroids, because of persisting symptoms. Only five of the eighteen infants survived after three months, but with severe neurological deficits.

Children with cancer combat both their illness and frequent infections as a result of weakened immune systems.

Professor of paediatric oncology at TMC,, Dr. Chetan Dhamne said, “These children rely on herd immunity—achieved through high vaccination rates in the community—for protection against common infections due to loss of humoral and cell mediated immunity caused by the disease and the treatment.” These grave repercussions resulted from the changes in usual immunization schedules caused by the epidemic, he said. For the experts, the picture was further complicated by the fact that measles was uncommon in the city prior to the outbreak.

In order to determine that problems after measles was the cause of the symptoms in youngsters, Tata physicians relied on a brain biopsy and a measles PCR test on cerebrospinal fluid, which is not regularly accessible. The ICMR-National Institute of Virology in Pune conducted the measles PCR.

The research highlighted the vital need of mass vaccination, especially for illnesses like measles, and was recently published in the journal of the American Society of Clinical Oncology. More than 95% of the population must be immune in order to successfully stop transmission and establish herd immunity, according to the physicians. The pandemic-related vaccination gap contributed to one of the biggest measles outbreaks in Mumbai’s history, which began in October 2022. In 2022, the epidemic claimed 15 lives and produced around to 600 cases.

Two of the thirteen children who died from the sickness were not inoculated, and three others’ vaccination status could not be verified, according to the primary author, Dr. Sudivya Sharma. Others had been vaccinated, but continued chemotherapy—which was meant to be a lifesaver in the battle against cancer—had reduced their immunity.