Experts call for measles epidemiology review in Kerala amid outbreaks
Public health specialists suggest reassessing disease patterns as cases appear in infants and vaccinated individuals across several districts.
Public health experts are calling for a detailed reassessment of measles epidemiology in Kerala as outbreaks occur in districts including Kozhikode, Malappuram and Palakkad, according to The Hindu. The disease, once primarily affecting children aged one to five, is now being reported across various age groups, including infants below nine months and fully vaccinated people.
As of November 6, the Integrated Disease Surveillance Programme reported 824 confirmed and 1,681 probable measles cases in the state. While five deaths related to measles have been reported, only one has been confirmed so far.
K.K. Purushothaman, former Professor of Paediatrics at Government Medical College, Thrissur, said many infants are developing measles before nine months, potentially due to lower antibody levels in mothers. He suggested the State Technical Advisory Group on Immunisation should consider an additional vaccine dose for adolescents or women before marriage.
A study by the Rajiv Gandhi Centre for Biotechnology (RGCB) involving 684 children aged four to 18 in Kerala and Tamil Nadu found that 8.5 per cent lacked protective antibody levels despite receiving at least two doses. The study, published in JAMA Network Open in August 2025, noted that 13 per cent of children tested positive for measles-specific IgM, suggesting recent infection.
While Kerala generally reports 95 per cent coverage for the first dose of the measles-rubella (MR) vaccine, coverage for the second dose at 18 months is lower, at approximately 85-88 per cent. The Health department has attributed outbreaks to vaccination gaps in districts like Malappuram and Kozhikode.
Experts state that larger epidemiological investigations are required to determine if outbreaks are driven by incomplete coverage or other immunity gaps by examining the age and vaccination status of laboratory-confirmed cases.