Sri Lanka verified as Rubella free – WHO
Sri Lanka ‘s excellent immunisation program has finally borne fruit with the country and neighbouring Maldives last week verified as being the first two countries in the WHO South East Asia Region to achieve both Measles and Rubella elimination well ahead of the 2023 target, a WHO statement said last week.
Congratulating both countries, WHO South East Asia Region Regional Director, Dr Poonam Khetrapal Singh was quoted as saying that, “Protecting all children against these killer diseases is an important step in our endeavour to achieve healthier populations and health for all”.
The announcement was made after the fifth meeting of the South East Asia Regional Verification Commission for Measles and Rubella Elimination which comprised eleven independent international experts in the field of epidemiology, virology and public health. The Maldives reported the last endemic case of Measles in 2009 and Rubella in October 2015, while Sri Lanka reported the last endemic case of Measles in May 2016 and Rubella in March 2017.
Speaking to the Sunday Observer, Consultant Epidemiologist, Epidemiology Unit Ministry of Health, Dr Deepa Gamage said a country is verified as having eliminated measles and rubella when there is no evidence of endemic transmission of the measles and rubella viruses for over three years, in the presence of a well performing surveillance system. She said at a time when the world was grappling with the Covid-19 pandemic, Sri Lanka’s success was due to a team effort comprising the Ministry of Health, health workforce and most importantly the communities from grassroots level up, which contributed to this public health achievement.
Vaccination services resumed islandwide
She said despite a brief suspension of vaccination services during the start of the Covid-19 pandemic the country had resumed its routine vaccination program which will be conducted as usual. Ïn recent years all countries in the Region introduced two doses of measles containing vaccine and at least one dose of rubella containing vaccine in their routine immunisation program. Our success rate so far from the feedback we have got is encouraging. But we cannot afford to be complacent. We need to be vigilant and ensure that every pregnant mother and young girl has been vaccinated against the Rubella disease, before they become pregnant. Our success is that we reach each and every child even in remote areas, and explain the immense benefits of these vaccines, through field level public health staff. We need to ensure that no child suffers or dies from a disease as easily preventable as measles in the future as well, and no pregnant woman loses her unborn baby due to a virus as avoidable as rubella or no neonate is born with a heart ailment or loss of hearing owing to in-utero rubella infection”, .she said.
Adverse impacts of Rubella
Explaining the adverse effects of Rubella she said the Rubella infection in early pregnancy can lead to miscarriage, still birth or Congenital Rubella Syndrome (CRS) in the baby – a condition that includes severe birth defect and lifelong disability such as vision and hearing impairment and heart defects. Deafness occurs in about two thirds of all those born with CRS she said.
Member countries of WHO South East Asia Region in September last year set 2023 as the target for the elimination of measles and rubella.
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Oral cancer, 2nd most common cancer in SL
Health experts have expressed concern over the rise in oral cancer in Sri Lanka which is said to be the second most common type of cancer among Sri Lankans. According to Cancer Control Program sources six new patients are identified with oral cancer daily. They said studies showed that oral cancer was commonest among Sri Lankan males and was one of the ten most common cancers in women.
Cancer Control Program sources, told the media at a seminar held at the Health Promotion Bureau ( HPB) in Colombo Tuesday, that oral cancer accounted for two or three deaths per day and was the second highest mortality ratio among cancer deaths reported in males.
Speaking to the Sunday Observer on grounds of anonymity, a cancer specialist lamented that many of these oral cancers were preventable if they had been reported at an early stage . Unfortunately, around seventy percent of oral cancers are reported at a late stage when they have reached the third and fourth stages which reduces the chance of a good outcome for the patient”, the source said.
According to recent surveys, the main risk factors of oral cancer are, using betel quid, tobacco and arecanut related products, smoking and alcohol. It was found that 45.7% of males and 5.3% of females use some type of tobacco product (smoke as well as smokeless) while 34.8% of males and 0.5 percent of females use alcohol. Asked who the risk groups were the sources said they included estate workers, drivers, fishermen, mine workers, construction workers ,security guards, three wheeler drivers and farmers. Long distance bus drivers too were a high risk group, they said. “We have found that the prevalence of Oral Potentially Malignant Disorders (OPMD) and oral cancer are higher among them “, they said.
Symptoms
They said that most of the time, pre-cancerous conditions or lesions occur in the mouth prior to getting an oral cancer. “Pre-cancers and cancers at the initial stage could be identified through a self mouth examination or a professional clinical oral examination. If those who fall into the risk categories mentioned persist in their risky habits, we advise them to have a self mouth examination once every month and a clinical oral examination one in at least six months”, they said.