International health specialists have cautioned against increasing cases of measles and felt that the world runs the risk of losing decades of progress in protecting children and communities against this devastating, but entirely preventable disease
Airing concerns over reported measles cases spike, Dr. Soumya Swaminathan, Deputy Director General for Programmes at WHO has said The resurgence of measles is of serious concern, with extended outbreaks occurring across regions, and particularly in countries that had achieved or were close to achieving measles elimination.
According to a new report published today by leading health organizations, reported measles cases spiked in 2017, as multiple countries experienced severe and protracted outbreaks of the disease. This is Because of gaps in vaccination coverage, measles outbreaks occurred in all regions, while there were an estimated 110 000 deaths related to the disease.
Measles is a serious and highly contagious disease. It can cause debilitating or fatal complications, including encephalitis (an infection that leads to swelling of the brain), severe diarrhea and dehydration, pneumonia, ear infections, and permanent vision loss. Babies and young children with malnutrition and weak immune systems are particularly vulnerable to complications and death.
Using updated disease modeling data, the report provides the most comprehensive estimates of measles trends over the last 17 years. It shows that since 2000, over 21 million lives have been saved through measles immunizations. However, reported cases increased by more than 30 percent worldwide from 2016.
The Americas, the Eastern Mediterranean Region, and Europe experienced the greatest upsurges in cases in 2017, with the Western Pacific the only World Health Organization (WHO) region where measles incidence fell.
She said, “Without urgent efforts to increase vaccination coverage and identify populations with unacceptable levels of under-, or unimmunized children, we risk losing decades of progress in protecting children and communities against this devastating, but entirely preventable disease.”
The disease is preventable through two doses of a safe and effective vaccine. For several years, however, global coverage with the first dose of measles vaccine has stalled at 85 percent. This is far short of the 95 percent needed to prevent outbreaks, and leaves many people, in many communities, susceptible to the disease. Second dose coverage stands at 67 percent.
“The increase in measles cases is deeply concerning, but not surprising,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “Complacency about the disease and the spread of falsehoods about the vaccine in Europe, a collapsing health system in Venezuela and pockets of fragility and low immunization coverage in Africa are combining to bring about a global resurgence of measles after years of progress. Existing strategies need to change: more effort needs to go into increasing routine immunization coverage and strengthening health systems. Otherwise, we will continue chasing one outbreak after another.”
Responding to the recent outbreaks, health agencies are calling for sustained investment in immunization systems, alongside efforts to strengthen routine vaccination services. These efforts must focus especially on reaching the poorest, most marginalized communities, including people affected by conflict and displacement.
The agencies also call for actions to build broad-based public support for immunizations while tackling misinformation and hesitancy around vaccines where these exist.
“Sustained investments are needed to strengthen immunization service delivery and to use every opportunity for delivering vaccines to those who need them,” said Dr Robert Linkins, Branch Chief of Accelerated Disease Control and Vaccine Preventable Disease Surveillance at the U.S. Centers for Disease Control and Prevention (CDC) and Measles & Rubella Initiative Management Team Chair.
The Measles and Rubella Initiative is a partnership formed in 2001 of the American Red Cross, CDC, the United Nations Foundation, UNICEF, and WHO.
Measles elimination is defined as the absence of endemic measles virus transmission in a region or other defined geographical area for more than 12 months. Conversely, a country is no longer considered to be measles free if the virus returns and transmission is sustained continuously for more than a year.
Measles is a highly contagious, serious disease caused by a virus. Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every 2–3 years and measles caused an estimated 2.6 million deaths each year.
Approximately 110 000 people died from measles in 2017 – mostly children under the age of 5 years, despite the availability of a safe and effective vaccine.
Measles is caused by a virus in the paramyxovirus family and it is normally passed through direct contact and through the air. The virus infects the respiratory tract, then spreads throughout the body. Measles is a human disease and is not known to occur in animals. Accelerated immunization activities have had a major impact on reducing measles deaths. During 2000– 2017, measles vaccination prevented an estimated 21.1 million deaths. Global measles deaths have decreased by 80% from an estimated 545 000 in 2000 to 110 000 in 2017.
The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about 3 days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days).
Most measles-related deaths are caused by complications associated with the disease. Serious complications are more common in children under the age of 5, or adults over the age of 30. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.
Unvaccinated young children are at highest risk of measles and its complications, including death. Unvaccinated pregnant women are also at risk. Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.
Measles is still common in many developing countries – particularly in parts of Africa and Asia. The overwhelming majority (more than 95%) of measles deaths occur in countries with low per capita incomes and weak health infrastructures.
Measles outbreaks can be particularly deadly in countries experiencing or recovering from a natural disaster or conflict. Damage to health infrastructure and health services interrupts routine immunization, and overcrowding in residential camps greatly increases the risk of infection.
Measles is one of the world’s most contagious diseases. It is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions.
The virus remains active and contagious in the air or on infected surfaces for up to 2 hours. It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts.
Measles outbreaks can result in epidemics that cause many deaths, especially among young, malnourished children. In countries where measles has been largely eliminated, cases imported from other countries remain an important source of infection.
No specific antiviral treatment exists for measles virus.
The measles vaccine is often incorporated with rubella and/or mumps vaccines. It is equally safe and effective in the single or combined form. Adding rubella to measles vaccine increases the cost only slightly, and allows for shared delivery and administration costs.
In 2017, about 85% of the world's children received 1 dose of measles vaccine by their first birthday through routine health services – up from 72% in 2000. Two doses of the vaccine are recommended to ensure immunity and prevent outbreaks, as about 15% of vaccinated children fail to develop immunity from the first dose. In 2017, 67% of children received the second dose of the measles vaccine.
Of the estimated 20.8 million infants not vaccinated with at least one dose of measles vaccine through routine immunization in 2017, about 8.1 million were in 3 countries: India, Nigeria, and Pakistan
But without sustained attention, hard-fought gains can easily be lost. Where children are unvaccinated, outbreaks occur. Because of low coverage nationally or in pockets, multiple regions were hit with large measles outbreaks in 2017, causing many deaths. Based on current trends of measles vaccination coverage and incidence, the WHO Strategic Advisory Group of Experts on Immunization (SAGE) concluded that measles elimination is greatly under threat, and the disease has resurged in a number of countries that had achieved or were close to achieving, elimination.
WHO continues to strengthen the global laboratory network to ensure timely diagnosis of measles and track the international spread of the measles viruses to allow more coordinated country approach in targeting vaccination activities and reduce measles deaths from this vaccine-preventable disease.
Airing concerns over reported measles cases spike, Dr. Soumya Swaminathan, Deputy Director General for Programmes at WHO has said The resurgence of measles is of serious concern, with extended outbreaks occurring across regions, and particularly in countries that had achieved or were close to achieving measles elimination.
According to a new report published today by leading health organizations, reported measles cases spiked in 2017, as multiple countries experienced severe and protracted outbreaks of the disease. This is Because of gaps in vaccination coverage, measles outbreaks occurred in all regions, while there were an estimated 110 000 deaths related to the disease.
Using updated disease modeling data, the report provides the most comprehensive estimates of measles trends over the last 17 years. It shows that since 2000, over 21 million lives have been saved through measles immunizations. However, reported cases increased by more than 30 percent worldwide from 2016.
The Americas, the Eastern Mediterranean Region, and Europe experienced the greatest upsurges in cases in 2017, with the Western Pacific the only World Health Organization (WHO) region where measles incidence fell.
She said, “Without urgent efforts to increase vaccination coverage and identify populations with unacceptable levels of under-, or unimmunized children, we risk losing decades of progress in protecting children and communities against this devastating, but entirely preventable disease.”
The disease is preventable through two doses of a safe and effective vaccine. For several years, however, global coverage with the first dose of measles vaccine has stalled at 85 percent. This is far short of the 95 percent needed to prevent outbreaks, and leaves many people, in many communities, susceptible to the disease. Second dose coverage stands at 67 percent.
“The increase in measles cases is deeply concerning, but not surprising,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “Complacency about the disease and the spread of falsehoods about the vaccine in Europe, a collapsing health system in Venezuela and pockets of fragility and low immunization coverage in Africa are combining to bring about a global resurgence of measles after years of progress. Existing strategies need to change: more effort needs to go into increasing routine immunization coverage and strengthening health systems. Otherwise, we will continue chasing one outbreak after another.”
Responding to the recent outbreaks, health agencies are calling for sustained investment in immunization systems, alongside efforts to strengthen routine vaccination services. These efforts must focus especially on reaching the poorest, most marginalized communities, including people affected by conflict and displacement.
The agencies also call for actions to build broad-based public support for immunizations while tackling misinformation and hesitancy around vaccines where these exist.
“Sustained investments are needed to strengthen immunization service delivery and to use every opportunity for delivering vaccines to those who need them,” said Dr Robert Linkins, Branch Chief of Accelerated Disease Control and Vaccine Preventable Disease Surveillance at the U.S. Centers for Disease Control and Prevention (CDC) and Measles & Rubella Initiative Management Team Chair.
The Measles and Rubella Initiative is a partnership formed in 2001 of the American Red Cross, CDC, the United Nations Foundation, UNICEF, and WHO.
Measles elimination is defined as the absence of endemic measles virus transmission in a region or other defined geographical area for more than 12 months. Conversely, a country is no longer considered to be measles free if the virus returns and transmission is sustained continuously for more than a year.
Measles is a highly contagious, serious disease caused by a virus. Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every 2–3 years and measles caused an estimated 2.6 million deaths each year.
Approximately 110 000 people died from measles in 2017 – mostly children under the age of 5 years, despite the availability of a safe and effective vaccine.
Measles is caused by a virus in the paramyxovirus family and it is normally passed through direct contact and through the air. The virus infects the respiratory tract, then spreads throughout the body. Measles is a human disease and is not known to occur in animals. Accelerated immunization activities have had a major impact on reducing measles deaths. During 2000– 2017, measles vaccination prevented an estimated 21.1 million deaths. Global measles deaths have decreased by 80% from an estimated 545 000 in 2000 to 110 000 in 2017.
The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about 3 days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days).
Most measles-related deaths are caused by complications associated with the disease. Serious complications are more common in children under the age of 5, or adults over the age of 30. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.
Unvaccinated young children are at highest risk of measles and its complications, including death. Unvaccinated pregnant women are also at risk. Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.
Measles is still common in many developing countries – particularly in parts of Africa and Asia. The overwhelming majority (more than 95%) of measles deaths occur in countries with low per capita incomes and weak health infrastructures.
Measles outbreaks can be particularly deadly in countries experiencing or recovering from a natural disaster or conflict. Damage to health infrastructure and health services interrupts routine immunization, and overcrowding in residential camps greatly increases the risk of infection.
Measles is one of the world’s most contagious diseases. It is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions.
The virus remains active and contagious in the air or on infected surfaces for up to 2 hours. It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts.
Measles outbreaks can result in epidemics that cause many deaths, especially among young, malnourished children. In countries where measles has been largely eliminated, cases imported from other countries remain an important source of infection.
No specific antiviral treatment exists for measles virus.
The measles vaccine is often incorporated with rubella and/or mumps vaccines. It is equally safe and effective in the single or combined form. Adding rubella to measles vaccine increases the cost only slightly, and allows for shared delivery and administration costs.
In 2017, about 85% of the world's children received 1 dose of measles vaccine by their first birthday through routine health services – up from 72% in 2000. Two doses of the vaccine are recommended to ensure immunity and prevent outbreaks, as about 15% of vaccinated children fail to develop immunity from the first dose. In 2017, 67% of children received the second dose of the measles vaccine.
Of the estimated 20.8 million infants not vaccinated with at least one dose of measles vaccine through routine immunization in 2017, about 8.1 million were in 3 countries: India, Nigeria, and Pakistan
But without sustained attention, hard-fought gains can easily be lost. Where children are unvaccinated, outbreaks occur. Because of low coverage nationally or in pockets, multiple regions were hit with large measles outbreaks in 2017, causing many deaths. Based on current trends of measles vaccination coverage and incidence, the WHO Strategic Advisory Group of Experts on Immunization (SAGE) concluded that measles elimination is greatly under threat, and the disease has resurged in a number of countries that had achieved or were close to achieving, elimination.
WHO continues to strengthen the global laboratory network to ensure timely diagnosis of measles and track the international spread of the measles viruses to allow more coordinated country approach in targeting vaccination activities and reduce measles deaths from this vaccine-preventable disease.
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