ELLY GRIMM • Leader & Times
Measles is a highly contagious disease caused by a virus and spreads easily when an infected person breathes, coughs or sneezes. It can cause severe disease, complications, and even death. Measles can affect anyone but is most common in children, according to the World Health Organization, and infects the respiratory tract and then spreads throughout the body. Symptoms include a high fever, cough, runny nose and a rash all over the body.
According to a recent release from the Centers for Disease Control (CDC), following years of declines in measles vaccination coverage, measles cases in 2022 have increased by 18 percent, and deaths have increased by 43 percent globally (compared to 2021). This takes the estimated number of measles cases to 9 million and deaths to 136,000 – mostly among children – according to a new report from the WHO and the CDC.
“Measles continues to pose a relentlessly increasing threat to children. In 2022, 37 countries experienced large or disruptive outbreaks compared with 22 countries in 2021. Of the countries experiencing outbreaks, 28 were in the WHO Region for Africa, six in the Eastern Mediterranean, two in Southeast Asia, and one in the European Region,” the CDC release noted.
“The increase in measles outbreaks and deaths is staggering, but unfortunately, not unexpected given the declining vaccination rates we’ve seen in the past few years,” John Vertefeuille, director of CDC’s Global Immunization Division, noted in the CDC release. “Measles cases anywhere pose a risk to all countries and communities where people are under-vaccinated. Urgent, targeted efforts are critical to prevent measles disease and deaths. Measles is preventable with two doses of measles vaccine. While a modest increase in global vaccination coverage occurred in 2022 from 2021, there were still 33 million children who missed a measles vaccine dose: nearly 22 million missed their first dose and an additional 11 million missed their second dose. The global vaccine coverage rate of the first dose, at 83 percent, and second dose, at 74 percent, were still well under the 95 percent coverage with the two doses necessary to protect communities from outbreaks.”
Low-income countries, where the risk of death from measles is highest, continue to have the lowest vaccination rates at only 66 percent, a rate that shows no recovery at all from the backsliding during the pandemic. Of the 22 million children who missed their first measles vaccine dose in 2022, over half live in just 10 countries: Angola, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Madagascar, Nigeria, Pakistan, and Philippines
“The lack of recovery in measles vaccine coverage in low-income countries following the pandemic is an alarm bell for action. Measles is called the inequity virus for good reason. It is the disease that will find and attack those who aren’t protected,” Kate O’Brien, WHO Director for Immunization, Vaccine and Biologicals, noted in the CDC release. “Children everywhere have the right to be protected by the lifesaving measles vaccine, no matter where they live.“
The CDC and WHO urge countries to find and vaccinate all children against measles and other vaccine-preventable diseases and encourage global stakeholders to aid countries to vaccinate their most vulnerable communities. In addition, to help prevent outbreaks, all global health partners at the global, regional, national, and local levels must invest in robust surveillance systems and outbreak response capacity to rapidly detect and respond to outbreaks.
The WHO also talked about transmission and treatment.
“Measles is one of the world’s most contagious diseases, spread by contact with infected nasal or throat secretions (coughing or sneezing) or breathing the air that was breathed by someone with measles. The virus remains active and contagious in the air or on infected surfaces for up to two hours,” the WHO noted. “For this reason, it is very infectious, and one person infected by measles can infect nine out of 10 of their unvaccinated close contacts. It can be transmitted by an infected person from four days prior to the onset of the rash to four days after the rash erupts. Measles outbreaks can result in severe complications and deaths, especially among young, malnourished children. In countries close to measles elimination, cases imported from other countries remain an important source of infection. There is no specific treatment for measles. Caregiving should focus on relieving symptoms, making the person comfortable and preventing complications. Drinking enough water and treatments for dehydration can replace fluids lost to diarrhoea or vomiting. Eating a healthy diet is also important. Doctors may use antibiotics to treat pneumonia and ear and eye infections. All children or adults with measles should receive two doses of vitamin A supplements, given 24 hours apart. This restores low vitamin A levels that occur even in well-nourished children. It can help prevent eye damage and blindness. Vitamin A supplements may also reduce the number of measles deaths.”
The WHO also talked about prevention.
“Community-wide vaccination is the most effective way to prevent measles. All children should be vaccinated against measles. The vaccine is safe, effective and inexpensive. Children should receive two doses of the vaccine to ensure they are immune. The first dose is usually given at 9 months of age in countries where measles is common and 12 to 15 months in other countries. A second dose should be given later in childhood, usually at 15 to 18 months. The measles vaccine is given alone or often combined with vaccines for mumps, rubella and/or varicella. Routine measles vaccination, combined with mass immunization campaigns in countries with high case rates are crucial for reducing global measles deaths. The measles vaccine has been in use for about 60 years and costs less than US$ 1 per child. The measles vaccine is also used in emergencies to stop outbreaks from spreading. The risk of measles outbreaks is particularly high amongst refugees, who should be vaccinated as soon as possible. Combining vaccines slightly increases the cost but allows for shared delivery and administration costs and importantly, adds the benefit of protection against rubella, the most common vaccine preventable infection that can infect babies in the womb.”