Worldwide more than 140,000 people died from measles in 2018, according to new estimates from the World Health Organization (WHO) and the United States Centers for Diseases Control and Prevention (CDC). These deaths occurred as measles cases surged globally, amidst devastating outbreaks in all regions.
“Our finding is that in 2018 there has been an increase in both the cases and the deaths that have occurred from measles, in other words we are backsliding,” said Dr Kate O’Brien, Director of the WHOs Department of Immunization, Vaccines & Biologicals.
Most deaths were among children under 5 years of age. Babies and very young children are at greatest risk from measles infections, with potential complications including pneumonia and encephalitis (a swelling of the brain), as well as lifelong disability – permanent brain damage, blindness or hearing loss.
Recently published evidence shows that contracting the measles virus can have further long-term health impacts, with the virus damaging the immune system’s memory for months or even years following infection. This ‘immune amnesia’ leaves survivors vulnerable to other potentially deadly diseases, like influenza or severe diarrhea, by harming the body’s immune defenses.
Measles is preventable through vaccination. However, vaccination rates globally have stagnated for almost a decade. WHO and UNICEF estimate that 86% of children globally received the first dose of measles vaccine through their country’s routine vaccination services in 2018, and fewer than 70% received the second recommended dose.
Worldwide, coverage with measles vaccine is not adequate to prevent outbreaks. WHO recommends that 95% vaccination coverage with two doses of measles vaccine is needed in each country and all communities to protect populations from the disease.
Poorest countries hardest hit but measles remains a staggering global challenge
Estimating the total number of cases and deaths globally and by region, the report finds that the worst impacts of measles were in sub-Saharan Africa, where many children have persistently missed out on vaccination.
In 2018, the most affected countries – the countries with the highest incidence rate of the disease – were Democratic Republic of the Congo (DRC), Liberia, Madagascar, Somalia, and Ukraine. These five countries accounted for almost half of all measles cases worldwide.
While the greatest effects have been in the poorest countries, some wealthier countries have also been battling measles outbreaks, with significant ramifications for people’s health.
This year, the United States reported its highest number of cases in 25 years, while four countries in Europe – Albania, Czechia, Greece, and the United Kingdom – lost their measles elimination status in 2018 following protracted outbreaks of the disease. This happens if measles re-enters a country after it has been declared eliminated and if transmission is sustained continuously in the country for more than a year.
Investment and commitment needed to ensure effective measles response
The Measles & Rubella Initiative (M&RI) – which includes the American Red Cross, CDC, UNICEF, the United Nations Foundation and WHO – as well as Gavi, the Vaccine Alliance, is helping countries respond to measles outbreaks, such as through emergency vaccination campaigns.
In addition to rapidly immunizing against measles, outbreak response also includes efforts to reduce the risk of death through timely treatment, especially for related complications like pneumonia. With partners, WHO is, therefore, providing support to help countries manage cases, including training health workers in effective care for children suffering from the effects of the disease.
Beyond outbreak response, there is an urgent need for countries and the global health community to continue investing in high-quality national immunization programs and disease surveillance, which helps ensure measles outbreaks are rapidly detected and stopped before lives are lost.
Over the last 18 years, measles vaccination alone is estimated to have saved more than 23 million lives.
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