Sun. Oct 2nd, 2022
A baby with measles hospitalized in the Philippines after an outbreak after Typhoon Haiyan in 2013.
enlarge / A baby with measles hospitalized in the Philippines after an outbreak after Typhoon Haiyan in 2013.

In 2010, the World Health Organization (WHO) set a number of ambitious goals for the control of measles worldwide. By 2015, they wanted to reduce the number of deaths from measles by 95 percent compared to 2000. They set equally ambitious goals for vaccination coverage and measles infections.

The world has not achieved these goals. And between 2016 and 2017, there was an alarming rise in measles cases worldwide, according to a joint report from the WHO and CDC. “Complacency about the disease and the spread of vaccine falsehoods in Europe, a collapsing health system in Venezuela, and vulnerabilities and low vaccination coverage in Africa are all driving a global measles resurgence after years of progress,” he said. dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance, in a statement on the report.

Overall, much progress has been made between 2000 and 2017: annual global deaths fell by 80 percent, from 545,174 to 109,638. During this period, measles vaccination has prevented approximately 21 million deaths worldwide, compared to a hypothetical world without measles vaccines (in this world the death rate would have been much higher in 2000 as well). The number of reported cases per year plummeted from 145 cases per million people to just 25, although the target was five cases per million. And 85 percent of people worldwide had received their first dose of the measles vaccine in 2017, compared to 72 percent in 2000.

That 85 percent is good, but lower than the 95 percent needed to create herd immunity — a vaccination rate in a population so high that the virus is unlikely to infect anyone, preventing it from spreading through -vaccinated people and people with compromised immune systems. The rate has “stalled for nearly a decade,” the report’s authors write. Meanwhile, global coverage of the critical second dose of the vaccine is just 67 percent.

In 2000, 169 countries reported the number of registered measles cases, and only 38 percent of those countries reported a rate consistent with the WHO target of 5 cases (or less) per million people. By 2016, that goal had been met by 69 percent of the 176 countries that reported their data. But in 2017, it fell to 65 percent of the 184 reporting countries.

Part of that dip can be explained by the eight additional countries that have reported their data, the authors of the report write. But that doesn’t fully explain the 31 percent increase in reported cases worldwide. The only region with a declining infection rate in 2017 was the Western Pacific (including Cambodia, Fiji, Micronesia and others), while Europe rates more than quadrupled, and in the Americas rates were more than 64 times higher.

Much of the increase in the Americas is caused by an ongoing outbreak in Venezuela, where the virus has now made a comeback as a fixture. This has also led to outbreaks in neighboring countries. The researchers are concerned about a similar situation in Europe, where measles may also have gone beyond rare outbreaks and re-established itself.

There is, of course, uncertainty in these findings — they’re based on reporting chains with many possible links, and comparisons between different countries and regions can be difficult to interpret, the authors note. But the slow progress and new outbreaks, they write, “highlight the fragility of the gains made in global and regional measles eradication.”

Weekly report on morbidity and mortality2018. DOI: 10.15585/mmwr.mm6747a6 (About DOIs).

By akfire1

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