The number of cases of measles — one of the world’s most contagious diseases — is climbing, warned the World Health Organisation (WHO), stating that preliminary global data shows that reported cases rose by 300% in the first three months of 2019, compared to the same period in 2018.
In 2017, the most recent year for which estimates are available, it caused close to 1,10,000 deaths. Worse, in recent months, spikes in case numbers have also occurred in countries with high overall vaccination coverage, including the United States of America as well as Israel, Thailand, and Tunisia, as the disease has spread fast among clusters of unvaccinated people.
“Measles has the potential to be extremely severe. Even in high-income countries, complications result in hospitalisation in up to a quarter of cases, and can lead to lifelong disability, from brain damage and blindness to hearing loss,” said WHO.
It added that while data released currently was “provisional and not yet complete, it indicates a clear trend”.
“The actual numbers of cases — captured in global estimates — will also be considerably higher than those reported. We estimate that less than 1 in 10 cases are reported globally, with variations by region. With this as the background to date, 2019 has seen 170 countries report 1,12,163 measles cases to WHO. As of this time last year, there were 28,124 measles cases from 163 countries. Globally, this is almost a 300% increase,” noted WHO. Countries with the most reported cases include Madagascar, Ukraine, India, Nigeria, Kazakhstan, Chad, Myanmar, Thailand, the Philippines and Democratic Republic of the Congo.
India at risk
A senior Health Ministry official said that to “eliminate measles and control rubella, mass [over 95%] immunisation of children is required. In India, measles is still one of the leading causes of death in young children. About 15% of vaccinated children fail to develop immunity from the first dose, meaning that if only 80% are fully immunised, an outbreak is likely. We have to ensure herd immunity to stay ahead of the disease.’’
WHO’s African region has recorded a 700% increase, the region of the Americas 60%, the European region 300%, the Eastern Mediterranean 100% and 40% increases have been observed in South-east Asia and the Western Pacific.
Many countries are in the midst of sizeable measles outbreaks, with all regions of the world experiencing sustained rise in cases. Current outbreaks include those from Democratic Republic of the Congo, Ethiopia, Georgia, Kazakhstan, Kyrgyzstan, Madagascar, Myanmar, Philippines, Sudan, Thailand and Ukraine, causing many deaths — mostly among young children.
The disease is almost entirely 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%. This is still short of the 95% needed to prevent outbreaks, and leaves many people, in many communities, at risk. Second dose coverage, while increasing, stands at 67%.