vaccination

Measles Outbreaks Catalysed by Vaccine Hesitancy

The increase in measles, a highly contagious scourge that had been nearly eradicated in many parts of the world, is concerning health officials. In Europe, measles had reached the highest levels in two decades. Experts blame this surge in infections on a drop in the number of people being vaccinated.

Measles is highly infectious and spreads by droplets in coughs and sneezes. The infection lasts from seven to ten days. Although most people recover completely, it can cause some serious complications such as encephalitis, meningitis, febrile convulsions, pneumonia, severe diarrhoea, vision loss or liver infection. Babies and young children with weakened immune systems are particularly vulnerable.

The MMR vaccine (measles, mumps, and rubella vaccine) can prevent infection. Around the world, vaccination has lowered mortality due to measles by 84% from 2000 to 2016, saving approximately 20.4 million lives. Public health officials say at least 95% of a population must have immunity to control the spread of measles. Now, immunization hesitancy is interfering with maintaining a high coverage rate.

Health officials have put the blame for the immunity problem partly on parental neglect and the mistaken belief that vaccines can cause autism and other afflictions.

“Without urgent efforts to increase vaccination coverage and identify populations with unacceptable levels of under or unimmunized children, we risk losing decades of progress,” Dr Soumya Swaminathan, deputy director general for programs at the World Health Organization, said for NY Times.

“Progress Toward Regional Measles Elimination – Worldwide, 2000-2017,” is a joint publication of the World Health Organization and the Centers for Disease Control and Prevention in the United States. The report’s unpleasant finding is that measles outbreaks affected nearly all regions, with the biggest surges in the Americas, the Eastern Mediterranean region and Europe.

The number of officially reported measles cases in 2017 totalled 173,330, the report said. An estimated 110,000 people, mainly children, died from disease symptoms. That is 31% higher than levels in 2016. Still, the number of reported cases last year remained far below the 853,479 reported in 2000.

The measles increase in Latin America was partly attributable to the economic calamity afflicting Venezuela, where many public health services have collapsed. In Europe, the report showed that measles had reached the highest levels in two decades.

“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,” said Dr Seth Berkley, chief executive officer of Gavi, the Vaccine Alliance.

Measles cases in Europe primarily occur in unvaccinated populations. Vaccination coverage is below 95% in most countries. In several European countries, the figure is 85% or less. Large outbreaks with fatalities are on-going in countries that had previously eliminated or interrupted endemic transmission.

European Centre for Disease Prevention and Control (ECDC) monitors the measles outbreaks in the EU/EEA and publishes regularly a monthly update. More than 41,000 people have been infected in the first six months of 2018. According to the WHO, last year there were 23,927 cases and the year before 5,273. The increase is worrisome. For now, 33 deaths have been reported in EU countries.

In Europe, Ukraine and Serbia are among the countries with the highest rates. In EU, on-going outbreaks take place in Romania, France, Greece, and Italy.

“This partial setback demonstrates that every under-immunized person remains vulnerable, no matter where they live and every country must keep pushing to increase coverage and close immunity gaps,” Dr Nedret Emiroglu, from the WHO, said for BBC.

WHO recommend and encourage people to ensure they are up to date with their MMR vaccine before traveling to countries with on-going measles outbreaks, heading to large gatherings such as festivals, or before starting university.

Dr Pauline Paterson, from the London School of Hygiene and Tropical Medicine, emphasized what could be the most important fact.

“With a vaccine preventable disease, one case is one too many, and the numbers of measles cases so far this year is astounding,” she said.

Learn more about what the virus actually does in the body, in the video below:

By Andreja Gregoric, MSc

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