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Deaths from measles worldwide hit their highest level in 23 years last year, according to a report released Thursday, a staggering increase in a vaccine-preventable disease that public health experts fear. it is only getting worse as the coronavirus pandemic continues to disrupt vaccination and detection efforts. .
The global death toll for 2019 – 207,500 – was 50% higher than three years earlier, according to the analysis, published jointly by the World Health Organization and the Centers for Disease Control and Prevention. No measles-related deaths have been reported in the United States, but measles cases in the country have reached an annual record of 1,282 in 31 states, the most since 1992, according to figures updated earlier this this month. As of 2012, the US case number was 55.
Public health experts said the spike in numbers was the result of years of insufficient vaccination coverage. They fear the pandemic will worsen the spread of measles, an even more contagious disease than Covid-19.
“We are concerned that there are new gaps in the opening of immunity due to Covid in addition to those that already existed,” said Dr Natasha Crowcroft, senior technical advisor for measles and rubella at the ‘WHO. “We cannot continue in the same way and expect a different outcome,” she added, calling for more resources and creative applications.
Although reported measles cases so far have been lower this year, public health experts are keeping those numbers at bay. They fear such numbers could be a drastic undercount, due to the pandemic’s global disruptions in healthcare, reducing detection and medical care for measles – as well as prevention efforts.
Measles outbreaks have already occurred this year in at least half of the 26 countries that have had to suspend immunization campaigns due to the pandemic. As of this month 94 million people are at risk of running out of measles vaccines, WHO says While measles cases can indeed be somewhat suppressed as a side effect of precautions to prevent the spread coronavirus, experts say that at best, the current low numbers represent only a temporary lull.
Details of the international measles outbreaks have been reported by the Measles and Rubella Initiative, an international consortium that includes the WHO and CDC as well as the American Red Cross and the United Nations Foundation. The group highlighted the grim figures to reinforce its message: that vaccination efforts must persist, especially during the pandemic, when health care resources are depleted.
As a positive example, public health officials cite Ethiopia, which has lagged behind many countries on its measles vaccination rate. In collaboration with the CDC and other organizations, Ethiopia implemented a vaccination campaign in June that included more protective gear for health workers and scheduled and socially distant appointments, and reached 14.5 million children.
International epidemiologists compare last year’s measles eruption to a slow-growing wildfire that eventually exploded. For a decade, vaccination rates around the world have stagnated, ensuring good coverage in many regions, but still not reaching the high percentage needed to stop the contagion. Many outbreaks, including 25 in the United States last year, have been triggered by travelers from other countries.
Of 184 reporting countries, nine accounted for 73% of cases in 2019: Central African Republic, Democratic Republic of the Congo, Georgia, Kazakhstan, Madagascar, North Macedonia, Samoa, Tonga and Ukraine.
In addition to low-income countries heavily affected by measles, public health experts noted with concern that middle-income countries such as Ukraine, North Macedonia, Georgia and Kazakhstan now feature prominently on the list. the list of the most affected. Alarmingly, the number of ‘zero dose’ children – those who had not received any vaccines – is starting to rise again, with middle income countries including Brazil, Mexico and the Philippines accounting for 9.5 million, or 69%, of this total.
Growing skepticism about the safety of vaccines worldwide has contributed to the decline in vaccination rates. But also, said Dr Robin Nandy, head of immunization for UNICEF: “There was an increasing amount of complacency and accelerator taking in some high coverage countries.
At the same time, he added, “we are still missing a large proportion of children in areas beyond the reach of health services – in rural areas, in urban slums or where there is conflict. armed.”
Much of the effort to eliminate measles boils down to a decades-long history involving the coordination of teams from the world’s richest cities and its poorest outposts. Indeed, from 2010 to 2016, measles-related cases and deaths had fallen to 18 cases per million people.
But at the same time, immunization coverage has started to stagnate. To avoid a measles epidemic, 95% of the population must receive two measles vaccines. But since 2010, rates for the first vaccine, ideally given when a child is about a year old, have hovered at a global average of around 85%; while full coverage for the second stroke, typically administered between ages 4 and 6, has increased, it is now only 71%.
And every day babies are born. The cumulative number of unvaccinated or under-vaccinated frames. In 2019, reported cases worldwide were 120 per million.
“What’s scary now is that our essential public health workers have been refocused on diagnosing, testing and reporting suspected cases of Covid-19 measles,” said Robb Linkins, CDC epidemiologist who chairs the management team of the Measles and Rubella Initiative. “With measles,” he says, “you have to be relentless.
The measles death rate in high-income countries like the United States is practically zero because general health is already good and the health care system is robust. But the high number of measles deaths last year around the world is a terrible testament to poor healthcare as well as under-vaccination, Dr Linkins said.
“I find it hard to believe that children are dying from a disease for which we have had a great vaccine for 50 years.
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