an epidemic that is gaining the world over

State of emergency in a suburb of New York, outbreak of cases in Ukraine, deadly epidemic in Madagascar … Preventable but potentially fatal disease, measles resurfaces all over the world, because of a mistrust of vaccines or poor access to care.

. What is measles?

It is a highly contagious viral disease, more than Ebola or the flu, and for which there is no cure.

It affects mostly children, but not only. The virus, which spreads when patients are coughing or sneezing, remains active for two hours.

The disease is manifested by a high fever and then a plaque eruption. It is contagious four days before and after this eruption.

Often benign, however, it can cause serious complications, respiratory (pulmonary infections) and neurological (encephalitis), especially in fragile people.

The global health authorities stress the importance of the vaccine, individually but also collectively: a high immunization coverage (95% of the population) protects people who can not themselves be vaccinated, especially because their immune system is weakened ( leukemia, anti-rejection treatment after a transplant …).

. Global alert

The World Health Organization (WHO) and UNICEF have warned of a resurgence of the disease.

WHO has seen a leap of about 50 percent of the cases reported last year compared to 2017, which killed 136,000 people worldwide.

Until 2016, however, the disease was decreasing.

According to Unicef, 98 countries reported more cases in 2018 than in 2017. Ten, including Ukraine, Brazil and France, account for three-quarters of the total increase.

In Ukraine, where the biggest rise occurred, 35,000 cases were recorded in 2018, 30,000 more than in 2017. And for the first two months of 2019, we are already at 24,000.

. Vaccine: the hint of life

In rich countries, this increase is largely attributed to mistrust of vaccines in general and MMR (measles / mumps / rubella) in particular.

The "anti-vax" is based on a 1998 publication linking this vaccine and autism. However, it was established that its author, the British Andrew Wakefield, had falsified his results, and several studies have since shown that the vaccine does not increase the risk of autism.

Mistrust can also have religious motives.

Stricken by a measles epidemic, a county in northern New York on Tuesday decided to declare a state of emergency and banish all unvaccinated minors from public places. The most affected neighborhoods are those with a high Jewish Orthodox population.

"It makes me angry to see that in the case of measles, we have the tools to prevent but they are not used enough," says AFP Françoise Barré-Sinoussi, Nobel Prize for Medicine 2008 for the codecovery of the AIDS virus. Because the AIDS vaccine is the Grail after which world research has been going on for years.

. Problems of access to care

According to the WHO, "the main reason" for inadequate immunization of children is that those "who need it most (do not) have access". In question: failing health systems in poor countries.

This is the case in Madagascar where, according to Unicef, 77,000 people contracted measles between September and February. More than 900 have died, mostly children.

Unicef ​​and WHO have supported a vaccination campaign for 11.5 million children in February in Yemen, where several years of conflict has led to an epidemic.

And in Venezuela, devastated by an economic crisis that has led to a shortage of medicines, thousands of cases have emerged in recent months.

. Measles, export product

"When measles appears in one country, it is likely that it will have repercussions in others because people travel a lot," says AFP Daniel Lévy-Bruhl, head of immunization at the French health agency Public Health France.

At the end of February, a French family with measles had been placed in isolation in Costa Rica, where she was staying.

The authorities feared that it would cause an epidemic in this country, which registered its last indigenous case in 2006 and is pursuing a free vaccination campaign.

And according to Dr. Levy-Bruhl, the epidemic affecting the ultra-orthodox Jewish community in the New York area began in Israel before being exported to the United States.