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While the number of measles cases in the United States continues to climb this year – exceeding 1,000 cases reported so far – the country risks losing its "elimination status," officials said. of health.
But what exactly does it mean to have eliminated measles, and when will measles no longer be considered "eliminated" in the United States?
On Wednesday, June 5th, the Centers for Disease Control and Prevention (CDC) announced that 1,001 cases of measles have been reported in the United States since the beginning of the year. This is the highest number of measles cases reported since 1992. The largest epidemics occur in New York, with 566 cases reported, and in Rockland County, New York, with 256 cases reported since October around. .
Measles was declared eliminated in the United States in 2000. The elimination of measles does not mean that there is no case of the disease in a country, said Dr. Amesh Adalja, an academic at the Security Center Johns Hopkins sanitary facility in Baltimore. It means rather that there is no "native" transmission of the disease. In other words, all the measles outbreaks that have occurred since 2000 originate in forge countries, and have not lasted very long – in particular, they lasted less than a year, he said. [27 Devastating Infectious Diseases]
But if the chain of transmission of measles continues for at least a year, the disease is no longer considered eliminated. This would mean that if epidemics in New York continued until the fall, until October, the United States would be removed from the list of countries where measles is eliminated, said Adalja.
This result is now a real possibility. "It is very likely that the United States will lose its status of measles elimination" in the fall, Adalja told Live Science.
Dr. William Schaffner, an infectious disease specialist at the Vanderbilt University Medical Center in Nashville, Tennessee, nodded. "At the rate that the measles outbreak is continuing in the United States, I think we risk losing our measles elimination status this year," Schaffner said.
Adalja noted, however, that measles transmission tends to slow down during the summer months and "hope this will reduce the rate of spread of this disease".
But with each new information from health officials announcing more cases of measles, "it is less and less likely" that the epidemic will be stopped in time, said Adalja.
If the US loses its elimination status, it would be "a huge step backward" and "embarrbadment" for the country, said Adalja. "All public health efforts to enable us to achieve this elimination status would be fundamentally almost futile," he said.
The return of measles to the United States could also be a blow to international efforts to eliminate the disease. "I think it would hold back the determination of the world" to continue the elimination of measles, Schaffner said.
And the fact that the United States has eliminated measles once does not mean it would be easy to do it again. Adalja noted that at the time of measles elimination in 2000, the crop was much more receptive to the science of vaccines. With the rise of the anti-vaccine movement, "it may be difficult to replicate what has been accomplished" in previous years, he said.
To requalify for status eliminated after losing, the United States should show that there has been no sustained transmission of measles in the country for at least a year.
The disease can lead to serious complications: about 1 in 4 people with measles have to be hospitalized, 1 in 20 pneumonia, 1 brain swelling can cause brain damage, and about 1 to 2 in 1,000 people die from it. the disease, according to the CDC.
And even without complications, the disease can be a "very unpleasant experience," said Schaffner. "It saddens me that so many children have been affected by measles this year," he said. "Why should they have to go through this?"
Measles is a highly contagious disease and a high vaccination coverage – over 90% – is needed in one region to prevent the spread of measles and end epidemics, Schaffner said. The current epidemic is spreading mainly in sensitive communities where pockets of unvaccinated people are found.
The stopping of the outbreak will require increased immunization coverage in these areas. However, for people who are hesitant about vaccines, telling them the facts about vaccine safety is usually not enough to convince them, Schaffner said. "The facts are cold."
Instead, doctors should be willing to discuss the concerns of these people and work with community leaders, who in turn help educate members about the need and social acceptability of vaccines, Schaffner said. . "It will not happen overnight," he said. "It takes time and effort, and a maintenance issue … we have to keep working [it]. "
Originally published on Science live.
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