Measles: The Point on a New Epidemic
By Blandina Steinhauslin, AILO Florence
What is it?
The virus of measles is part of the paramyxovirus family, meaning viruses that are mainly responsible for causing acute respiratory diseases, like mumps, rubella and others.
Measles spreads through droplets in the air; it is transmitted by coughing and sneezing, and generally close personal contact. It infects the respiratory tract and then spreads into the rest of the body. Measles is exclusively a human disease, since it doesn't affect animals.
The virus is active and contagious for up to 2 hours and can be transmitted from 4 days before to 4 days after the rash occurs. Measles is therefore one of the most contagious diseases.
The disease can cause an epidemic and consequently many deaths, mainly among malnourished children who have had no vaccination against it. We are presently witnessing a resurgence of the disease, even in countries where it seemed to have been eliminated, as it is being imported from countries where the virus is still active.
Effect of the vaccination on the population
The vaccine was introduced in 1963, and a great portion of the world's population was vaccinated, thus dramatically reducing the number of epidemics (which had previously been one every 2-3 years, with the number of total deaths estimated at 2.6 million per year).
In 2000, 72 percent of the world's children received the first dose of the measles vaccine, in 2017, about 85 percent. But it is essential to receive the second dose, since about 15 percent of children who receive the first dose fail to develop immunity. In 2017, 67 percent of children received the second dose of the vaccine.
It is estimated that about 20.8 million infants were not vaccinated in 2017; of these, about 38 percent live in India, Nigeria and Pakistan.
Widespread immunization has reduced the number of deaths caused by measles. It is estimated that global deaths decreased by 80 percent between 2000 and 2017, saving 21.1 million lives.
BUT…..
Updated information says that presently in the US, 23 states are facing the worst outbreak of the measles since 1994. The disease is mainly hitting people who did not receive the recommended two doses of the live measles vaccine. Pity, considering that the virus had not been present in the country since 2000.
So, who gets the disease? The vast majority are unvaccinated children, but up to 10 percent of current patients are adults who received only one dose of the measles-mumps-rubella vaccine.
In Europe the situation is even worse. There has been an increase in the number of vaccinations, and more children than ever before are receiving their two doses. Nevertheless, there are small areas where this doesn't occur, thus leaving unprotected children and adults, and the number of people who contracted measles increased dramatically in 2018.
Some statistics, cases in the last years:
US Europe *
2016 86 5,273
2017 120 25,863
2018 372 82,596 (47 of 53 countries)
2019 940 (as of May 24th)
*The WHO includes the countries of the former USSR in its European Region: http://www.euro.who.int/en/countries
There are several causes for the increase in cases:
- parents who refuse to vaccinate their children
- children who are not given the second dose which confers immunity to the disease
- outbreaks still happen via travelers coming from countries where measles is still common
https://www.cdc.gov/measles/cases-outbreaks.html