Report: Measles spike triggered by vaccination gaps

Young boy with measles
Young boy with measles

Teseum / Flickr cc

In the most comprehensive estimate of measles trends that covers the last 17 years of data, health groups said today that illness reports surged in 2017, reflecting severe and long outbreaks in many countries, along with gaps in vaccine coverage.

Outbreaks touched all regions of the world, and researchers estimated that measles caused about 110,000 deaths in 2017.

In the United States this year, Kansas City, Mo., reported two measles clusters, and parts of New Jersey and New York are currently experiencing measles outbreaks linked to people infected during overseas travel.

Researchers from the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) published their findings today in Morbidity and Mortality Weekly Report and the WHO Weekly Epidemiological Record.

In a statement today, Soumya Swaminathan, MBBS, MD, deputy director-general for programs at the WHO said measles resurgence is concerning, especially in countries that had achieved or were close to achieving measles elimination.

"Without urgent efforts to increase vaccination coverage and identify populations with unacceptable levels of under-, or unimmunized children, we risk losing decades of progress in protecting children and communities against this devastating, but entirely preventable disease," she said.

Vaccines saved an estimated 21 million

Using updated modeling data, the group estimates that since 2000, measles immunization has saved more than 21 million lives. However, since 2016, illness reports have increased by more than 30%.

Regions that experienced the greatest spikes in 2017 include the Americas, the Eastern Mediterranean region, and Europe. The only WHO region in which measles cases dropped was the Western Pacific.

As of July, measles has become endemic again in Venezuela, sparking imported cases and outbreaks in bordering countries. The report also says measles resurgence in Europe has probably reestablished endemic transmission in some of the region's countries.

"These outbreaks highlight the fragility of gains made toward global and regional measles elimination goals," the group wrote.

According to the report, global coverage for the first of two measles doses has stalled at 85%, which the authors say is far short of the 95% level needed to prevent outbreaks. Second-dose coverage is much lower at 67%.

Complacency, vaccine misinformation fuel increase

Seth Berkley, MD, chief executive officer of Gavi, the Vaccine Alliance, said in the WHO statement that the increase is deeply concerning but not surprising. He said complacency, the spread of falsehoods about the vaccine in Europe, Venezuela's collapsing health system, and pockets of fragility and low vaccine coverage in Africa have combined to trigger a global resurgence after years of progress.

"Existing strategies need to change: more effort needs to go into increasing routine immunization coverage and strengthening health systems. Otherwise we will continue chasing one outbreak after another," he said.

In their report, the authors call for investments in immunization systems combined with efforts to strengthen routine immunization, especially targeting the poorest, most marginalized communities, including those struggling with conflict and displacement.

They also said actions to bring down measles levels need to address misinformation and hesitancy about vaccines.

See also:

Nov 29 MMWR report

Nov 29 WHO statement

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