According to WHO and UNICEF, the global increase in measles cases can potentially lead to a serious outbreak in children.
In a recent news release, the World Health Organization (WHO) and UNICEF reported a 79% increase in global measles cases in 2022. According to health authorities, the world reported more than 17,000 cases in January and February of this year. However, during the same period in 2021 only 9,600 measles cases were reported. Thus, raising the risk of a global measles outbreak.
As of April 2022, 21 large and disruptive measles outbreaks have occurred around the world in the last 12 months. Africa and the East Mediterranean regions reported the majority of these cases. Recently, the WHO took notice of a measles outbreak in Somalia where a total of 3509 cases occurred between January and March 2022. Moreover, the country recorded the highest number of measles cases in the past 12 months – more than 9,000. While Yemen, Nigeria, Afghanistan, and Ethiopia followed behind.
According to the WHO-UNICEF national estimates of immunization coverage, for the last 10 years, Somalia’s vaccine uptake was just 46%. However, health experts state at least 95% is required to prevent the spread of disease in a region. The high rate of malnutrition and vitamin A deficiency among children in the affected countries further increases the risk of complications and death from measles.
Moreover, countries such as Somalia, Yemen, and Afghanistan are areas of conflict. In armed conflict, there is often destruction of medical facilities, killing of healthcare professionals, displacement of people, and obstruction of humanitarian access. All these pose a barrier to vaccination campaigns and result in suboptimal vaccine coverage; thus, leading to outbreaks.
Most Contagious Vaccine-Preventable Disease
Caused by the measles virus, the highly contagious disease spreads via direct contact with infected persons, inhaling infected droplets, or through contaminated surfaces. Once inside, the virus infects the respiratory system resulting in a high fever, cough, runny nose, and conjunctivitis. Moreover, about 3-5 days later, small red spots begin to appear all over the face and then later the rest of the body. This is the characteristic rash of measles and lasts for five to six days. In immunocompromised individuals, the disease can also result in several complications such as ear infections, blindness, severe diarrhoea, pneumonia, encephalitis, and seizures.
Thanks to vaccines the mortality rate has significantly decreased over the years. However, in countries with malnutrition and poor access to health care, the disease is responsible for more than 100,000 deaths. Most of these deaths occur in children under the age of 5 years.
There is currently no specific treatment for the disease and care is mostly supportive. Children are often administered vitamin A drops to reduce the severity of measles and prevent blindness. Vaccination remains the most effective solution to prevent the disease. The WHO recommends that children in endemic countries receive two doses of the measles vaccine, at six and nine months of age. Between 2000 and 2017, routine vaccination campaigns helped cause an 80% reduction in deaths from measles. Thus, emphasizing the importance of vaccination in controlling outbreaks.
The ‘Perfect Storm’ for a Measles Outbreak
During the beginning of the pandemic, countries across the world implemented strict lockdown restrictions. Coupled with other preventive measures such as regular handwashing and wearing masks, this resulted in a reduction in global cases of other infectious diseases such as the flu and respiratory syncytial virus (RSV). However, as COVID-19 cases began to decline, countries began relaxing these restrictions. Thus, causing a rise in cases of RSV, flu, and even co-infections with COVID.
Although vaccines are highly effective at controlling measles, the COVID-19 pandemic also caused disruptions to routine immunizations of non-COVID diseases. According to recent stats, 23 million children did not receive basic childhood vaccines in 2020. Whereas, in 2019 only 3.7 million children missed out. Thus, creating what health experts say is the ‘perfect storm’ for a global measles outbreak.
Along with vaccine disruptions, the pandemic also highly saturated the healthcare staff at facilities and diverted sources from other deadly diseases. Moreover, many people also faced inequal access to routine immunizations. Thus, leaving too many children and adults without life-saving vaccines.
The WHO reports that as of April 2022, 57 vaccine-preventable disease campaigns in across 43 countries are still postponed due to the pandemic. Out of these 19 are measles campaigns that could have protected 73 million children at risk of measles. In countries such as Ukraine, war and COVID have further interrupted vaccine campaigns.
However, measles is not the only infectious disease that has scientists worried. The WHO believes that more preventable diseases will likely resurface due to these disruptions.