Measles outbreaks continue to spread rapidly around the world, according to the latest preliminary reports provided to the World Health Organization (WHO), with millions of people globally at risk of the disease.
In the first six months of 2019, reported measles cases are the highest they have been in any year since 2006, with outbreaks straining health care systems, and leading to serious illness, disability, and deaths in many parts of the world. There have been almost three times as many cases reported to date in 2019 as there were at this same time last year.
This follows successive yearly increases since 2016, indicating a concerning and continuing upsurge in the overall measles burden worldwide.
The Democratic Republic of the Congo, Madagascar and Ukraine have reported the highest numbers of cases this year. However, cases have dramatically decreased in Madagascar in the past several months as a result of nationwide emergency measles vaccine campaigns, highlighting how effective vaccination is in ending outbreaks and protecting health.
Major outbreaks are ongoing in Angola, Cameroon, Chad, Kazakhstan, Nigeria, Philippines, South Sudan, Sudan and Thailand.
The largest outbreaks are in countries with low measles vaccination coverage, currently or in the past, which has left large numbers of people vulnerable to the disease. At the same time, protracted outbreaks are occurring even in countries with high national vaccination rates. This results from inequities in vaccine coverage, and gaps and disparities between communities, geographic areas, and among age-groups. When enough people who are not immune are exposed to measles, it can very quickly spread.
The United States has reported its highest measles case count in 25 years. In the WHO European region, there have been close to 90,000 cases reported for the first six months of this year: this exceeds those recorded for the whole of 2018 (84 462) already the highest in this current decade.
The reasons for people not being vaccinated vary significantly between communities and countries including lack of access to quality healthcare or vaccination services, conflict and displacement, misinformation about vaccines, or low awareness about the need to vaccinate. In a number of countries, measles is spreading among older children, youth and adults who have missed out on vaccination in the past.
With governments and partners such as the Measles & Rubella Initiative, Gavi, the Vaccine Alliance and others, WHO is helping countries stop outbreaks, strengthen health services, and increase essential vaccination coverage.
Measles is almost entirely preventable with two doses of measles vaccine, a safe and highly effective vaccine. High rates of vaccination coverage 95 per cent nationally and within communities – are needed to ensure that measles is unable to spread.
According to WHO and UNICEF coverage data released in July 2019, 86 per cent children have received the first dose of measles vaccine and 69 per cent the second. This means that around 20 million children in 2018 received no measles vaccine through their routine vaccination programmes. Furthermore, 23 countries have yet to introduce the second measles vaccine dose into their national schedule.
WHO is urging everyone to ensure their measles vaccinations are up to date, with two doses needed to protect against the disease, and to check their vaccination status prior to travel.
According to its latest travel recommendations, everyone 6 months and older should be protected against measles prior to travel to an area where measles is circulating. Anyone unsure of their vaccination status should consult with their healthcare provider. WHO recommends that travelers get vaccinated against measles at least 15 days prior to travel.