Worldwide more than 140,000 people died from measles in 2018, according to new estimates from the World Health Organization (WHO) and the United States Centers for Diseases Control and Prevention (CDC). These deaths occurred as measles cases surged globally, amidst devastating outbreaks in all regions.
Estimating the total number of cases and deaths globally and by region, the report finds that the worst impacts of measles were in sub-Saharan Africa, where many children have persistently missed out on vaccination.
In 2018, the most affected countries – the countries with the highest incidence rate of the disease – were Democratic Republic of the Congo (DRC), Liberia, Madagascar, Somalia and Ukraine. These five countries accounted for almost half of all measles cases worldwide.
Most deaths were among children under five years of age. Babies and very young children are at greatest risk from measles infections, with potential complications including pneumonia and encephalitis (a swelling of the brain), as well as lifelong disability – permanent brain damage, blindness or hearing loss.
“We’ve had a safe and effective measles vaccine for over 50 years,” said Dr. Robert Linkins, Branch Chief of Accelerated Disease Control and Vaccine Preventable Disease Surveillance at the CDC and Chair of the Measles & Rubella Initiative. “These estimates remind us that every child, everywhere needs and deserves – this life-saving vaccine. We must turn this trend around and stop these preventable deaths by improving measles vaccine access and coverage.”
While the greatest impacts have been in the poorest countries, some wealthier countries have also been battling measles outbreaks, with significant ramifications for people’s health.
Recently published evidence shows that contracting the measles virus can have further long-term health impacts, with the virus damaging the immune system’s memory for months or even years following infection. This ‘immune amnesia’ leaves survivors vulnerable to other potentially deadly diseases, like influenza or severe diarrhoea, by harming the body’s immune defenses.
“The fact that any child dies from a vaccine-preventable disease like measles is frankly an outrage and a collective failure to protect the world’s most vulnerable children,” said Dr Tedros Adhanom Ghebreysus, Director-General of the World Health Organization. “To save lives, we must ensure everyone can benefit from vaccines – which means investing in immunization and quality health care as a right for all.”
Measles is preventable through vaccination. However, vaccination rates globally have stagnated for almost a decade. WHO and UNICEF estimate that 86 per cent of children globally received the first dose of measles vaccine through their country’s routine vaccination services in 2018, and fewer than 70 per cent received the second recommended dose.
Worldwide, coverage with measles vaccine is not adequate to prevent outbreaks. WHO recommends that 95 per cent vaccination coverage with two doses of measles vaccine is needed in each country and all communities to protect populations from the disease.
In addition to rapidly immunizing against measles, outbreak response also includes efforts to reduce the risk of death through timely treatment, especially for related complications like pneumonia. With partners, WHO is therefore providing support to help countries manage cases, including training health workers in effective care for children suffering the effects of the disease.
“It is a tragedy that the world is seeing a rapid increase in cases and deaths from a disease that is easily preventable with a vaccine,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “While hesitancy and complacency are challenges to overcome, the largest measles outbreaks have hit countries with weak routine immunization and health systems. We must do better at reaching the most vulnerable, and that will be a fundamental focus of Gavi’s next five-year period.”
Over the last 18 years, measles vaccination alone is estimated to have saved more than 23 million lives.