WHO announces imminent global spread of measles

(ORDO NEWS) — One of the consequences of the COVID-19 pandemic has been the complication of access to routine medical care and the decrease in the level of vaccination against other diseases, in particular from measles (Measles morbillivirus), which is considered long defeated in the developed world.

As a result, in November 2022, the World Health Organization declared measles an “imminent threat in all regions of the world.”

In 2021, a record number of children (nearly 40 million) missed at least one dose of the measles vaccine, according to the WHO.

Measles is a viral respiratory disease. Transmission of the disease is similar to COVID, with spread between people occurring through droplets and aerosols. The infection can cause high fever (up to 40.5 °C), inflammation of the mucous membranes of the mouth and upper respiratory tract, and a characteristic maculopapular skin rash. And severe cases can include encephalitis (swelling of the brain), blindness, and pneumonia.

About nine million cases and 128,000 deaths are recorded annually.

The measles vaccine, which can be given alone or in combination with other vaccines such as mumps, chickenpox, and rubella (collectively referred to as MMR or MMRV), is very effective. Most countries have a two-dose schedule, with the first dose usually given at 12 months of age and the second dose at four to six years of age.

The vaccine provides very high and long-term protection and is an exemplary example of how disease can be prevented through immunization. The two-dose regimen provides approximately 99% protection against measles infection. For those few people who have been vaccinated in two doses and still become infected, the disease should be in a milder form.

In developing countries where vaccine uptake is low, one in ten people with measles dies from it.

In developed countries, the vast majority of deaths occur in unvaccinated people and is approximately one case per 1000-5000 cases of measles. WHO notes that the likelihood of new outbreaks of vaccine-preventable diseases in areas such as conflict zones and among refugees is high.

Measles is incredibly contagious. Its basic reproductive number (R0), that is, the number of people an infected person in a susceptible population would infect on average, is estimated to be between 12 and 18.

For comparison, the R0 of the micron variant of COVID is thought to be “only” about 8.2. The proportion of the population that must be vaccinated to keep outbreaks under control and minimize further transmission of disease in the community is called the herd immunity threshold (HIT). For measles, HIT should account for at least 95% vaccination coverage.

In most of the world, this coverage does not reach such a threshold. The WHO reports that currently global vaccination coverage on the planet is about 71 percent for two doses and 81 percent for one dose.

Significant progress has now been made worldwide in reducing all-cause mortality among children under five years of age. Annual deaths have dropped from 12.5 million in 1990 to 5.2 million in 2019. However, low vaccination coverage could undermine these gains.

Even if children survive measles, there is a possibility of long-term damage to their immune systems, described as a “form of immune amnesia.”

In an unvaccinated population, a severe case of measles resulted in an average loss of 40 percent of the antibodies normally recognized by the microbes. After a mild case of measles, unvaccinated children lost 33 percent of these antibodies.

The immunization of the population is also hindered by the “anti-vaxurers” movement, which has given rise to false rumors and horror stories. The most famous and enduring myth is former physician and anti-vaccination activist Andrew Wakefield’s claim that the MMR vaccine causes autism.

A 2020 US population survey found that 18 percent of respondents mistakenly state that the claim that vaccines cause autism is very or somewhat true.

“Measles spreads easily and is a severe infection in the short and long term among unvaccinated populations. There is a great need for immunization campaigns to increase protection against vaccine-preventable diseases around the world.”

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