Colombia’s first measles case since 2015 exposes danger across its borders

COLOMBIA has largely prevented war, death and famine from spilling over from Venezuela, its perpetually troubled neighbour, but it may be that it has failed to stop that final apocalyptic scourge – pestilence.

The fourth Horseman of the Apocalypse is more persistent: for Colombian health officials last week announced the country’s first case of measles in years.

Declining vaccination rates in the developed world combined with vulnerable populations displaced from conflict zones ensure that diseases evade eradication.

At a press conference in Medellin, Colombia, Alejandro Gaviria, the health minister, confirmed that an unvaccinated 14-month-old boy who arrived in the city from Caracas is the country’s first measles case since 2015.

Now Colombian authorities are tracking down the 32 people most likely to have been exposed to the boy so that they can be vaccinated

“Fortunately, here in Colombia, we have a relatively calm situation. Our vaccination rates [for measles] are 100 per cent,” Mr Gaviria said.

In 2014, the World Health Organisation (WHO) announced that Colombia was entirely free of measles, however, Venezuela suffered an outbreak in September last year with 34 cases confirmed in its Bolivar region. A report from Venezuelan health groups has warned that at least 1.15 million babies have not been vaccinated since 2007.

Prof Peter Openshaw, the president of the British Society for Immunology told The Daily Telegraph that measles is a particularly virulent disease that can lead to serious complications for some.

“In a population where no one is vaccinated, it is estimated that each person with measles would, on average, pass the infection on to eight other people – an extraordinarily high rate of transmission,” he said.

He added that in England and Wales in 1967, the year before the vaccine was introduced, there were 460,407 cases of measles, but in the past few years, there have only been around 130 cases.

“Herd immunity” is the key to measles vaccination: from 2000 to 2016, it prevented an estimated 20.4 million deaths globally. But there has been a

‘Infectious diseases don’t respect borders. The outbreak of measles is a global problem’

major caveat to this success. February marked two decades since The Lancet, the medical journal, published the now-infamous research paper of Andrew Wakefield, who falsely linked the MMR (measles, mumps and rubella) vaccine to autism.

It was only after investigative journalist Brian Deer thoroughly debunked the claims that Wakefield’s co-authors and the journal retracted the paper.

However, the damage was done. Since the paper’s release, UK families experienced more than 12,000 cases of measles, hundreds of hospitalisations and at least three deaths.

Prof Openshaw warns that under-vaccination threatens to undo decades of work.

“In September 2016, the Americas were the first region in the world to be declared free of measles. This was the culmination of a 22-year effort of mass vaccination costing many millions of dollars,” he said.

“But infectious diseases don’t respect borders. If the vaccination programme breaks down in one country, that makes it much more likely that cases will be imported into another.”

In Boa Vista, the Brazilian city closest to the Venezuelan border, there is an ongoing measles outbreak. As of early March, there were eight confirmed cases – all in children – including one fatality.

Measles is not the only threat. Figures provided to The Daily Telegraph by Colombia’s health ministry show an increasing number of diseases being brought into the country.

From the beginning of 2017 until mid-february 2018, 882 Venezuelans arrived at Colombian health clinics with malaria, 15 with dengue fever, 93 with HIV/AIDS, 52 with tuberculosis and two with diptheria.

One of those patients, a Venezuelan toddler, died of diptheria in January.

Prof Jonathan Ball, a molecular virologist from the University of Nottingham, said this problem was present in conflict zones across the world.

“Any country that has low vaccination rates is prone to outbreaks,” he said. “Due to unrest in conflict zones, vaccine programmes break down and vaccinations just don’t happen.”

Unhelpfully, the manufacturer of the MMR vaccine also recommends the medicine should be kept in a fridge with an uninterrupted power supply – something that’s hard to come by such places as Venezuela, Syria and Yemen.

Prof Openshaw says new outbreaks of measles is “a global problem”. Meanwhile, Colombian authorities continue to be alert, but not alarmed.

“For now, we’re calm but we can’t let our guard down,” Mr Gaviria said.