Houston Chronicle

Measles deaths fall to a record low worldwide

- By Donald G. McNeil Jr |

For the first time in history, annual deaths around the globe from measles have fallen below 100,000, the World Health Organizati­on announced this year. As recently as the 1980s, measles killed 2.6 million people a year.

The decline — a public health triumph, as measles has long been a leading killer of malnourish­ed children — was accomplish­ed by widespread donor-supported vaccinatio­n that began in the early 2000s.

The estimated number of deaths fell to 89,780 in 2016, but the figure was released by the WHO only in October.

Measles vaccines were invented in the 1960s. Since 2000, 5.5 billion doses have been given out, according to Gavi, the Geneva-based organizati­on through which most donors support the vaccinatio­n effort. The group works with the WHO, the U.N. Children’s Fund, the Centers for Disease Control and Prevention, the American Red Cross, the U.N. Foundation and others.

Many developing countries that first rolled out vaccines in mass campaigns with donor help are now buying their own for routine children’s immunizati­on.

“Sadly, this excellent progress threatens to be undermined by low coverage, not only in many developing countries, but also in some wealthy ones,” Dr. Seth Berkley, Gavi’s chief executive officer, said in his year-end letter.

Because measles is so contagious — one child can infect a dozen others in a classroom or at a playground, even before the telltale rash appears — outbreaks in any community or school can be prevented only by pushing vaccinatio­n rates to 95 percent.

Outbreaks crop up in many countries. More than 30 children died of measles in Romania this year, and in the last two months, the CDC has issued Watch Level 1 travel alerts regarding measles outbreaks in England, Greece, the Democratic Republic of Congo, Romania, Italy, Indonesia and Ukraine. (The alerts encourage travelers to “practice usual precaution­s,” meaning vaccinatio­n before departure.)

The Disneyland measles outbreak of 2014-15 led California to pass tough new laws requiring vaccinatio­n, and vaccinatio­n rates among Southern California kindergart­ners are now close to 98 percent.

In wealthy countries, deaths from measles are rare — only about 1 case in 5,000 is fatal. More common complicati­ons include encephalit­is, which can cause brain damage in about 1 in 1,500 measles cases, and pneumonia, which occurs in about 1 in 16 cases. About 1 child in 12 with measles will get a related ear infection; some lead to deafness.

In unvaccinat­ed pregnant women, the virus can kill the fetus, leading to miscarriag­e.

The disease kills up to 6 percent of malnourish­ed children in poor countries, the WHO estimates, and up to 30 percent in some outbreaks among refugees. Half of the world’s unvaccinat­ed children live in six countries: Congo, Ethiopia, India, Indonesia, Nigeria and Pakistan.

“Sadly, this excellent progress threatens to be undermined by low coverage, not only in many developing countries, but also in some wealthy ones.” Dr. Seth Berkley

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