WHO updates fact sheet on Measles (29 November 2018)

Recently, the World Health Organization updated its fact sheet on Measles.

Background Information:

Measles is a highly contagious, serious disease caused by a virus.

Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every 2–3 years and measles caused an estimated 2.6 million deaths each year.

Key Messages:

The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days.

A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage.

After several days, a rash erupts, usually on the face and upper neck. Over about 3 days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days).

Most measles-related deaths are caused by complications associated with the disease. Serious complications are more common in children under the age of 5, or adults over the age of 30. The most serious complications include

  • blindness,
  • encephalitis (an infection that causes brain swelling),
  • severe diarrhoea and related dehydration,
  • ear infections, or
  • severe respiratory infections such as pneumonia.

Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.

Unvaccinated young children are at highest risk of measles and its complications, including death. Unvaccinated pregnant women are also at risk. Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.

Measles is still common in many developing countries – particularly in parts of Africa and Asia. More than 95% of measles deaths occur in countries with low per capita incomes and weak health infrastructures.

Measles is one of the world’s most contagious diseases, and is spread by

  • coughing and sneezing,
  • close personal contact or
  • direct contact with infected nasal or throat secretions.

The virus remains active and contagious in the air or on infected surfaces for up to 2 hours. It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts.

No specific antiviral treatment exists for measles virus.

All children diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. This treatment restores low vitamin A levels during measles that occur even in well-nourished children and can help prevent eye damage and blindness. Vitamin A supplements have been shown to reduce the number of deaths from measles by 50%.

Routine measles vaccination for children, combined with mass immunization campaigns in countries with high case and death rates, are key public health strategies to reduce global measles deaths.

The measles vaccine has been in use for over 50 years. It is safe, effective and inexpensive. It costs approximately one US dollar to immunize a child against measles.

Even though a safe and cost-effective vaccine is available, in 2017, there were 110 000 measles deaths globally, mostly among children under the age of five.

Measles vaccination resulted in a 80% drop in measles deaths between 2000 and 2017 worldwide.

In 2017, about 85% of the world’s children received one dose of measles vaccine by their first birthday through routine health services – up from 72% in 2000.

During 2000-2017, measles vaccination prevented an estimated 21.1 million deaths making measles vaccine one of the best buys in public health.

Of the estimated 20.8 million infants not vaccinated with at least one dose of measles vaccine through routine immunization in 2017, about 8.1 million were in 3 countries: India, Nigeria and Pakistan.

Because of low coverage nationally or in pockets, multiple regions were hit with large measles outbreaks in 2017, causing many deaths. Based on current trends of measles vaccination coverage and incidence, the WHO Strategic Advisory Group of Experts on Immunization (SAGE) concluded that measles elimination is greatly under threat, and the disease has resurged in a number of countries that had achieved, or were close to achieving, elimination.

Useful Links:

Link to the updated fact sheet:

http://www.who.int/news-room/fact-sheets/detail/measles

Link to a related news release on Measles:

http://www.who.int/news-room/detail/29-11-2018-measles-cases-spike-globally-due-to-gaps-in-vaccination-coverage

Link to Weekly Epidemiological Review (30 November 2018) containing report on progress towards Measles elimination (English) [PDF]:

http://apps.who.int/iris/bitstream/handle/10665/276217/WER9348.pdf?ua=1

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