Should We Be Worried About Measles?

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With the recent announcement by the World Health Organization (WHO) and the Measles Initiative that measles deaths around the world declined by 78 percent during the years 2000 to 2008, some people may wonder whether we still need to be worried about measles. The answer is yes.

The WHO reports that more than 20 million people around the world are affected by measles each year, and it remains the leading cause of vaccine-preventable death among young children. Measles deaths declined an estimated 733,000 in 2000 to 164,000 in 2008, and this significant achievement is credited to mass vaccination efforts. However, about 450 people still die each day of measles, and the number of deaths could resurge if projected funding cuts prevent the continuation of vaccinations around the world.

In the United States, there were 3 to 4 million cases of measles annually until 1963, and 400 to 500 children died each year. By 2000, however, extensive vaccination programs had wiped out transmission in the states, but because of transcontinental travel, the disease can be imported easily from overseas. In 2008, for example, measles outbreaks occurred in more than seven states, with 64 cases reported during the first four months of the year. The largest outbreak was in New York City and was believed to have been introduced by travelers from other countries, including Israel and Belgium. By the end of July 2008, the total number of measles cases in the United States had risen to 131.

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Currently there are outbreaks of measles in the United Kingdom and Burkina Faso. In the United Kingdom, for example, the number of cases reported since the beginning of 2009 through July 10 was 4,141. In Burkina Faso, the United Nations Office for the Coordination of Humanitarian Affairs reported that more than 51,000 cases of measles and 300 deaths related to the disease had occurred thus far this year.

Other countries that still have outbreaks of the measles include India, Indonesia, and Bangladesh, a region where measles deaths declined by only 46 percent between 2000 and 2008. The target for all nations is a 90 percent reduction. In 2010, China, Indonesia, Pakistan, Bangladesh, Vietnam, Nigeria, and Ethopia are planning a national immunization campaign to achieve the 90 percent goal.

Because of the risk of measles in both developed and developing countries, anyone who travels internationally should be current on their immunizations, regardless of their destination. Expatriates should always make sure their vaccinations are up to date.

Dr. Thomas R. Frieden, Director of the Centers for Disease Control and Prevention, notes that measles could “make a rapid comeback” if the worldwide vaccination campaign falters. “We saw this happen in the United States between 1989 and 1991,” he notes, “when an estimated 55,000 measles cases and more than 130 deaths occurred.” To prevent the risk of resurgence, the WHO says countries must continue follow-up vaccination programs every two to four years until their healthcare systems are able to provide two doses of the vaccine to all children as well as treatment for the disease.

SOURCES:
Measles Initiative
New York Times, May 2, 2008
World Health Organization

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