WHO shows its concern over the stalled progress in eliminating Measles

Nov 16, 2014 Ruchira Dhoke News 0

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Measles is highly contagious, serious disease caused by a virus in the paramyxovirus family and it is transmitted through droplets from the nose, mouth or throat of infected person.

Normally it is passed through the direct contact with infected person and through the air. The virus infects the mucous membranes of the body and then spreads throughout.

In and before 1980, measles caused an estimated 2.6 million deaths each year before widespread vaccination. It is one of the leading causes of death among young children globally, despite a safe and effective vaccine. According to WHO approximately 145 700 people died from measles in 2013 – mostly children under the age of 5.

The initial symptoms usually appear 10–12 days after the contact and include high fever, runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. A rash is developed after a few days starting on the face and upper neck and gradually spreading downwards.

There is still no specific treatment for measles, but mostly people recover within 2–3 weeks. However this is not the case in the malnourished children and in immunocompromised people who have reduced immunity. Measles in them can cause serious complications, including blindness, encephalitis, severe diarrhea, ear infection and pneumonia.

The WHO has issued a grave concern in the progress of eliminating measles that seems to have stalled. According to new data published in the WHO Weekly Epidemiological Report and the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report, the number of deaths from measles increased from an estimated 122 000 in 2012 to 145 700 in 2013. The estimated number of measles deaths in 2013 represents a 75% decline in mortality since 2000, significantly below the target of a 95% reduction in deaths between 2000 and 2015.

This is a serious matter of concern for WHO.

Dr Peter Strebel from the WHO Department of Immunization, Vaccines, and Biologicals said that:

 “Poor progress in increasing measles vaccination coverage has resulted in large outbreaks of this highly contagious disease, throwing the 2015 elimination targets off-track. Countries urgently need to prioritize maintaining and improving immunization coverage. Failure to reverse this alarming trend could jeopardize the momentum generated by a decade of achievements in reducing measles mortality.”

The Member States of all 6 WHO Regions have set goals for measles elimination and meeting these goals on time is one of the 6 goals of the Global Vaccine Action Plan which was endorsed by all Member States at the World Health Assembly in 2012.

What is more mind boggling is that despite of being vaccine-preventable, measles is still is responsible for the cause of death and disability among children worldwide. There is a need of strong efforts to maintain the current level of control and to continue reducing the number of cases and deaths.

Measles has the potential to rebound if vaccination and surveillance efforts are not maintained and strengthened thus WHO and its partners in the Measles & Rubella Initiative have been issuing warning for its control.

While the rise in incidence was high in 2013 due to outbreaks in China, the Democratic Republic of the Congo, and Nigeria, the progress seems to have stalled in the WHO Eastern Mediterranean region, where weak health systems and conflict and population displacement have hampered vaccination efforts.

There are reports of re-emergence of measles in the European region including outbreaks in a number of countries including Georgia, Turkey and Ukraine, thus a renewed high-level political commitment is needed to reverse this trend.

Reduced funding puts impressive gains at risk

The huge reductions in mortality which is tapering off can be due to reduced global funding. Robert Kezaala, UNICEF’s Senior Health Advisor, for Immunization elobrated on this by saying that :

“The net effect of reduced global funding by governments and partners has caused postponed and suboptimal immunization campaigns, resulting in large outbreaks that threaten our hard earned gains,” says

Steve Cochi, Senior Advisor for the US Centers for Disease Control and Prevention’s Global Immunization Division believes that the resurgence of measles which is especially seen in Africa, is largely due to a marked decrease in financial support during the global recession. “This funding gap is only recently being closed and the world’s children cannot afford yet another setback in progress,” he said.

Aim is to get back on-track

To reach the estimated 2015 milestone for measles the partners in the Measles & Rubella Initiative agree that it is important to raise awareness about measles elimination and the risks associated with not getting the children vaccinated among the parents.

According to WHO barriers that are hampering immunization efforts will need to be addressed, including diminishing funding and the need to strengthen health systems. It also strongly recommends that every child receives 2 doses of measles vaccine and that countries unable to reach high coverage through routine immunization services continue follow-up vaccination campaigns every 2–4 years to eliminate the risk of resurgence.

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