From many peoples’ perspectives, the world is only now returning “back to normal” following the disastrous COVID-19 pandemic. Yet, a familiar viral menace still seems to be making a comeback: measles.
Despite being on the brink of eradication due to widespread vaccination efforts, this highly contagious childhood illness is experiencing a concerning resurgence in multiple nations.
During the European Society of Clinical Microbiology and Infectious Diseases Global Congress held in Spain this year, scientists voiced concern over the escalating frequency and scale of measles outbreaks across the globe.
Dr. Patrick O’Connor, who represented the World Health Organization (WHO) headquarters in Switzerland, reported that, thus far in 2024, the cumulative count of measles cases documented is anticipated to reach or surpass the 321,582 provisional cases documented in 2023.
So, while reporting delays imply that the actual tally for 2024 is probably substantially higher than the 94,481 cases registered by early April, it’s evident that the trajectory is unfavorable. Even more concerning, the 321,582 cases of measles in 2023 nearly doubled the count from 2022, which stood at 171,153.
Close to 50% of the cases reported this year have emerged in the WHO European Region, where countries such as Azerbaijan, Kyrgyzstan, and Yemen have recorded the highest incidence rates of measles worldwide.
This has worried researchers as the number of nations contending with large or disruptive outbreaks – which are defined as 20 cases per 1 million people sustained over 12 months – has tripled from 17 to 51 within just one year.
“Over the last decade, there has been significant progress towards measles and rubella elimination – the Regional Verification Commissions for Measles and Rubella Elimination (RVCs) from all of the WHO Regions will review all national measles and rubella 2023 reports in 2024,” Dr. O’Connor said.
“Large outbreaks and continuous transmissions of measles are always a concern and can make achieving and maintaining elimination challenging.”
Tetiana – stock.adobe.com – illustrative purposes only, not the actual person
Immunization, or vaccinations, is a critical tool for halting the spread of measles. The measles virus is highly contagious, and any lapses in immunization coverage pose a potential risk for outbreaks, according to Dr. O’Connor. So, he stated that coverage must be extensive yet, at the same time, uniform and equitable.
Hanna Nohynek, a professor at the Finnish Institute for Health and Welfare in Helsinki, highlighted how measles cases around the globe were already on the rise in 2019. This was most notable in Africa, where vaccine coverage is the lowest.
The COVID-19 pandemic led the transmission of measles, as well as other respiratory viruses, to slow down due to decreased human interactions. But, the pandemic also disrupted regular childhood vaccination schedules, resulting in many children being left without protection.
Nohynek stated that, throughout the pandemic, numerous children missed out on vaccinations, and efforts to catch up with immunization “have not reached them.” Consequently, we are witnessing a resurgence of cases in multiple regions around the globe.
Still, measles vaccination continues to stand as a remarkable achievement in public health, even though more work still needs to be done.
According to Dr. O’Connor, immunization efforts against measles have prevented an estimated 57 million deaths globally from 2000 to 2022. Plus, in just the WHO European region, the yearly measles-related deaths drastically decreased by 98%, dropping from 3,584 in 2000 to a mere 70 in 2022.
“Over the last 20 years, there has been significant progress toward achieving measles and rubella elimination. In order to solidify and maintain those gains, we need to ensure high uniform and equitable routine immunization coverage and robust outreach and rapid outbreak response,” he said.
The successful eradication of measles from the WHO Region of the Americas in 2016 may be able to serve as a blueprint for replication. This achievement was accomplished through a comprehensive approach that included one-time national catch-up campaigns for children, bolstering routine vaccination to consistently achieve 95% coverage and periodic follow-up doses.
Other crucial components included resilient healthcare infrastructure, public confidence in vaccines, and political commitment.
Conversely, global coverage with the initial dose of the measles vaccine dipped to 83% in 2022, which is 3% below pre-pandemic levels and falls significantly short of the 95% threshold necessary to prevent outbreaks.
Now, Nohynek claims that countries need to address the underlying reasons for declining vaccine coverage, including logistical hurdles, access barriers, and hesitancy. She suggests that innovative methods such as needle-free microarray vaccine patches could play a role in closing these vaccination gaps.
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