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Measles mortality fell markedly; sustained immunization vital to maintain progress
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The good news is that measles mortality dropped by nearly 75% by 2010. The bad news is that 15 children die every hour of each day as a result of measles, according to experts who spoke during a press conference this week.
Rapid progress in measles control from 2000 to 2007 resulted in the significant reduction in measles mortality. Estimated global measles mortality decreased 74%, from 535,300 deaths in 2000 to 139,300 in 2010.
“This has been a tremendous success,” Anthony Lake, PhD, executive director of UNICEF, said during the teleconference. “This shows that these campaigns can work, even in the poorest countries and the most remote communities. This is one of the most remarkable victories in the history of public health.”
Despite this success, measles still claims 382 lives daily. “The vast majority of them are children younger than 5 years, and every one of them could have been saved with two doses of a 22-cent vaccine,” Lake said.
The delayed implementation of accelerated disease control measures in India and continued outbreaks in Africa halted the momentum toward the 2010 global measles mortality reduction goal. India accounted for 47% of estimated measles mortality in 2010, and the WHO African region accounted for 36%, according results of a new study by Simons and colleagues published online this week in The Lancet.
Therefore, intensified control measures and renewed political and financial commitments are necessary to reach the targets and continue toward the goal of global eradication of measles.
“We have to ramp up our efforts,” Lake said.
So far, India has begun to rollout a health care initiative to help immunization against measles, and the GAVI Alliance has committed to supporting the introduction of a combined measles and rubella vaccine in 52 additional countries, according to Lake. The new Measles and Rubella Initiative, a partnership aiming to ensure no child dies of measles or is born with congenital rubella syndrome, has unveiled the Global Measles and Rubella Strategic Plan to reach that goal.
“This initiative is absolutely committed to seeing this through, and we damn well will,” Lake said.
The Global Measles and Rubella Strategic Plan includes a five-pronged strategy to cut global measles deaths by at least 95% by 2015 compared with 2000 levels and to achieve measles and rubella elimination in at least five WHO regions by 2020. The strategies to reach elimination include: 1) high vaccination coverage; 2) monitoring spread of disease using laboratory-backed surveillance; 3) outbreak preparedness and response and measles case management; 4) communication and community engagement; and 5) research and development.
“This plan creates a great road map to eliminate measles and rubella by 2020. The addition of rubella is a game-changer because we have a way to accelerate vaccination of all children younger than 15 years with the combined measles and rubella vaccine,” Jean-Marie Okwo-Bele, MD, director of the immunization, vaccine and biologicals department at WHO, said during the teleconference.
In a commentary, also published in The Lancet, Walter A. Orenstein, MD, an Infectious Diseases in Children Editorial Board member, along with Alan R. Hinman, MD, said, “If immunization programs fail to immunize new susceptibles added to the population daily through births and migration, enough susceptibles will accumulate to fuel another measles outbreak.”
The Measles and Rubella Initiative is a collaborative effort of WHO, UNICEF, the American Red Cross, the CDC and the United Nations, according to a joint news release from the participating agencies. — by Cassandra A. Richards.
Disclosure: The study was funded by the CDC. The researchers report no relevant financial disclosures.
Perspective
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Richard F. Jacobs, MD
The global measles information published in The Lancet highlights the importance of vigilance in our efforts to control this highly contagious infection. The recent report from the US demonstrating a 15-year high in reported cases of measles is a warning to our physicians, public health officials, parents and patients that continuing to strive for high immunization rates is necessary and critical to control this infection in a highly mobile population.
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