Over 9 million measles cases, 1.36 lakh fatalities: Study

By Dani Blum

NEW YORK: Measles cases worldwide rose 18% and deaths increased by more than 40% from 2021 to 2022, as countries struggled to get routine vaccinations back on track after the pandemic, according to a new report from the World Health Organization and the Centers for Disease Control and Prevention.

The report captures the continued burden of measles, one of the world’s most contagious diseases. In 2022, there were an estimated 9 million measles cases and 136,000 deaths, according to the report.

The disease spreads when infected people cough or sneeze; someone can get infected by breathing in the virus, which can linger in the air for hours, or by touching a contaminated surface and then rubbing the eyes, nose or mouth. Vaccination is highly effective at stopping the spread of measles and preventing people from getting sick if exposed to the virus. The measles vaccine, which experts say is ideally delivered in childhood, also includes protection against two other infectious diseases, mumps and rubella.

The report found that slightly more people were vaccinated against measles in 2022 than the year prior but that nearly 33 million children still missed a dose of the vaccine. Worldwide, 74% of people were fully vaccinated, meaning they had received two doses. Low-income countries had the lowest vaccination rates, with only 66% of children receiving their first dose, and the highest risk of death from measles.

Countries in Africa and Southeast Asia had particularly low coverage, said Cynthia Hatcher, a public health scientist at the CDC who works on measles elimination in Africa.

“Many areas are struggling to recover their public health systems after the pandemic,” she said. “Measles is really difficult. It will find even the smallest gaps in your protection.”

Public health officials estimate that 95% of people in a community must be fully vaccinated to prevent outbreaks, a concept known as herd immunity.

Most cases and deaths in 2022 occurred among children, who are at risk for severe complications from the disease, including pneumonia and brain swelling. More commonly, measles leads to fevers, rashes and coughs. Large or disruptive outbreaks of the disease also became more widespread in 2022. As many as 37 countries experienced such outbreaks that year, compared to the 22 countries in 2021.

“The rise in cases is likely a legacy of the pandemic,” said Dr Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security. “Vaccinations against many diseases, including measles, were pushed off to the wayside as people focused on COVID. There was just major disruption in getting children back on schedule. It’s harder than it appears to be.”

And, many people avoided going to the doctor during the worst of the pandemic, “delaying routine vaccinations and potentially leaving people susceptible,” said Dr. Walter Orenstein, associate director of the Emory Vaccine Center.

While the burden of measles is largely concentrated abroad, the US has faced its own challenges controlling the disease. In 2019, there were several large outbreaks across more than 25 states. So far this year, the CDC has reported 41 measles cases nationwide.

But experts are eyeing the US with concern. “The pandemic and misinformation about the safety and efficacy of COVID vaccines have fuelled vaccine hesitancy across the country,” Adalja said.

A CDC report released this month showed that the number of vaccine exemptions increased slightly among US kindergarten students between the 2021-22 and 2022-23 school years.

“What people need to understand, and where we have not done a good job in public health, is explaining to people that all vaccines are not created equal,” pointed out Dr Camille Sabella, a paediatric infectious disease specialist at the Cleveland Clinic, Ohio.

The CDC estimates that two doses of the vaccine are 97% effective against measles. And it’s never too late for someone to get vaccinated. “The way out of this is to increase vaccination rates and make sure all children have received their age-appropriate measles vaccination on time,” he said. “That’s really the only way out of this.”