2023-11-23 12:46:14
A report from the WHO and the United States CDC analyzes the number of outbreaks of this contagious disease that is growing due to the lack of vaccination. In 2022, 37 countries experienced major measles outbreaks, compared to 22 countries in 2021.
The global threat of measles remains for another year. There is still a high exposure of millions of unvaccinated children to viruses of the paramyxovirus family, the cause of the infection. “The structural problems caused by wars, climate disasters and the lack of access to vaccines prevent the elimination of this infection,” laments Jordi Casabona, epidemiologist and secretary of the STI Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc). .
After years of declines in measles vaccination coverage, measles cases in 2022 increased by 18% and deaths increased by 43% globally (compared to 2021). This results in an estimated nine million infections and 136,000 deaths (mostly children), according to a new report from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). USA.
These two international organizations insist on the public health problem caused by the lack of immunization. “This is a serious and highly contagious infection,” explains its vice president, Pedro Gorrotxategi, from the Spanish Association of Primary Care Pediatrics (AEPap). “The problem arises when a child, who has not been vaccinated, enters a community where there are gaps in vaccination rates. If there is circulation of the virus, he and those unimmunized minors will generate an outbreak,” recalls Gorrotxategi.
The problem is not only in children, but also “in the vulnerable population,” as Casabona adds. “Older people, adults in whom the body loses its shield against the virus; “In them, it can generate a significant health problem.”
In 2022, 37 countries experienced major measles outbreaks, compared to 22 countries in 2021. Of the countries that experienced outbreaks, 28 were in the WHO African Region, six in the Eastern Mediterranean, two in Southeast Asia and one in the European region.
“Amazing, but not unexpected”
“The increase in measles outbreaks and deaths is staggering, but unfortunately not unexpected given the decline in vaccination rates we have seen in recent years,” said John Vertefeuille, director of the CDC’s Division of Global Immunization. . “Measles cases anywhere pose a risk to all countries and communities where people are not sufficiently vaccinated. “Urgent and targeted efforts are essential to prevent measles illness and deaths.”
It should be noted that Spain was declared a country “free of endemic measles transmission” by the WHO in 2017, recognizing that the few cases and outbreaks that are identified are a consequence of imports from other countries and not of sustained circulation of the virus in our territory.
In our country, according to the latest report from the Carlos III Health Institute, 49 cases were reported this year, in only nine the infection was confirmed and all but one were imported. “That is why it is important that every time a child arrives in a new community, in pediatrics we adjust their vaccination schedule to that of their peers. Only in this way will we all be protected,” says Gorrotxategi.
This is important in the face of migratory movements, “because not all countries have the same access to vaccines and that is the first thing that should be addressed,” Casabona insists. Furthermore, the Seimc spokesperson emphasizes that in our country after Covid we once again have coverage above 95%, “and these are necessary to ensure that the circulating virus does not impact. That is why it is important to do pedagogy and insist on the benefits of vaccination.”
The only way to avoid measles is with two doses of the vaccine. In Spain it is regulated and covered by Health in the first years of life. Although, as the international report points out, there was a modest increase in global vaccination coverage in 2022 compared to 2021, there were still 33 million children who missed a dose of the measles vaccine: almost 22 million missed their first doses and another 11 million missed their second dose.
The global vaccination coverage rate for the first dose of 83% and the second dose of 74% was still well below the 95% two-dose coverage needed to protect communities from sprouts. “We must ensure that the rates are higher, because, although it is considered a benign disease, it sometimes has serious consequences,” Casabona replies.
Low-income countries, where the risk of death from measles is highest, continue to have the lowest vaccination rates, at just 66%; a rate that does not show any recovery from the decline during the pandemic. Of the 22 million children who did not receive their first dose of measles vaccine in 2022, more than half live in just 10 countries: Angola, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Madagascar, Nigeria, Pakistan and the Philippines.
“The lack of recovery of measles vaccine coverage in low-income countries after the pandemic is a warning signal to act. Measles is called the virus of inequality for good reason. It is the disease that will find and attack those who are not protected,” says Kate O’Brien, director of Immunization, Vaccines and Biologicals at the WHO. “Children around the world have the right to be protected by the life-saving measles vaccine, no matter where they live.” Pilar Perez
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