Posts tagged ‘Measles’
Measles causes high fever, a rash and can be fatal.
Outbreaks of measles are putting Europe’s commitment to eliminate the disease by 2015 under threat, the World Health Organization (WHO) has warned.
Levels of vaccination have been too low in some countries, particularly in rich western European nations.
It says catch-up vaccination campaigns, such as the one launched in the UK, are needed across the continent.
Experts said it was not too late to hit the target, but “extraordinary” effort was needed.
It is theoretically possible to eradicate measles from the planet in the same way smallpox was defeated in 1980.
The 53 nations which form the WHO’s European region, from Portugal to Uzbekistan, have pledged to stop the disease spreading on the continent.
However, there are high numbers of cases in the UK, Turkey, Ukraine and Romania. These follow outbreaks in Italy and France in previous years.
Robb Butler, the technical officer for WHO Europe’s vaccination team, told the BBC: “It’s too early to say the 2015 goal is not achievable, but it is certainly under threat, we would be fools to think it is not under threat.”
One thing is clear, if we continue to do the same as we did last year we will not reach the goal”
Dr Pier Luigi Lopalco European Centre for Disease Prevention and Control
Two doses of the MMR vaccine give almost total protection against measles. It is a highly infectious disease, however, if 95% of people are fully immunised it should stop the virus spreading.
Some countries fall short of this target and even in countries with high uptake there are pockets of unvaccinated people.
Claims of a link between the vaccine and autism in 1998, which have since been completely discredited, damaged uptake figures – particularly in the UK.
Dr Pier Luigi Lopalco, the head of vaccine preventable diseases at the European Centre for Disease Prevention and Control, said “that story survives” and keeps cropping up across Europe.
He said: “Another problem is the acceptability of vaccination by a part of the population that is becoming larger and larger.
“I’m talking about middle class people that more and more are sceptical towards vaccination and accepting alternative remedies instead.”
Smallpox is the ultimate poster-child for vaccination.
More than 300 million people were thought to have died from smallpox in the 20th Century alone.
The disease once killed 30% of those infected, but after an intense global vaccination campaign it was declared eradicated in 1980.
Measles is a tougher proposition as it is more infectious than smallpox, which means you have to vaccinate a higher percentage of the world’s population.
However, lessons from polio show that the achievements from smallpox are not easy to repeat.
In 1988 the World Health Assembly set a target of eradicating polio by 2000.
Even now, polio is stubbornly clinging on in a handful of countries.
In theory measles could be completely eradicated, but it is still a very distant prospect.
Some countries are on target, particularly in Scandinavia and parts of central and eastern Europe. The Ministry of Health in Slovakia said it has not had a case among its own residents since 1998, with cases coming only from abroad.
But across the 53 countries, Dr Lopalco said it would be difficult to reach the target.
He said: “One thing is clear, if we continue to do the same as we did last year we will not reach the goal. We will not do it if we do not put in place extraordinary measures – large catch-up campaigns.”
In response to epidemics in the UK, a large vaccination campaign has been launched to target more than one million schoolchildren who have not had their two doses of MMR.
Mr Butler, at the WHO, said other countries needed to act before they had outbreaks.
“At the European level we would like to see more member states doing what the UK are doing right now – going out and vaccinating adolescents and younger adults.”
He argues that even countries with 97% uptake of the vaccine still have pockets of unvaccinated people so some form of catch-up campaign would be needed.
“I honestly believe most member states need to consider it as one of the best alternatives to seeing increased cases and outbreaks in the future.”
Dr David Elliman, an immunisation expert at the Royal College of Paediatrics and Child Health in the UK, said the 2015 target was in danger.
“I think it is very difficult because we are talking about a very infectious disease so it is not like smallpox where uptake of the vaccine could be much lower and you would still be able to eradicate it.
“Unfortunately I think 2015 is very, very optimistic. It is possible, but I think two years hence, I would be surprised.”
A baby boy waits in the queue for the MMR vaccination outside Morriston Hospital
Health officials are bracing themselves for the number of confirmed cases in the Swansea measles epidemic to rise.
On Friday the number of cases stood at 588 but officials say around 15-20 new cases are currently confirmed each day.
Parents across Swansea, Neath Port Talbot and Bridgend are being urged to vaccinate children before they return to school after the Easter break.
Meanwhile, a Swansea newspaper has defended itself against claims that its 1990s anti-MMR campaign was to blame.
Jonathan Roberts, editor of the South Wales Evening Post, said the campaign was hard-hitting but reflected parents’ concerns at the time about the safety of the vaccine.
It is clear that there were genuine concerns in the mid-90s about MMR and the Post gave them full and responsible coverage”
Jonathan RobertsSouth Wales Evening Post Editor
It is the first time the newspaper has responded to claims that its campaign could have been responsible for a lower uptake of the MMR (measles, mumps and rubella) vaccine in the Swansea area.
“It is clear that there were genuine concerns in the mid-90s about MMR and the Post gave them full and responsible coverage,” he said in the article on the Evening Post website.
He added that “with the benefit of hindsight” it is easy to be critical.
“To judge it honestly and fairly, one has to consider the fear which existed at the time, the fact that medical experts were publicly expressing concerns about the vaccine and the duty of this paper to reflect public opinion.”
Mr Roberts will host a live webchat at 14:30 BST on Tuesday on the paper’s website.
If the number of cases in the Swansea area reaches 622, it will exceed the figure in the north west of England in the year to February 2013, with most on Merseyside, in Greater Manchester and west Lancashire.
About 1,700 people were vaccinated at special hospital drop-in clinics at the weekend and health officials are urging others to get the jab.
- How safe is it to take children to mainland Europe who have had two doses of the MMR vaccine?
It gives 99% protection against the measles virus.
- What if they have had only one dose of MMR?
One dose is better than none, but two doses is better than one. If you are concerned about travelling to an outbreak area you can bring forward the second MMR dose. Speak to your GP about it.
- What if my children are not vaccinated at all?
The advice is to go to your GP and arrange for them to be immunised as soon as possible before you travel. Measles is a dangerous viral illness that can be fatal.
Sara Hayes, Abertawe Bro Morgannwg University Health Board’s director of public health, said: “Many children who missed the MMR jabs when they were little will be sitting exams once they go back to school.
“We are not in any way judgmental about why their children may have missed the MMR in the past. The important thing is that they get the jab now,” she added.
Before the introduction of the MMR in 1988, about half a million children caught measles and about 100 died from it each year in the UK.
Concerns over the jab’s safety were raised in the late 1990s when a surgeon published a since discredited paper in The Lancet suggesting MMR was linked to an increased risk of autism.
Although the epidemic is based in Swansea, cases continue to be reported across Wales.
Most are in the Abertawe Bro Morgannwg health region, which also includes Neath, Port Talbot and Bridgend.
There are also cases in Powys and in the Hywel Dda Health Board area, which covers Carmarthenshire, Ceredigion and Pembrokeshire.
Officials have said it is “just a matter of time” before a child is left with serious and permanent complications, such as eye disorders, deafness or brain damage, or even dies.
Typical symptoms of measles include fever, cough, conjunctivitis and a rash. Complications are quite common even in healthy people, and about 20% of reported measles cases experience one or more complication.
These can include ear infections, vomiting and diarrhoea, pneumonia, meningitis and serious eye disorders.
Queues at Morriston Hospital on Saturday
According to the UN body, 210 of cases occurred in the southern province of Sindh affected by worst floods during the past 3 years.
“Most of (the) children who have died because of suspected measles are reported from the districts affected by the floods for (the) last three years,” WHO spokeswoman Maryam Yunus said.
“Most of the affected children died due to post-measles complications such as pneumonia, post-measles encephalitis and diarrhoea,” Yunus added.
The organization also said from among the 64 children, who died from measles in Pakistan in 2011, 28 were from Sindh Province, mostly in northern districts.
Yunus went on to say that malnourishment is a major reason behind the high number of deaths among children in Sindh Province.
“Floods, displacements and food shortages have played a major role behind these deaths,” she added.
Meanwhile a Pakistani health ministry official said more than half of the cases in Sindh occurred in the last three months of the year, with 50 children dying in December alone.
Speaking on the condition of anonymity, the official said the number of deaths in 2012 was “a record high.”
On December 31, Pakistan began a new measles vaccination drive in the flood-stricken areas, which will continue until January 9, the Pakistani officials added.
Health authorities in the US and Europe are reporting a sudden rise in the number of people contracting measles.
Ten years ago, the infection killed 800,000 people worldwide, but aggressive vaccination campaigns have sharply reduced the global mortality rate, especially in Africa and Asia.
Yet in the US, where the disease had been declared eradicated, measles is on a comeback. Most cases are traced to unvaccinated travellers, but the highly contagious virus may also be spreading because of parents who refuse to vaccinate their children.
Al Jazeera‘s Tom Ackerman reports.
In 2010, 19 million infants did not get their measles vaccine
By James Gallagher Health and science reporter, BBC News
Global efforts to cut the number of deaths from measles have fallen short of World Health Organization (WHO) targets.
An analysis published in the Lancet said deaths had fallen by 74% between 2000 and 2010, but the target was 90%.
Outbreaks in Africa and delays in vaccination programmes in India have stalled progress, researchers say.
A new campaign to tackle the disease has been launched, which will combine measles and rubella jabs.
In 2000 there were 535,300 deaths from measles. This fell to 139,300 deaths in 2010, according to the analysis.
The Measles and Rubella Initiative, a collaboration of international organisations including the WHO, said the decline in measles deaths was strong up to 2007, but measures “faltered” in 2008 and 2009.
This lead to outbreaks in Africa, Asia and even Europe.
Africa and India accounted for a combined total 79% of all deaths from measles between 2000 and 2010.
- A highly infectious viral illness
- Causes a fever, coughing and distinctive red-brown spots on the skin
- Contracted by breathing in tiny droplets created when an infected person coughs or sneezes
- Possible complications include pneumonia, ear and eye infections, and croup
- Serious complications include inflammation of the brain (encephalitis), which can be fatal
- Infection during pregnancy can cause miscarriage, premature labour or low birth weights
Anthony Lake – the executive director of the United Nations children’s organisation Unicef, which is also part of the Measles and Rubella Initiative – said there were still 382 deaths from measles every day.
“Every one of them could have been saved by a vaccine,” he said.
However, he said the 74% drop in deaths showed “vaccine campaigns can succeed even in the poorest countries and the remotest regions”.
The next target is a 95% drop in deaths from their 2000 levels by 2015.
Dr Okwo-Bele, director of immunisation, vaccines and biologicals at the WHO, said: “We have reason to be optimistic that the 95% goal will be achieved by 2015.”
The new campaign will see the introduction of a vaccine for both measles and rubella.
Dr Margaret Chan, the director general of the WHO, said: “A three-quarters drop in measles deaths worldwide shows just how effective well-run vaccination programmes can be.
“Now we need to take the next logical step and vaccinate children against rubella, too.”
Measles outbreaks in parts of Europe and Africa led to some 60,000 more cases worldwide in 2010 over the previous year, after nearly a decade of declines, U.S. health authorities say.
Due to a boost in global efforts to vaccinate people against measles, total cases declined from more than 853,000 in 2000 to nearly 278,000 in 2008, and remained stable in 2009.
But 2010 saw an increase to 339,845 measles cases, driven largely by outbreaks in Africa and Europe, said the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly report.
The rise came despite increasing global vaccine coverage of at least one dose against measles to 85% of the world in 2010, up from 72% in 2000.
The biggest jump in measles cases from 2009-2010 was in Malawi, which had 118,712 cases, followed by Burkina Faso with 54,118 and Iraq with 30,328.
Some European countries also figured in the top 15, with Bulgaria reporting 22,004 cases and France with 5,048.
Vietnam had 9,391 cases and the Philippines reported 6,368.
The outbreaks were mainly linked to low vaccination coverage of the population, in some cases due to little access to health services and in others due to religious or philosophical objections by parents who oppose vaccinating their children.
“By the end of 2010, 40% of countries had not met the annual incidence target of fewer than five cases per million,” the CDC said.
“Promising advances” were seen in the world’s two most populous countries, with China vaccinating some 103 million children and India beginning a two-dose vaccination strategy, the CDC added.
In 2010, the World Health Assembly set forth a series of goals for 2015, including raising vaccination coverage for children aged one year to up to 90% in each nation and cutting measles mortality by up to 95% from the 2000 estimate of 733,000.
“Key challenges must be overcome to meet the 2015 objectives,” the CDC report said.
Efforts to meet 2015 goals require “overcoming declining political and financial commitments to measles control” and “achieving uniform high coverage” of vaccinations, the CDC said.
Measles is a highly contagious viral disease characterized by rash, skin bumps, aches and fever. Complications such as bronchitis, pneumonia, encephalitis and ear infections can sometimes be fatal.
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