important facts
Measles is a serious, highly contagious airborne disease caused by a virus that can lead to serious complications and death. Measles vaccination averted more than 60 million deaths between 2000 and 2023. Despite the availability of safe and cost-effective vaccines, there will be an estimated 107,500 measles deaths worldwide in 2023, most of whom were unvaccinated or under-vaccinated. These were children under the age of 5 who had not received the same. The proportion of children who received their first dose of measles vaccine in 2023 was 83%, significantly lower than the 2019 level of 86%.
overview
Measles is a highly contagious disease caused by a virus. It is easily spread by an infected person breathing, coughing, or sneezing. It can lead to serious illness, complications, and even death.
Although anyone can get measles, it is most common in children.
Measles infects the respiratory tract and then spreads throughout the body. Symptoms include high fever, cough, runny nose, and rash all over the body.
Getting vaccinated is the best way to prevent getting sick with measles and infecting others. Vaccines are safe and help your body fight viruses.
Before the introduction of the measles vaccine in 1963 and widespread vaccination, major outbreaks occurred approximately every two to three years and caused an estimated 2.6 million deaths each year.
Despite the availability of a safe and cost-effective vaccine, measles will cause an estimated 107,500 deaths in 2023, most of them children under 5 years of age.
Accelerated immunization efforts by countries, the WHO, the Measles and Rubella Partnership (formerly the Measles and Rubella Initiative), and other international partners have prevented an estimated 60 million deaths between 2000 and 2023. Vaccination has reduced the estimated number of measles deaths from 800,062 in 2000 to 107,500 in 2022 (1).
Impact of the novel coronavirus disease (COVID-19) pandemic
The COVID-19 pandemic has derailed surveillance and vaccination efforts. The suspension of immunization services and reduced immunization coverage and surveillance around the world have left millions of children vulnerable to preventable diseases like measles.
No country is exempt from measles, and areas with low vaccination rates accelerate the spread of the virus, increasing the likelihood of outbreaks and putting all unvaccinated children at risk.
Despite the COVID-19 pandemic, we must restore progress and meet regional measles elimination goals. Immunization programs need to be strengthened within primary health care, and efforts to vaccinate all children with two doses of measles vaccine must be accelerated. Countries should also put in place robust surveillance systems to identify and close immunity gaps.
signs and symptoms
Measles symptoms usually begin 10 to 14 days after exposure to the virus. A noticeable rash is the most visible symptom.
Initial symptoms usually last 4 to 7 days. They include:
Runny nose, watery eyes, small white spots on the inside of the cheeks.
The rash begins about 7 to 18 days after exposure and usually appears on the face and upper neck. It spreads in about three days and eventually spreads to the hands and feet. It usually lasts 5-6 days before the color fades.
Most measles deaths are due to measles-related complications.
Complications include:
Blinding encephalitis (an infection that causes brain swelling and potentially brain damage) Severe diarrhea and associated dehydration Ear infections Severe breathing problems, including pneumonia.
If a woman contracts measles during pregnancy, it can be dangerous for the mother and the baby may be born prematurely with a low birth weight.
Complications are most common in children under 5 years of age and adults over 30 years of age. Complications are more likely to occur in children who are malnourished, especially those who are deficient in vitamin A, or who have weakened immune systems due to HIV or other illnesses. Measles itself can weaken the immune system, causing the body to “forget” how to protect itself from infection, leaving children extremely vulnerable.
Who is at risk?
People who are not immune (those who have not been vaccinated or who have been vaccinated but have not developed immunity) can become infected. Unvaccinated young children and pregnant people are most at risk for serious complications from measles.
Measles remains endemic, especially in parts of Africa, the Middle East, and Asia. The vast majority of measles deaths occur in countries with low per capita incomes or weak health infrastructure that makes it difficult to vaccinate all children.
In countries experiencing or recovering from natural disasters and conflicts, health infrastructure and services are damaged, routine immunizations are disrupted, and overcrowding in residential camps increases the risk of infection. I am. Children with weakened immune systems due to malnutrition or other causes are most at risk of dying from measles.
contagion; infection
Measles is one of the most contagious diseases in the world and is spread by contact with infected nasal or throat secretions (coughing or sneezing) or by breathing air breathed by someone with measles. The virus remains active and contagious in the air or on infected surfaces for up to two hours. This makes it highly contagious, and one person infected with measles can infect nine out of ten unvaccinated close contacts. It can be transmitted by an infected person from 4 days before the rash appears to 4 days after the rash appears.
Measles outbreaks can cause severe complications and death, especially in young, malnourished children. In countries nearing measles elimination, cases imported from other countries remain an important source of infection.
process
There is no specific treatment for measles. Nursing care should focus on relieving symptoms, making the patient comfortable, and preventing complications.
Drinking enough water and treating dehydration can replace fluids lost through diarrhea and vomiting. Eating a healthy diet is also important.
Doctors may use antibiotics to treat pneumonia and ear and eye infections.
All children or adults with measles should take two doses of vitamin A supplements 24 hours apart. This reverses the low vitamin A levels that occur even in well-nourished children. Helps prevent eye damage and blindness. Vitamin A supplements may also reduce the number of deaths from measles.
prevention
The most effective way to prevent measles is community-wide vaccination. All children should be vaccinated against measles. Vaccines are safe, effective and inexpensive.
Children need two doses of the vaccine to ensure immunity. The first vaccination is usually given at 9 months of age in countries where measles is endemic and at 12 to 15 months of age in other countries. The second dose should be given later in childhood, usually after 15 to 18 months.
Measles vaccine is often given alone or in combination with mumps, rubella, and chickenpox vaccines.
Routine measles vaccination, combined with mass immunization campaigns in high-infection countries, is critical to reducing measles deaths worldwide. Measles vaccines have been used for about 60 years and cost less than $1 per child. Measles vaccines are also used in emergencies to prevent the spread of epidemics. The risk of measles outbreaks is particularly high among refugees and they should be vaccinated as soon as possible.
Combining vaccines costs slightly more, but allows you to share the costs of shipping and administration, and importantly, prevents the most common vaccine-preventable infections that can infect your baby in the womb. It has the added benefit of protection against the infectious disease rubella.
By 2023, 74% of children will have received two doses of measles vaccine, and approximately 83% of children worldwide will have received one dose of measles vaccine by their first birthday. Not all children develop immunity after the first dose, so two doses of the vaccine are recommended to ensure immunity and prevent outbreaks.
In 2023, approximately 22 million infants will not receive at least one measles vaccine through routine immunization.
WHO response
In 2020, WHO and global stakeholders endorsed the 2021-2030 Immunization Agenda. This agenda positions measles as tracking the ability of health systems to provide essential vaccines to children and aims to achieve regional targets as a central indicator of impact.
In 2020, WHO published the Measles and Rubella Strategic Framework, setting out seven strategic priorities needed to achieve and sustain regional measles and rubella elimination targets.
Without continued attention, hard-earned gains can be easily lost. Outbreaks occur where children are not vaccinated. Based on current trends in measles vaccination coverage and incidence, the WHO Strategic Advisory Group of Experts on Immunization (SAGE) has concluded that measles is likely to re-emerge in many countries that have achieved or were close to eliminating measles. Therefore, they concluded that measles eradication is under threat.
WHO will ensure timely diagnosis of measles and track the spread of the virus to help countries coordinate targeted vaccination efforts and reduce the number of deaths from vaccine-preventable diseases. We continue to strengthen the Global Measles and Rubella Testing Network (GMRLN).
IA2030 Measles and Rubella Partnership
Immunization Agenda 2030 Measles and Rubella Partnership (M&RP) is a partnership led by the American Red Cross, United Nations Foundation, Centers for Disease Control and Prevention (CDC), Gavi, Vaccine Alliance, Gates Foundation, UNICEF, and WHO. Achieve the measles and rubella specific goals of IA2030. Launched and reinvigorated in 2001 as the Measles and Rubella Initiative, this partnership is committed to ensuring that no child dies from measles or is born with congenital rubella syndrome. This partnership will help countries plan, finance and measure efforts to permanently stop measles and rubella.
References
1. Minta AA, Ferrari M, Antoni S, et al. Progress towards measles elimination—globally, 2000–2023. MMWR Morb Mortal Wkly Rep 2024;73:1036–1042. DOI: http://dx.doi.org/10.15585/mmwr.mm7345a4
