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Measles Deaths Falling Worldwide
Date:4/24/2012

By Steven Reinberg
HealthDay Reporter

MONDAY, April 23 (HealthDay News) -- Deaths from measles fell 74 percent worldwide between 2000 and 2010, but progress is still short of the World Health Organization's target, health officials reported Monday.

"This is one of the most remarkable victories in the history of public health," said Anthony Lake, executive director of the United Nations Children's Fund (UNICEF), during a morning press briefing, while calling for increased vaccination efforts.

The WHO, which aimed to cut measles deaths by 90 percent between 2000 and 2010, said India -- with the world's highest rate of measles deaths -- and Africa have offset the considerable gains made elsewhere.

In the United States, which since 2008 has had no reported measles deaths, 222 cases of measles were reported in 2011 -- the most in 15 years. Nearly all stemmed from foreign travel, and a majority of those who developed the disease had not been vaccinated, the U.S. Centers for Disease Control and Prevention reported last week.

Vaccination is the only way to prevent measles, experts say. Mass vaccination programs around the globe "were the main driver behind the huge fall in mortality," the researchers said, noting more than 1 billion doses of measles vaccine were dispensed over the past decade.

But still more people need vaccination, health experts say.

"The bad news is that every day measles still claims 382 lives worldwide -- a vast majority of them children under 5 -- and every one of them could have been saved by two doses of 22-cent vaccine," Lake said. The vaccine was introduced in 1963.

The report was published in the April 23 online issue of the journal The Lancet.

For the study, Peter Strebel, from the WHO's department of immunization, vaccines and biologicals, and colleagues developed a new statistical model to assess measles around the world.

The researchers found measles deaths fell from more than 535,000 in 2000 to around 139,000 in 2010. Almost half of those deaths (47 percent) occurred in India, and more than one-third (36 percent) in Africa.

Other areas in southeast Asia accounted for 8 percent of deaths; the eastern Mediterranean region, 7 percent; the western Pacific region, 2 percent; and the Americas and Europe less than 1 percent each.

It's believed that the high death rates in India and Africa are due to lower vaccination rates.

India's vaccination rate is about 74 percent, and Africa's is 76 percent. For the rest of Southeast Asia the vaccination rate is 79 percent, in the Eastern Mediterranean it's 85 percent and in the Americas it's 93 percent. Europe has a 95 percent vaccination rate and the Western Pacific has a 97 percent rate, the researchers said.

All regions except Southeast Asia plan to eradicate measles by 2020 or sooner, they added.

"Despite rapid progress in measles control from 2000 to 2007, delayed implementation of accelerated disease control in India and continued outbreaks in Africa stalled momentum toward the 2010 global measles mortality reduction goal," the researchers concluded.

"Intensified control measures and renewed political and financial commitment are needed to achieve mortality reduction targets and lay the foundation for future global eradication of measles," they added.

"This is a highly preventable illness," said Dr. Walter Orenstein, a professor of medicine and pediatrics and director of the Emory Vaccine Center at Emory University in Atlanta.

Orenstein, co-author of an accompanying journal editorial, said financially supporting immunization efforts around the world not only saves lives, but also helps prevent measles from entering the United States.

"In 2000, the U.S. declared that measles was no longer an indigenous disease," he said. "So all of our cases of measles are now due to importations with limited spread, which is why we need to insure our children are vaccinated."

"Measles is receding globally because of vaccination, but the problem that remains is twofold," said Dr. Marc Siegel, an associate professor of medicine at New York University in New York City.

That problem involves parents who resist vaccination. A residual fear that the measles-mumps-rubella vaccine causes autism has taken a decade to overcome following the publication in Britain of a later-discredited study linking the two, Siegel said. In addition, some people in the United States choose not to have their children vaccinated for religious reasons, he said.

The main symptom of measles is an itchy skin rash. A fever and cough can follow.

More information

For more information on measles, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Walter Orenstein, M.D., professor of medicine and pediatrics, and director, Emory Vaccine Center, Emory University, Atlanta; Marc Siegel, M.D., associate professor, medicine, New York University, New York City; April, 23, 2012, press briefing with: Anthony Lake, Executive Director, UNICEF; April 23, 2012, The Lancet, online


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