The once nearly vanquished disease measles is making a worrying comeback. This week, the World Health Organisation and UNICEF reported that global cases of the viral illness have so far jumped almost 80% in 2022 compared to last year. Without immediate action, the conditions are “ripe” this year for a large-scale resurgence of the vaccine-preventable illness, they warn.
According to data collected by the organisations, there were around 17,000 measles cases reported in the first two months of 2022 — a 79% increase over cases reported during the same period in 2021. The majority of cases have come from countries in Africa and the Mediterranean, such as Somalia, Yemen and Afghanistan. And as of April 2022, they’ve tracked 21 large outbreaks in the last 12 months.
Measles is a highly contagious disease (moreso than even the latest Omicron variant of the coronavirus). So in unprotected populations, it can swiftly spread and cause widespread illness. And given the early start, the WHO and UNICEF fear that millions of cases could happen this year. For context, about 860,000 cases were reported in 2019 — the highest annual number since 1996.
Signs of measles infection include flu-like symptoms along with a distinct rash that usually starts in the face several days later. Though most people don’t develop serious complications, it can be deadly, especially to younger malnourished children. In 2019, it’s estimated that over 200,000 people were killed by measles, mostly children under five. Recently, it’s also become apparent that even a mild case of measles can effectively reset the immune system, causing us to forget our immunity to other infectious diseases, at least temporarily.
Despite its threat, measles is easily preventable, thanks to a highly effective vaccine (97% effective with the full two doses) that provides lifelong protection against infection. Vaccination has steadily eroded the global incidence of measles over the decades, and for a time, it appeared as if measles would be eradicated. But because the germ is so contagious, it requires high vaccine coverage in a population — at least 95% — to provide herd immunity and protect those too young or otherwise unable to get vaccinated. And sadly, the world has been losing ground in vaccinating everyone lately, leading to the return of measles in many areas, including the U.S., though it remains locally eliminated here.
The last few years of the pandemic have seen lower reported case numbers of measles but also further gaps in vaccination coverage. Adding to the trouble has been ongoing warfare in Afghanistan and more recently Ukraine, which has disrupted routine vaccination programs and has led to the mass displacement of refugees. These pandemic- and war-related disruptions, along with the return to socialising for many, will likely allow measles to explode back onto the world stage, the WHO and UNICEF warn.
“It is encouraging that people in many communities are beginning to feel protected enough from COVID-19 to return to more social activities. But doing so in places where children are not receiving routine vaccination creates the perfect storm for the spread of a disease like measles,” said Catherine Russell, UNICEF executive director, in a statement.
In 2020 alone, according to their data, around 23 million children missed out on their recommended vaccines, a number higher than 2019. And unless we can catch up soon, measles threatens to become the sort of nightmare this year it often used to be.
“The covid-19 pandemic has interrupted immunization services, health systems have been overwhelmed, and we are now seeing a resurgence of deadly diseases including measles. For many other diseases, the impact of these disruptions to immunization services will be felt for decades to come,” said Tedros Adhanom Ghebreyesus, director-general of the WHO. “Now is the moment to get essential immunization back on track and launch catch-up campaigns so that everybody can have access to these life-saving vaccines.”