Global Measles Outbreaks

Children in Aden, Yemen show off the spots where they received their Measles and Rubella vaccinations. -  Image Courtesy of UNICEF

Children in Aden, Yemen show off the spots where they received their Measles and Rubella vaccinations.

Image Courtesy of UNICEF

Measles cases are on the rise. All WHO regions are experiencing large, often extended outbreaks of the disease. Many countries have declared outbreaks.

Outbreaks occur when the actual number of cases reported in an area exceed the expected number. The expected number is specific to the individual country. It can range from a very small number of cases (in areas where the disease has previously been eliminated) to a high number (where endemic transmission is still present). Movement of disease within a country and from country to country through travel is especially concerning.

Measles is extremely contagious. It can spread to others through coughing and sneezing. Also, measles virus can live for up to two hours in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. It is estimated that around 9 in 10 people who are not already immune will become infected following exposure.

Measles can be very serious. In 2017, measles caused approximately 110,000 deaths. Possible complications include encephalitis (an infection that leads to swelling of the brain), pneumonia, severe diarrhea and dehydration, and/or permanent disability. In developing countries, approximately 1 of every 100 children with measles will die from the disease or its complications.

 Measles is preventable. Measles can be prevented with the MMR vaccine. It is very safe and effective. Two doses of the vaccine are about 97% effective at preventing measles; one dose is about 93% effective. Because of vaccination, measles deaths have been reduced by 80% since 2000, and more than 21 million lives have been saved. Additional work is required to ensure high levels of vaccination coverage in many areas. Without urgent efforts to address gaps in coverage, outbreaks like the ones occurring around the world will continue to occur.

Latest Outbreak Information by Region and Country

WHO AFRICA REGION

 

Democratic Republic of the Congo (DRC)

  • As of 23 April 2019, 61,097 suspected cases were reported and 1,129 deaths.
  • Since August 2010, DRC has experienced a resurgence of outbreaks of measles in almost all provinces.
  • Provinces reporting large numbers of cases include Tshopo, Haut-Lomami and Lualaba. Sixty health zones are now in epidemic status. DRC’s case count for 2019 will surpass the 67,072 cases identified in 2018 in less than 6 months into the year.
  • The government has been conducting localized outbreak response measures including case management and mass vaccination in the affected provinces since mid-2018 with the help of partners.

 

Madagascar

  • Between 3 September 2019 and 28 April 2019, more than140,000 cases were reported and 902 deaths. More than 18,000 cases have been recorded as complicated measles cases requiring additional medical care.
  • The most highly impacted age groups is children ages 9 months to 9 years old. They comprise 54% of cases.
  • Case management services for confirmed cases are being provided free of charge.
  • Active case search electronic surveillance, social mobilization and point of entry are ongoing.
  • Cases have declined over the past 7 weeks, indicating the positive impact of the outbreak response. Additional efforts may be required to prevent new outbreaks and address gaps in vaccine coverage.
  • The third round of a three-phase vaccination campaign took place from March 25th to April 5th, 2019. Preliminary data reported that more than 3.9 million children of 6 months to 9 years of age were vaccinated.

 

Nigeria

  • As of 14 April 2019, more than 20,000 suspect cases of measles and 50 deaths were reported.
  • Nigeria’s Emergency Operations Center was activated in March 2019 to respond to the outbreak and coordinate the multi-sector response. Rapid response teams were sent to the most highly affected areas.
  • The state suffering the greatest impact is Borno, with more than 48% of the cases reported in country.
  • Supplemental immunization and strengthened surveillance activities are planned as part of the response, including campaigns for children 6 months to 9 years in selected areas in Borno State.

South America Region

  • Between 1 January 2019 and 20 April 2019, PAHO reported 285 confirmed cases of measles in South America: Argentina (4), Brazil (48), Chile (3), Columbia (86), Peru (1), Uruguay (3), and Venezuela (140).
  • Many of these cases were linked back to the ongoing outbreak in Venezuela that began in 2017. New importations that have been documented in the region contribute to the overall surge in cases and persistence of the outbreak.
  • Efforts are ongoing in each country to increase coverage of two doses of measles containing vaccine. As a result, measles cases from all sources have decreased dramatically in 2019 compared to 2018.

 United States

France

  • In the first two month of 2019, 313 cases were reported.An outbreak of measles at a ski resort in the region of Trois Vallées, France was identified in February 2019. As of 13 March, a total of 53 cases of measles linked to this outbreak have been reported by five European countries.
  • Outbreak response measures are being implemented by the Regional Health Authority including: contact tracing, screening, vaccination, risk communication and treatment of cases.

Israel

  • In the first two months of 2019, more than 400 cases of measles were reported.
  • More than 3,500 cases were reported in the 12 months period beginning in January 2018 and ending in February 2019.
  • Reports indicate cases in Israel are linked to the outbreak in the Ukraine (including travel to Uman, Ukraine for Rosh Hashana) and to cases in the United States.
  • WHO EURO recently noted that mismatches between the Israeli health system and the individuals it provides services to may have contributed to low vaccination rates.

 Poland 

  • Between 1 January 2019 and 30 April 2019, Poland reported 808 measles cases. This is over twice the number of cases recorded in 2018 and fifteen times as many cases as reported for that same period in 2018.
  • Due to the increase in the number of measles outbreaks and cases, The National Institute of Public Health of Poland has moved the age of the second dose of measles (MMR) from 10 years of age to 6 years in 2018 and 2019. The first dose of the measles containing vaccine is still given between 13 and 15 months of age. 

Ukraine

  • In the first 17 weeks of 2019, 43,783 cases of measles and 15 deaths were reported.
  • At this rate, Ukraine will supersede the 54,000 cases reported in 2018 long before the end of 2019.
  • Since the beginning of the outbreak in 2017, more than 103,000 cases have been reported. The prolonged nature of the outbreak has been linked to a fall in measles vaccination coverage that reached 31% in 2016.
  • Of the cases reported in the first three months of 2019, 46% were adults.
  • Nationwide efforts are ongoing to vaccinate children and at risk-adults by making vaccine free for all ages. Coverage remains at just over 80% in 2018.

 

Japan

  • Between 1 January 2019 and 17 April 2019, 406 cases of measles were reported.
  • More than 75% of cases were in adults over 15 years of age. Individuals ages 20-39 were the most highly impacted.
  • A concurrent outbreak of Rubella, which presents with similar symptoms and is addressed by giving the same measles-rubella vaccine, is ongoing with more than 1,000 cases reported in the first 3 months of 2019. Similar to the measles outbreak, adults are the most highly impacted age group. 

Hong Kong

  • Between 1 January 2019 and 2 May 2019, 64 confirmed cases of measles were reported.
  • More than 40% of cases are employees at the local international airport and an international airline.
  • Vaccination for airport staff is ongoing for employees.
  • Outbreak response measures have been put in place for cases outside of the airport staff as needed.
  • More than 8,300 individuals have been vaccinated as part of the response.

The Philippines

  • As of 13 April 2019, 31,056 cases of measles and 415 deaths were reported from all 17 regions of the country. In 2018, the total number cases reported was 18,407.
  • About half of all cases have been children under 5 years of age.
  • More than 80% of deaths were of children under age 5 years of age.
  • WHO estimates that 2.6 million children under the age of 5 years in the Philippines are not protected from measles due to decreases in immunization coverage over the last decade.
  • As of the end of March 2019, over 3.8 million children aged 6 to 59 months had been vaccinated as part of outbreak response measure.
  • A communications campaign has also been launched to increase awareness of the importance of immunization.

What is CDC Doing

In coordination with partners including WHO, Gavi and the Measles & Rubella Initiative, CDC provides the following services

  • Guidance on measles and rubella elimination across the globe
  • Support for outbreak investigations
  • Surveillance and specialized laboratory testing
  • Planning, implementation, monitoring & evaluation of immunization campaigns
  • Reviews of immunization programs

Supporting Global Health Security

Diseases do not respect geographical borders. Diseases travel as easily as people and products. Through rigorous programs around the globe targeting vaccine-preventable disease globally, CDC protects Americans from getting sick from diseases that come into the United States from other countries. Learn more about CDC’s role in Global Health Security.

Page last reviewed: February 24, 2019
Content source: Global Health