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.

Measles is extremely contagious. 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 it 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. Because of vaccination, measles deaths have been reduced by 80% since 2000, and more than 21 million lives have been saved. 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

Democratic Republic of the Congo (DRC)

  • In 2018, DRC reported 67,072 measles cases with 901 measles-related deaths.
  • The outbreak continues with more than 16,000 suspected measles cases, including 284 measles-related deaths occurring in the first weeks of 2019.

Madagascar

  • Between September 2018 and February 2019, Madagascar reported 67,422 measles cases, including 828 deaths.
  • All 22 regions of Madagascar have active measles outbreaks.
  • Most (84%) of measles-related deaths have been in children under nine months of age.

Brazil

  • Brazil reported 10,274 confirmed measles cases and 12 deaths in 2018, with the highest number of cases in children under 1 year.
  • The outbreak is related to an outbreak in neighboring Venezuela.
  • Brazil conducted selective vaccination campaigns in Roraima State for people 6 months to 49 years old from March 2018 to June 2018 and a nationwide follow-up campaign for people 12 to 59 months old in October 2018.

Colombia

  • Between March 2018 and January 2019, Colombia reported 212 confirmed measles cases, with 103 requiring hospitalization.
  • The highest number of cases are associated with importation from Venezuela, with Colombians under 1 year old being most affected.
  • Colombia conducted campaigns to vaccinate children 6-11 months against measles in prioritized departments from September 2018 to January 2019.

Ecuador

  • Ecuador experienced 19 cases in 2018, but no new cases have been reported since October 24, 2018.

United States

Venezuela

  • Between July 2017 and January 2019, Venezuela reported 6,395 confirmed measles cases (727 in 2017 and 5,668 in 2018), including 76 deaths (2 in 2017 and 74 in 2018).
  • Venezuela is experiencing a humanitarian and economic crisis, which has weakened the health system, resulting in gaps in vaccination coverage and reporting of cases and deaths.
  • The crisis in Venezuela has also led to a resurgence of other diseases previously under control, such as diphtheria and malaria.
  • Venezuela conducted a nationwide measles and rubella vaccination campaign targeting children 6 months to 14 years old from April to November 2018.

France

  • The current outbreak began in New Aquitaine in November 2017, but France reports the outbreak has been in decline since March 2018. A total of 2,913 measles cases have been reported.
  • France made the MMR vaccination, along with several others, mandatory for children born after January 1, 2018.

Israel

  • Israel has reported 3,125 confirmed cases and 2 deaths from March 2018 to January 2019.
  • Sixty-two percent of cases have occurred in Jerusalem District.
  • Cases are concentrated almost completely within Ultraorthodox Jewish communities.
  • Israel has undertaken a nationwide campaign to identify and vaccinate unvaccinated or incompletely vaccinated people. Nationwide, unvaccinated visitors are restricted from entering sensitive hospital departments.

Italy

  • Italy has reported 2,517 measles cases during 2018.
  • The Italian health ministers declared a measles emergency in November 2018 and is implementing a vaccination plan that aims to vaccinate 800,000 children up to the age of 16 during 2019.

Serbia

  • The current measles outbreak began in October 2017 and Serbia has reported 5,076 cases, with 88% of the cases reported in the City of Belgrade and the districts of Nišavski, Pčinjski, Raški, and Jablanički.
  • Serbia’s Public Health Institute has declared this outbreak to be the largest in Serbia in 25 years.

Ukraine

  • Ukraine has reported 80,618 measles cases since the latest outbreak began in 2017, with 21,355 of those cases occurring in 2019. Ukraine is the most heavily impacted country in the European region.
  • The most affected areas of Ukraine are: Lviv, Ivano-Frankivsk, Zakarpattya, Chernivtsi, and Ternopil. Vaccine priority is being given to those areas.
  • The extended nature of the outbreak in Ukraine is due to a fall in vaccination coverage. Between 2008 and 2016, the number of eligible children who were fully vaccinated against measles fell from 95% to 31%. This is the lowest coverage in the WHO European Region and among the lowest in the world.
  • Since July 2017, a national measles task force, including the Ministry of Health, key stakeholders and international partners, has been working to provide measles vaccine to all unvaccinated children, train laboratory staff, sensitize parents and health professionals about the importance of vaccination coverage, and dispel unfounded rumors about vaccinations. Vaccination rates for young children have improved dramatically as a result.

Philippines

  • Between January 1 and February 18, 2019, the Department of Health (DOH) in the Philippines reported 8,400 measles cases, including 130 deaths.
  • The outbreak is located in five regions in the Philippines: Metro Manila (National Capital Region), Central Luzon (Region 3), CALABARZON (Region 4A), Western Visayas (Region 6), and Central Visayas (Region 7). Other regions also have increasing numbers of measles cases and are at risk for possible outbreaks if the epidemic is not contained.
  • The Philippines has seen a decline in measles vaccination in the past decade from above 80% in 2008 to below 70% in 2017. Initial figures for 2018 indicate a further decrease. Inadequate vaccine delivery, accessibility issues in hard-to-reach areas and a decrease in vaccine confidence are among the multiple factors contributing to low immunization coverage in the Philippines.
  • In April 2018, the Department of Health launched a measles immunization campaign called “Ligtas Tigdas” to address the rising measles cases in the Philippines. The government has expanded the campaign to reach “defaulters” or unvaccinated children under 5 years old.

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