Created in June, 2014, by Centers for Disease Control and Prevention (CDC) Medical Epidemiologist, Umid Sharapov, M.D., M.Sc., this image depicts CDC Epidemic Intelligence Service (EIS) Officer, Lucy Breakwell, Ph.D., M.Sc., wearing the appropriate personal protective equipment (PPE), which included a face mask, gloves, and a lab coat, as she was in the process of obtaining a nasopharyngeal swab from a child with measles, on the island of Kosrae, part of the Federated States of Micronesia (FSM). FSM is an independent sovereign island nation in the Western Pacific Ocean. No measles cases were reported in 20 years before this outbreak. When the first cases were reported, a CDC Epi-Aid team was dispatched to investigate the outbreak. There were 371 cases reported on three islands, over a 6 month period. This was one of the entries in the 2015 CDC Connects, Public Health in Action Photo Contest.

CDC Epidemic Intelligence Service (EIS) Officer, Lucy Breakwell, Ph.D., M.Sc. obtaining a nasopharyngeal swab from a child with measles. By Centers for Disease Control and Prevention (CDC) Medical Epidemiologist, Umid Sharapov, M.D., M.Sc. View this image or search images by topic on the Public Health Image Library (PHIL)

Measles is an acute viral infectious disease. References to measles can be found from as early as the 7th century. The disease was described by the Persian physician Rhazes in the 10th century as “more to be dreaded than smallpox.” Despite the fact that it is preventable through vaccination, measles remains a common disease in many parts of the world, including areas in Europe, Asia, the Pacific, and Africa.

What is the global impact of measles?

  • Worldwide, 36 cases of measles per 1 million persons are reported each year; about 134,200 die.
  • For every 1,000 children who get measles, one or two will die from it. As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children. About one child out of every 1,000 who get measles will develop encephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or with intellectual disability.

Who is at risk?

  • Measles is highly contagious and spread through airborne transmission (person-to-person through sneezing or coughing).
  • Measles can be a serious in all age groups. However, children younger than 5 years of age and adults older than 20 years of age are more likely to suffer from measles complications. Common measles complications include ear infections and diarrhea. Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.
  • Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops 7 to 10 years after a person has measles, even though the person seems to have fully recovered from the illness.
  • Measles is a serious and potentially fatal disease, but it can be prevented through vaccination. The vaccine can be delivered as a combined measles-rubella (MR) vaccine, or combined with vaccines against mumps (MMR) and varicella (chickenpox) (MMRV).

What is CDC doing?

  • As a founding member of the Measles and Rubella Initiative (M & RI)External, launched in 2001, CDC provides both scientific and technical support to partners and countries in other parts of the world to reduce measles and rubella deaths. CDC played a key role, in partnership with the Pan American Health Organization (PAHO)External, to develop a regional measles elimination strategy in 1996, and in 2016, measles and rubella were eliminated in the Western Hemisphere (Americas). We know that it can be done in the rest of the world!
  • As part of the Measles and Rubella Initiative, the CDC:
    • Helps plan at a macro-and micro-level, implement, monitor, and evaluate measles and rubella vaccination campaigns in targeted areas to eliminate measles, rubella and CRS.
    • Conducts operational research to provide evidence for recommendations that strengthen and guide measles- and rubella-control activities at the local, regional, and global levels.
    • Helps evaluate the burden of rubella and CRS in countries to provide evidence for the introduction of rubella-containing vaccines.
    • Provides technical assistance to conduct measles and rubella outbreak investigations, surveillance reviews, and routine vaccination program evaluations.
    • Helps create and/or strengthen case-based measles, rubella, and CRS surveillance systems that allow countries to detect, monitor, and quickly respond to the presence of measles, rubella, and CRS.
    • Serves as the global reference laboratory for measles and rubella.
    • Provides resources for national reference laboratories.
    • Provides technical assistance to global public health laboratories for the collection and shipment of clinical samples for measles testing using real-time polymerase chain reaction (RT-PCR).
Global Measles: CDC Science in the News
Photo: MeaslesVaccineTW
Progress Toward Regional Measles Elimination — Worldwide, 2000–2017

“In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan; as a result, countries in all six World Health Organization regions have adopted goals for elimination of measles by 2020. During 2000–2017, annual reported measles incidence decreased 83%, and annual estimated measles deaths decreased 80%.

Since 2000, global measles elimination efforts have prevented an estimated 21.1 million deaths. However, measles elimination milestones have not been met, and three regions are experiencing a large measles resurgence.”
Read the full Morbidity and Mortality Weekly Report

Global Measles – CDC in the News
NPR: Venezuela’s Health Crisis Spills Over To Neighboring CountriesExternal – February 15, 2019
Measles is highly contagious, and Linkins at the CDC says that to stop outbreaks, health officials need to keep 95 percent of the population immunized. Each year that children weren’t vaccinated in Venezuela, the pool of people whom measles could potentially infect grew. And the country became fertile ground for the virus.
“It was not a surprise to many of us that Venezuela was going to have an outbreak. It was inevitable that a [measles] case would be introduced because there’s measles all over the world.”
-Dr. Robert Linkins, Branch Chief of Accelerated Disease Control and Vaccine Preventable Disease Surveillance

Science News: Around the world, reported measles cases jumped 31 percent in 2017External – November 30, 2018
“Global efforts to eliminate measles continue to make progress. Despite these gains, multiple regions have experienced large measles outbreaks in 2017, primarily due to low vaccination coverage nationally or in geographic pockets, illustrating how fragile gains in disease elimination can be.”
-Dr. Rebecca Martin, Director of CDC’s Center for Global Health

In Nigeria, a little girl prepares to receive her measles vaccination while other children watch.

In Nigeria, a little girl prepares to receive her measles vaccination while other children watch.

Nurses document their measles vaccination activities.

Nurses document their measles vaccination activities.

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Page last reviewed: February 27, 2019
Content source: Global Health