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), 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), 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

During 2000–2018, increased coverage with measles vaccines, supplemental immunization activities, and other elimination efforts contributed to a 66% decrease in reported measles incidence, 73% reduction in estimated measles mortality, and a reduction in the number of circulating wild measles genotypes worldwide. Measles vaccination prevented an estimated 23.2 million deaths during this period.

Despite this progress, global measles control milestones have not been achieved, reported measles incidence has increased in five of the six World Health Organization regions since 2016, and estimated global measles deaths have increased since 2017. Large measles outbreaks in countries with weak immunization systems accounted for most reported measles cases. Outbreaks should serve as opportunities to investigate underlying causes for under-vaccination and to design and implement specific routine immunization strengthening activities to prevent future outbreaks.

Learn More:

Global Measles – CDC in the News
Washington Post: CDC sends experts to fight measles outbreaks in Pacific islands neighboring Samoa – December 11, 2019
“Health officials want to make sure “to communicate that the disease is dangerous and that the vaccine is good,” Robert Linkins, a global immunization official at CDC’s headquarters in Atlanta, said in a recent interview.”

NPR Measles Numbers Were Bad In 2018. This Year, They’re Even Worse – December 5, 2019
“”[Measles] indicates that there are problems in a community with other vaccine preventable disease coverage,” Robert Linkins, head of the Accelerated Disease Control and Surveillance Branch at the Centers for Disease Control and Prevention, says. “And in many respects, it’s a signal that we’ve got to pay more attention to where measles is occurring.””

The Hill: CDC: Herd immunity helps to protect the entire community (Opinion) – May 2, 2019
“Measles, a leading childhood killer globally, will exploit gaps in our ability to reach every child and adult with the recommended two doses of vaccine. We know that 90 percent of people who are exposed to the virus, who have not had measles or are under-vaccinated, will become infected and will be contagious to others for days before they develop the telltale measles rash.”
-Dr. Rebecca Martin, Director of CDC’s Global Health Center

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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