Measles-a Very Preventable Disease-on the Rise Globally and in the United States

Measles killed more 142,300 people in 2018, most of them children 5 years and younger, and the provisional data for 2019 points to a 3-fold increase in the disease globally, according the World Health Organization (WHO). The disease infected about 9.7 million people in 2018, compared to 7.5 million in 2017, when 124,000 died from the disease. 

Sub-Saharan Africa bore the brunt due to a lack of adequate immunization. Specifically, the countries where the disease hit hardest in 2018 were Liberia, Ukraine, Democratic Republic of Congo, Madagascar, and Somalia. These countries accounted for nearly half the cases worldwide. 

But the disease is also resurfacing in developed nations, driven in part by a vocal anti-vaccine campaign. For instance, 4 European countries-the United Kingdom, Greece, Albania, and the Czech Republic-lost their measles-free status in 2018 as a result of outbreaks.  

In the United States, measles hit 1261 cases, as of November 7, a 240% increase over all of 2018, according to the US Centers for Disease Control and Prevention (CDC). That represents the highest number of measles cases in this country in 25 years.

States that have reported outbreaks of the disease include California, Georgia, Illinois, Michigan, New Jersey, New York, Oregon, Pennsylvania, Texas, and Washington.

No one in this country has died from measles. “From January 1-November 7, 2019, 123 of the people who got measles this year were hospitalized, and 61 reported having complications, including pneumonia and encephalitis,” according to the CDC. 

Although measles has seen a worrisome rise year-to-year recently, the 9.7 million infections worldwide is dwarfed by the 28 million cases the WHO recorded in 2000, the first year it began tracking the disease. 

But that also may be fueling the frustration of health professionals everywhere: Here was a disease on its way to elimination that’s now making a comeback. That, and the fact that most of the victims are children. 

The WHO's director general, Tedros Adhanom Ghebreysus, said in a statement that “the fact that any child dies from a vaccine-preventable disease like measles is frankly an outrage and a collective failure to protect the world's most vulnerable children.”

As the CDC states, the majority of cases are among people who were not vaccinated against measles. Social media has helped to spread misinformation about vaccination and the WHO warned that that could “reverse progress made in tackling vaccine-preventable diseases.”

Some of those refusing to vaccinate their children against the disease do so for philosophical or religious reasons, or they believe the widely debunked theory that it causes autism and other health problems. The WHO this year labeled the anti-vax movement and vaccine hesitancy 1 of the top 10 health threats. 

Both the CDC and WHO warned of the serious life-threatening complications of measles, which were laid out recently in studies in the journals Science and Science Immunology.

Severe complications include brain damage, pneumonia, blindness, and deafness. In addition, it can damage the victim’s immune memory for years, leaving measles survivors vulnerable to flu or severe diarrhea.

And the WHO calls measles the world’s most contagious disease, more so than influenza, tuberculosis, or Ebola. It remains in the air or on surfaces for several hours after an infected person has left.

Measles usually begins as a high fever that kicks in about 10 to 12 days after exposure and can last between 4 to 7 days. The initial stage usually includes a runny nose, cough, red and watery eyes, and small white spots inside the cheeks. Then, comes a rash that erupts usually on the face and upper neck. It takes about 3 days for the rash to spread, eventually reaching the hands and feet.