Explainer: Low vaccination rates, global outbreaks fuel U.S. measles spread
UNTV News • February 18, 2019 • 11471
(Reuters) – A measles outbreak that has stricken at least 225 people in New York state since October began with a traveler who visited Israel during the Jewish high holidays and returned to a predominantly ultra-Orthodox Jewish neighborhood of Rockland County.
A similar pattern unfolded three months later and nearly 3,000 miles (4,800 km) away when a person who visited Eastern Europe returned to a community with strong ties to a local church group in Vancouver, Washington. More than 50 people fell ill there.
In both instances, U.S. travelers picked up measles in foreign countries where the highly contagious disease was running rampant and brought it back to places where vaccination rates were too low by U.S. public health standards, setting off the worst outbreaks seen in those states in decades.
The U.S. Centers for Disease Control and Prevention says New York’s outbreak marks the highest tally of imported cases since measles was declared eradicated in the United States in 2000.
The two outbreaks appear to be winding down, health officials say, after concerted efforts to pinpoint the origins and isolate and inoculate those who were exposed but unprotected and educate parents who had resisted vaccines.
The disease has spread mostly among school-age children whose parents declined to get them vaccinated. Most cited philosophical or religious reasons, or concerns – debunked by medical science – that the three-way vaccines against measles, mumps and rubella (MMR) could cause autism, authorities said.
New York State Health Commissioner Dr. Howard Zucker said another key factor was mere “complacency” in an age where the potential ravages of measles are unfamiliar to parents who came of age after the vaccine was introduced in 1957.
In Rockland County, the suburb north of Manhattan accounting for the bulk of cases, the state has vaccinated 15,000 children since the outbreak began there last autumn, Zucker said. The Brooklyn borough of New York City was another hot spot.
Still, officials say the measles crisis in New York and Washington states offer a lesson about the importance of maintaining a minimum level of “herd” immunization against dangerous, preventable diseases such as measles.
It also highlights the global nature of disease control, in which a hot spot of infection in one country can ignite a distant outbreak in an immunization-weak spot of another, said Dr. Scott Lindquist, Washington’s top epidemiologist.
Here are some key facts about measles and immunization, according to public health experts and the CDC.
WHAT IMMUNIZATION RATES ARE IDEAL?
A 95 percent rate of immunization is required to provide sufficient “herd” protection in a given population. Rates as low as 60 percent were found in parts of New York where measles spread, Zucker said.
HOW BAD CAN MEASLES GET?
Symptoms typically include high fever, cough, runny nose and watery eyes, followed by tiny white spots inside the mouth and a red rash that can cover the body.
Serious and potentially fatal complications, especially in young children and pregnant women, can include pneumonia and swelling of the brain. Ear infections occur in about 10 percent of children with measles and can lead to permanent hearing loss.
One rare but fatal complication is subacute panencephalitis (SSPE), which can attack the central nervous system seven to 10 years after a person has recovered from measles.
HOW CONTAGIOUS IS MEASLES?
Measles is spread through casual contact with the virus, which can linger and remain infectious in the air of an enclosed space for up to two hours after it is breathed out by someone carrying the disease. The rate of transmission from an infected person to another individual nearby who lacks immunity is about 90 percent.
ORIGINS OF LATEST OUTBREAKS?
Health authorities say the strain of the virus identified in Washington state matches the one circulating widely in Ukraine since last year. The New York outbreak has been tracked back to separate flare-ups of measles in Israel and in Eastern Europe.
Reporting by Steve Gorman in Los Angeles; Editing by Bill Tarrant and Peter Cooney
The world is backsliding in the fight against measles, which can disable or kill, especially children, with a record number of cases recorded up to August only since 2006 and nearly three times as many cases than in July 2018 at that time, the World Health Organization (WHO) said on Thursday (August 30).
The biggest outbreaks of the highly contagious disease — one person with measles can spread it up to 18 non-immunized other people — are raging in the Democratic Republic of Congo (155,460 cases), Madagascar (127,454) and Ukraine (54,246) it said.
Europe has lost ground also, with four countries stripped off their “measles-free” status in 2018 — Albania, Czech Republic, Greece, and Britain, the WHO said.
The United States has recorded 1,215 measles cases across 30 states in its worst outbreak since 1992, federal health officials said on Monday.
Nearly 365,000 cases have been reported globally this year, the highest figure since 2006, according to the U.N. Health Agency, noting that they represent only a fraction of the 6.7 million estimated cases annually.
A vaccine-preventable disease, measles caused an estimated 109,000 deaths in 2017, figures for 2018 won’t be known before November.
Weak health systems, a lack of vaccines in some areas, and complacency towards the disease, leading people to believe that since it has been eliminated there is no need to get vaccinated, are behind the surge, the WHO says.
Trust in vaccines — one of the world’s most effective and widely-used medical products — is highest in poor countries but weaker in wealthier ones where skepticism has allowed outbreaks of diseases such as measles to persist, a global study found in June.
In 53 countries of Europe, 90,000 measles cases were recorded in the first half of this year, more than that for all of 2018, according to the WHO. (REUTERS)
MANILA, Philippines – The Department of Health (DOH) onWednesday relaunched its school-based immunization program in a bid to have some 9 million children catch up on missed vaccinations this year.
Health Secretary Francisco Duque III said the program aims to immunize students from kindergarten to Grade 7 with the measles and rubella vaccines. Students will also be given booster doses of tetanus-diptheria vaccines.
Duque led the vaccination of some children in Signal Village National High School in Taguig City on Wednesday morning (July 3).
The DOH chief said all students will undergo a quick health assessment and review of their vaccination status, stressing that only students with parental consent will be immunized.
In a speech, Duque called on parents to have their children vaccinated to protect them against diseases. He also cited the low response rate on the government’s immunization program due to reduced public trust following the dengvaxia controversy.
Although public response and trust in national immunization program has been notably increasing in Metro Manila in the past few months, Duque admitted, much is still needed to be done.
“Mababa pa rin, so iyan po mababa pa rin. That’s why we still need to aggressively pursue our National Immunization Program,” he said.
The DOH’s relaunching of its school-based immunization program comes after the declaration of a measles outbreak in February 2019. The outbreak status has yet to be lifted since its declaration in Metro Manila, Central Luzon, Calabarzon, Western Visayas and Central Visayas.
According to Duque, they are targeting to reach 95% vaccination coverage this year to prevent repeated declaration of disease outbreaks due to the proliferation of false information.
“May iba umiiyak dahil namatay isa, dalawang anak dahil lang sa ayaw magpabakuna dahil nga bunsod ng maling impormasyon na kumakalat sa mga komunidad at minsan hindi naman talaga naippliwanag ng sapat.. ang nagiging resulta ay ang kaaawa-awang bata na nagkakaroon ng komplikasyon gaya ng measles,” he added.
The health official further emphasized the importance of availing free immunization in relation to the implementation of the Universal Health Care Law.
Duque said the school-based immunization program for this year will run until September. (with details from Aiko Miguel)
The Department of Health has given a total of 862,237 measles vaccines to 862,237 children in Cavite, Laguna, Batangas, Rizal, Quezon (Calabarzon).
According to the Regional Epidemiology and Surveillance Unit’s report, this number of vaccinees from January 1, 2019 to March 11, 2019, is just around one-half (50.9%) of the total population of children in the region.
Cavite recorded the highest number of cases with 235,604 (52.10%); followed by Laguna, 189,433 (52.53%); Batangas, 108,898 (34.09%); Rizal, 214,253 (61.55%) and Quezon 114,049 (47.35%), according to Regional Dir. Eduardo Janairo.
Based on DoH-Calabarzon’s account, the region has recorded at least 5,041 cases of measles, 104 of which have died due to complications.
Janairo assured that they will continue to scour the region, as well as the far-flung communities to provide vaccines.
From January 1 to March 7, the DOH has recorded a total of 18,553 measles cases nationwide with 286 deaths. — Freema Salonga-Gloria /DOH
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