Cases of measles are rising around the world

Measles cases rose by 18 percent globally and deaths by more than 40 percent between 2021 and 2022, as countries struggled to get routine vaccinations back on track after the pandemic, according to a study. new report from the World Health Organization and the Centers for Disease Control and Prevention.

The report documents the ongoing burden of measles, one of the most contagious diseases in the world. According to the report, there were an estimated nine million cases of measles and 136,000 deaths in 2022.

The sickness spreads when infected people cough or sneeze — A person can become infected by breathing in the virus, which can linger in the air for hours, or by touching a contaminated surface and then rubbing the eyes, nose or mouth. Vaccination is very effective in stopping the spread of measles and prevents people from getting sick if exposed to the virus. The measles vaccine, which experts say is so ideally delivered in childhood, also includes protection against two other infectious diseases, mumps and rubella.

The report found that slightly more people were vaccinated against measles in 2022 than the year before, but almost 33 million children still missed a dose of the vaccine. Globally, 74 percent of people had been fully vaccinated, meaning they had received two doses. Low-income countries had the lowest vaccination rates, with only 66 percent of children receiving their first dose, and the highest risk of death from measles. Countries in Africa and Southeast Asia had particularly low coverage, said Cynthia Hatcher, a public health scientist at the CDC who works on measles elimination in Africa.

Many areas are struggling to rebuild their public health systems in the wake of the Covid-19 pandemic, she said.

“Measles is very difficult – it will find even the smallest holes in your protection,” she said. Public health officials estimate that 95 percent of people in a community need to be fully vaccinated to prevent outbreaks, a concept known as “herd immunity.”

Most cases and deaths in 2022 occurred among at-risk children serious complications of the disease, including pneumonia and swelling of the brain. More often, measles leads to fever, rash and coughing.

Large or disruptive outbreaks of the disease also became increasingly common in 2022. Thirty-seven countries experienced such outbreaks that year, compared to 22 countries in 2021.

The rise in cases is likely a legacy of the pandemic, said Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security. Vaccinations against many diseases, including measles, were being “pushed to the side” as people focused on Covid, he said. “There’s just been a major disruption in getting kids back on schedule — it’s harder than it looks,” he said. And many people avoided going to the doctor during the worst of the pandemic, delaying routine vaccinations and potentially leaving people susceptible, said Dr. Walter Orenstein, deputy director of the Emory Vaccine Center.

Although the burden of measles is largely concentrated abroad, the United States has faced its own challenges in controlling the disease. In 2019, there were several major outbreaks in more than 25 states. So far this year, the CDC has reported 41 cases of measles nationwide.

But experts are watching the United States with concern: The pandemic and misinformation about the safety and efficacy of Covid vaccines have fueled vaccine hesitancy across the country, Dr. Adalja. A CDC report released this month shows a slight increase in vaccine exemptions among American preschoolers students between the school years 2021-2022 and 2022-2023.

“What people need to understand, and where we haven’t done a good job in public health, is explaining to people that not all vaccines are equal,” says Dr. Camille Sabella, a pediatric infectious disease specialist at the Cleveland Clinic. The CDC estimates that two doses of the vaccine are 97 percent effective against measles. And it is never too late to get someone vaccinated.

“The way out of this situation is to increase vaccination rates and ensure that all children receive the age-appropriate measles vaccination,” he said. “That’s actually the only way out.”