WHO reports measles deaths decline, but elimination stalls in some regions

Improved vaccination rates critical for success

17 JANUARY 2013 | GENEVA ― The number of measles deaths globally decreased by 71% between 2000 and 2011, from 542 000 to 158 000. Over the same period, new cases dropped 58% from 853 500 in 2000 to 355 000 in 2011, according to new data released Thursday by the World Health Organization, a leading member of the Measles and Rubella Initiative. Although the WHO Region of the Americas* has sustained measles elimination since 2002, and the WHO Western Pacific Region** is on track to achieve elimination, large outbreaks of measles are jeopardizing progress in the remaining regions that have these goals.

WHO recommends that every child receive two doses of measles vaccine.[1] The new data, published in this week’s edition of the CDC’s Morbidity and Mortality Weekly Report and then in WHO’s Weekly Epidemiological Record, show overall progress in reducing deaths is linked largely to increased vaccination coverage.

Estimated global coverage with a first dose of vaccine increased from 72% in 2000 to 84% in 2011. The number of countries providing the second dose through routine services increased from 97 in 2000 to 141 in 2011. Since 2000, with support from the Measles & Rubella Initiative, more than 1 billion children have been reached through mass vaccination campaigns ― about 225 million of them in 2011.

Despite this global progress, some populations remain unprotected. An estimated 20 million children worldwide did not receive the first dose of vaccine in 2011. More than half of these children live in five countries: the Democratic Republic of the Congo (DRC) (0.8 million), Ethiopia (1 million), India (6.7 million), Nigeria (1.7 million), and Pakistan (0.9 million).

In 2011, large measles outbreaks were reported in all these countries and several others: in DRC (134,042 cases), Ethiopia (3,255 cases) India (29,339 cases), Nigeria (18,843 cases), Pakistan (4,386 cases) France (14,949 cases), Italy (5,189 cases), and Spain (3,802 cases). Most of these countries are in WHO regions which have committed to eliminate measles by 2015 or 2020.

The measles outbreaks pose a serious challenge to the regional elimination efforts and signal where national health systems and routine immunization programmes need strengthening. Resuming progress in reducing measles cases and deaths means strengthening health systems so that they can provide effective immunization services and laboratory-supported surveillance for vaccine-preventable diseases to all children. The outbreaks also indicate the need to ensure that parents are fully aware of the benefits of immunization and the risks associated with not vaccinating children.