Houston, Texas, USA : A raging measles outbreak in Europe may be a warning sign of what could occur in the U.S. if something doesn’t change soon, experts say.
So far this year, there have been 41,000 cases in Europe and 40 deaths, according to the World Health Organization. The European experience may offer a window on how quickly things can go awry when parents choose not to vaccinate their children, doctors caution.
Because measles is relatively rare in the U.S., many Americans have no idea of the disease’s frightening impact and its stunning contagiousness.
Many forget that measles isn’t just a childhood disease.
Silvia Rosetti, who lives in Rome, still has nightmares about contracting measles when she was 32 weeks pregnant in 2017. When Rosetti, now 41, was a child, measles vaccines were not required and she didn’t think about the risk of exposure when she first became pregnant. She was healthy and ecstatic at the thought of having her first child. But then she caught measles and the symptoms came on in a rush: fever, cough and congestion so bad she could barely breathe.
“The situation got worse and worse so they decided to do a C-section,” Rosetti said. “I went into quarantine for five days. I couldn’t see my baby.” Her newborn son, Nathan, was also quarantined until doctors determined he was not infected. Rosetti developed pneumonia as a complication of her measles and was so weak she couldn’t stand up.
“And I had a rash even in my eyes, so I couldn’t see anything,” Rosetti said.
Rosetti eventually recovered. Her baby, Nathan is now a year old and has gotten all his vaccinations.
“If you do the vaccination, you love yourself, you love your sons, and you love everybody,” she said. “You protect everybody. It’s not just for myself or for my son.”
Rosetti is one of the more than 2,000 people in Italy who have been diagnosed with measles already this year.
“We have a very serious situation,” said Dr. Alberto Villani, pediatric infectious disease doctor at Bambino Gesù Pediatric Hospital and the president of the Italian Pediatric Society. “People are dying from measles. This was unbelievable five or 10 years ago.”
Even in England, which had been declared free of measles by the World Health Organization a year ago, cases are surging.
The reason, experts say, is that in Europe, many parents have opted to skip vaccinating their children. “It’s the main factor leading to the outbreaks,” said Anca Paduraru of the European Commission in Brussels. “It’s unacceptable to have in the 21st century diseases that should have been and could have been eradicated.”
At least 95 percent of the population must have received at least two doses of measles vaccine to prevent outbreaks, WHO said. Some parts of Europe are below 70 percent.
The measles vaccine has been available in the U.S. since 1963, and is now commonly administered to children in tandem with the vaccines for mumps and rubella. The effectiveness of the vaccine led federal officials to declare measles eradicated in the U.S. back in 2000. Before the vaccine, there were 3 million to 4 million cases annually, according to the Centers for Disease Control and Prevention.
But the success of vaccines has at least in part been their undoing.
Many parents are unfamiliar with the havoc measles can wreak because there have been few cases in the U.S. since the vaccine became widely available, said Dr. Jeffrey D. Klausner, a professor of medicine and public health at the University of California, Los Angeles.
“People don’t see them and so they forget about them or they think the diseases don’t exist anymore,” Klausner said. “They don’t realize their child is at risk for measles meningitis, encephalitis and permanent brain damage.”
As in Europe, the number of children in the U.S. going unvaccinated has been increasing in certain parts of the country, said Dr. Albert W. Wu, an internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.
“This is a real setup for disaster since measles is insanely contagious,” Wu said. “This is an accident waiting to happen.”
Why, when vaccines have been so successful at wiping out scourges like smallpox and polio, have parents become so skeptical of them?
“What has been happening in Europe is now happening in the U.S. — on a smaller scale at this point,” said Dr. Peter Hotez, director of the Texas Children’s Hospital Center for Vaccine Development at Baylor College of Medicine and author of “Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad.”
The problem is the plethora of misinformation online, Hotez said. “The anti-vaccine groups have made very strategic use of the internet and social media,” he added. “It’s estimated that there are more than 400 anti-vaccine websites now, and when you put ‘vaccine’ into a search engine, it’s almost inevitable you’re going to get an anti-vaccine website popping up.”
And it’s not just the internet, Hotez said. “Now there are political action committees popping up in several states, including Texas,” he added.
It’s not clear what exactly is driving the anti-vaccine movement, Hotez said. But “there’s an element of the anti-vaccine movement that is peddling alternative therapies and making money off of phony treatments,” he said. “And there’s an element that have tied themselves to different political groups. In Texas the major anti-vaccine lobby likes to use libertarian garbage terms like ‘medical freedom’ or ‘medical choice.’ ”
The anti-vaxxers have had such a large impact that “now there is a terrific vulnerability in states like Texas and up in the Pacific Northwest,” Hotez said. “People forget that before kids were getting vaccinated we had between 400 and 700 deaths from measles annually in the U.S.”
Right now, there is no public relations campaign to explain why vaccines are so important, Hotez said. “It’s left to a handful of academics who are willing, like me, to go out and tell their personal stories,” he said. “And we’re clearly outgunned.”
Hotez said he wouldn’t be surprised to see a major measles outbreak in the U.S. this year.
That might help people understand what’s at stake, Wu said, adding, “I’m afraid it will take a really big outbreak in the United States before we begin to see a reversal of this anti-vaccine sentiment.”
EARLIER : Measles Cases In Europe Hit Record High, WHO Says
Copenhagen, Denmark : Over 41,000 children and adults in the European Region have been infected with measles in the first six months of 2018, the World Health Organization (WHO) reported on Monday.
Monthly country reports also indicate that at least 37 people have died due to measles so far this year.
The total number for this period far exceeds the 12-month totals reported for every other year this decade. So far, the highest annual total for measles cases between 2010 and 2017 was 23 927 for 2017, and the lowest was 5273 for 2016.
“Following the decade’s lowest number of cases in 2016, we are seeing a dramatic increase in infections and extended outbreaks,” says Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “We call on all countries to immediately implement broad, context-appropriate measures to stop further spread of this disease. Good health for all starts with immunization, and as long as this disease is not eliminated we are failing to live up to our Sustainable Development Goal commitments.”
Seven countries in the Region have seen over 1000 infections in children and adults this year (France, Georgia, Greece, Italy, the Russian Federation, Serbia and Ukraine). Ukraine has been the hardest hit, with over 23 000 people affected; this accounts for over half of the regional total. Measles-related deaths have been reported in all of these countries, with Serbia reporting the highest number of 14.
Uneven progress towards measles and rubella elimination
According to the latest assessment by the European Regional Verification Commission for Measles and Rubella Elimination (RVC), released today, 43 of the Region’s 53 Member States have interrupted the endemic spread of measles and 42 have interrupted rubella (based on 2017 reporting).
At the same time, the RVC expressed concerns about inadequate disease surveillance and low immunization coverage in some countries. It also concluded that chains of measles transmission continued for more than 12 months in some countries that had interrupted the endemic spread of the disease, reverting their status back to endemic.
“This partial setback demonstrates that every person who is not immune remains vulnerable no matter where they live, and every country must keep pushing to increase coverage and close immunity gaps, even after achieving interrupted or eliminated status,” says Dr Nedret Emiroglu, Director of the Division of Health Emergencies and Communicable Diseases at the WHO Regional Office for Europe.
Measles can be stopped
The measles virus is exceptionally contagious and spreads easily among susceptible individuals. To prevent outbreaks, at least 95% immunization coverage with 2 doses of measles-containing vaccine is needed every year in every community, as well as efforts to reach children, adolescents and adults who missed routine vaccination in the past.
While immunization coverage with 2 doses of measles-containing vaccine increased from 88% of eligible children in the Region in 2016 to 90% in 2017, large disparities at the local level persist: some communities report over 95% coverage, and others below 70%.
WHO is working closely with Member States currently facing outbreaks to implement response measures, including enhanced routine and supplemental immunization as well as heightened surveillance to quickly detect cases. WHO is also working with other countries to attain the 95% threshold.
“At this midterm juncture for the European Vaccine Action Plan, we must celebrate our achievements while not losing sight of those who are still vulnerable and whose protection requires our urgent and ongoing attention,” concludes Dr Jakab. “We can stop this deadly disease. But we will not succeed unless everyone plays their part: to immunize their children, themselves, their patients, their populations – and also to remind others that vaccination saves lives.”
“All 53 countries in the Region will review midterm progress towards the goals of the European Vaccine Action Plan at the 68th session of the WHO Regional Committee for Europe, taking place in Rome, Italy, on 17–20 September 2018”, WHO said.
The increase in Europe has come even as measles continues to decline worldwide.
Public health officials say that at least 95 percent of a population must have immunity to control the spread of measles, which experts call the world’s most contagious human disease. But in Europe, only about 90 percent of children receive the recommended two-dose vaccine in early childhood as recommended, the W.H.O. said, and last year, only Russia and a handful of small countries reached the 95 percent mark in young children. The rate in the United States was 94 percent.
Several European countries, including relatively wealthy ones like France, Belgium and Austria, were at 85 percent or less. And in many countries, vaccination rates for young children have actually declined somewhat in recent years.