Measles cases spike as Nigeria, 4 others record largest outbreak in one year 

The United Nations Children’s Fund, UNICEF, and the World Health Organisation, WHO, have warned of a “perfect storm” of conditions for measles outbreaks, as measles cases increased by 79 per cent in the first two months of 2022, compared to the same period in 2021.

In a related development, Nigeria, Somalia, Yemen, Afghanistan, and Ethiopia recorded the largest measles outbreak in 2021 due to insufficient measles vaccine coverage during outbreaks, wherever they occur.

In a report, the UN agencies stated that an increase in measles cases in January and February 2022 is a worrying sign of a heightened risk for the spread of vaccine-preventable diseases and could trigger larger outbreaks, particularly of measles affecting millions of children this year.

Pandemic-related disruptions, increasing inequalities in access to vaccines, and the diversion of resources from routine immunization are leaving too many children without protection against measles and other vaccine-preventable diseases, the report stated.

According to the report: “Almost 17,338 measles cases were reported worldwide in January and February 2022, compared to 9,665 during the first two months of 2021.

As measles is very contagious, cases tend to show up quickly when vaccination levels decline. 

Speaking on the development, UNICEF Executive Director, Catherine Russell, said measles is more than a dangerous and potentially deadly disease. According to Russell, “It is also an early indication that there are gaps in our global immunisation coverage, gaps vulnerable children cannot afford. 

“It is encouraging that people in many communities are beginning to feel protected enough from COVID-19 to return to more social activities. But doing so in places where children are not receiving routine vaccination creates the perfect storm for the spread of a disease like measles.” 

The risk for large outbreaks has increased as communities relax social distancing practices and other preventive measures for COVID-19 implemented during the height of the pandemic.

“Apart from its direct effect on the body, which can be lethal, the measles virus also weakens the immune system and makes a child more vulnerable to other infectious diseases like pneumonia and diarrhoea, including for months after the measles infection itself among those who survive.  Most cases occur in settings that have faced social and economic hardships due to COVID-19, conflict, or other crises, and have chronically weak health system infrastructure and insecurity, “the report noted.

In 2020, 23 million children missed out on basic childhood vaccines through routine health services, the highest number since 2009 and 3.7 million more than in 2019.

As of April 2022, the agencies report 21 large and disruptive measles outbreaks around the world in the last 12 months. Most of the measles cases were reported in Africa and the East Mediterranean region. The figures are likely higher as the pandemic has disrupted surveillance systems globally, with potential underreporting.

Speaking, the Director-General of the World Health Organisation, Dr Tedros Adhanom Ghebreyesus said: “The COVID-19 pandemic has interrupted immunization services, health systems have been overwhelmed, and we are now seeing a resurgence of deadly diseases including measles. For many other diseases, the impact of these disruptions to immunization services will be felt for decades to come.

“Now is the moment to get essential immunization back on track and launch catch-up campaigns so that everybody can have access to these life-saving vaccines.”

 As of 1 April 2022, 57 vaccine-preventable disease campaigns in 43 countries that were scheduled to take place since the start of the pandemic are still postponed, impacting 203 million people, most of whom are children. Of these, 19 are measles campaigns, which put 73 million children at risk of measles due to missed vaccinations.

In Ukraine, the measles catch-up campaign of 2019 was interrupted due to the COVID-19 pandemic and thereafter due to the war. Routine and catch-up campaigns are needed wherever access is possible to help make sure there are not repeated outbreaks as in 2017-2019 when there were over 115,000 cases of measles and 41 deaths in the country – this was the highest incidence in Europe.

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