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Measles death rate drops; still a major public health concern
From: CNN          Published On: August 24, 2012, 11:41 GMT
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Measles death rate drops; still a major public health concern
In 2007 the World Health Organization set a goal to reduce measles deaths by 90% worldwide between 2000 and 2010.

Death rates did fall 74% during that time, according to a new report in the British medical journal The Lancet. But the highly infectious disease is still a major public health concern across the globe, with almost 200,000 new cases reported each year.

"A three-quarters drop in measles deaths worldwide shows just how effective well-run vaccination programs can be," said Dr. Margaret Chan, director-general for the World Health Organization. "Now we need to take the next logical step and vaccinate children against rubella too."

On Monday, WHO and its partners - the U.S. Centers for Disease Control and Prevention (CDC), UNICEF, United Nations Foundation and the American Red Cross - announced a new plan to stamp out measles and rubella around the world.

Extremely contagious, measles is a virus that affects mostly children. Ten to 12 days after being exposed, symptoms usually begin with a high fever that can last up to 7 days. Patients also get a runny nose, cough, white spots inside their mouth, and within days, a rash that spreads over their body.

There is no specific treatment according to WHO, and most people recover within a few weeks.

But in malnourished children and people with compromised immune systems, measles can cause serious complications like blindness, encephalitis - an infection that causes brain swelling, severe diarrhea and pneumonia. Today it is one of the leading causes of death in children (especially under 5) around the world despite the fact that there is a safe and effective vaccine.

Rubella is a mild infection also known as German measles. It's caused by a virus and usually spread through the air or by close contact. Symptoms are much milder than measles, but also include fever and rash.

For women in their first trimester of pregnancy however, the disease can cause severe complications including miscarriage, still births and a birth defect called congenital rubella syndrome or CRS. CRS can result in chronic heart problems, blindness and deafness. According to WHO, there are about 112,000 cases of CRS reported annually - all preventable by vaccination.

The Measles & Rubella Initiative is a five-part plan to reduce measles deaths by 95% around the world by 2015 and eliminate both measles and rubella in five WHO regions by 2020. The WHO says those five regions are: The Americas, who reached their goal in 2002; the Western Pacific region, who will reach that goal this year; the Eastern Mediterranean and European regions, who will both reach their goals in 2015; and the African region who plans for elimination in 2020.

The Southeast Asian region did not set a target goal. The plan for all regions is to provide greater vaccination coverage with two doses that contain both measles and rubella; better surveillance to monitor and track spread; respond rapidly to outbreaks and monitor cases; enhance community outreach and boost demand for the vaccine and support research and development.

"Measles continues to kill children around the world and rubella is the leading infectious cause of congenital malformations in newborn infants - these are avoidable tragedies," said CDC Director Dr. Thomas R. Frieden. "This new plan outlines strategies we know work. It's time to partner with key countries to implement the plan in order to save our children from these terrible diseases."

Mortality rates dropped from 535,3000 deaths in 2000 to 139,300 in 2010. All of the WHO regions logged drops except Southeast Asia. India had nearly half of all measles deaths globally in 2010. Africa was close behind with 36% of all deaths. Study authors believe low vaccination rates play a major role in those numbers.

"Despite rapid progress in measles control from 2000 to 2007, delayed implementation of accelerated disease control in India and continued outbreaks in Africa stalled momentum towards the 2010 global measles mortality reduction goal," the study authors concluded. "Intensified control measures and renewed political and financial commitment are needed to achieve mortality reduction targets and lay the foundation for future global eradication of measles."

Sixty-two countries that don't use the rubella vaccine are being encouraged to use the combined shot. GAVI Alliance, formerly the Global Alliance for Vaccines and Immunization, is investing $605 million to make sure developing countries have access to both the measles-rubella (MR) vaccine and the second dose measles vaccine.

Still, Kathy Calvin, CEO of the United Nations Foundation said an additional $112 million is needed to reach the measles/rubella goals for 2015.

"While this progress is remarkable, it's still not enough, especially when we have the tools to eliminate measles entirely," Calvin said. "A shortfall in funding is preventing us from reaching more children and is currently why we are seeing more outbreaks. We need everyone from individuals to world leaders to step up their commitment if we are to achieve our goal"

Dr. Walter Orenstein from the School of Medicine and Emory Vaccine Center at Emory University in Atlanta said the drop in deaths is good news, but the work is far from done.

"In 2010, an estimated 139,300 persons died from measles, an average of almost 382 deaths per day. Despite the progress, this is still far too many deaths that could be easily prevented through better use of available measles vaccines."

And although virtually eradicated in 2000 here in the United States, sporadic cases still pop up. In fact, the U.S. Centers for Disease Control and Prevention recently reported 17 outbreaks and 222 cases of the disease last year. Most of those were infected while traveling abroad. There were no deaths.

"Measles is a serious and potentially fatal disease that will return if given the opportunity to do so," said Dr. Rebecca Martin, director of the global immunization division at the CDC. "This is a large cost to society. While we may not see the deaths, there is a large cost of hospitalization. We've seen with the outbreaks in Europe and the US how quickly it can happen... It just takes one person on a plane."

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