Global Measles Mortality: India Accounts for 47 Percent of Worldwide Deaths

Measles is a highly infectious and potentially dangerous illness which spreads very easily. Whether you stay in the United Kingdom or travel abroad it is crucial that individuals who may be at risk are fully immunized.

Reports of measles go back to at least 600 BC. In 1954, the virus causing the disease was isolated, and licensed vaccines to prevent the disease became available in 1963. Humans are the only known natural hosts of measles.

In the 1990s, experts thought they were close to eliminating measles for good. But now the World Health Organization (WHO) has put back its target date for getting rid of the disease to 2015. But even that seems unlikely.

The reason? A measles outbreak which is spreading across Europe, affecting France, Belgium, Germany and Romania - and now the United Kingdom.

According to the WHO, other significant outbreaks are taking place in Serbia, Spain, Macedonia and Turkey. Over the last few months, the Health Protection Agency has seen an increase in measles cases in children and young adults in England and Wales. Their figures show that between January and April, 275 laboratory-confirmed cases of measles were reported, compared to 33 cases for the same period the previous year.

Africa and India accounted for a combined total 79 per cent of all deaths from measles between 2000 and 2010. Anthony Lake - the executive director of the United Nations children's organization UNICEF, which is also part of the Measles and Rubella Initiative - said there were still 382 deaths from measles every day.

India Faces Alarming Situation

Delayed implementation of accelerated disease control in India has led the country to account for 47 per cent of estimated measles mortality in 2010. At 36 per cent, even the WHO African region accounted for lesser mortality than India. Although India achieved 26 per cent reduction in measles mortality between 2000 and 2010, its contribution to the percentage of global measles deaths increased from 16 per cent in 2000 to 26 per cent in 2010.

Except for the Southeast Asia WHO region, all the other WHO regions recorded a reduction in mortality by more than three-quarters during 2000-2010. Even in the case of WHO Southeast Asia region, except for India, the other countries in the region had reported a reduction.

Africa is a study in contrast. The mortality reduction during the same period, 2000-2010, was 85 per cent. The effect of this decline gets reflected in the continent's contribution to the global measles deaths — 63 per cent in 2000 to 36 per cent in 2010.

According to the Federal Health Ministry, India has introduced the second dose of measles vaccine in 2010. "India started giving a second dose of vaccine to children through routine immunization in 21 better performing states where coverage for measles vaccination was more than 80 per cent. In the remaining 14 high-risk states, we are carrying out the campaign in a phased manner. These 14 states also include second dose of measles vaccination under the routine immunization program, six months from completion of the campaign.”

New WHO Findings

The WHO study states that measles mortality has been reduced by more than three-quarters in all regions of the world except in south-east Asia. Anti-measles efforts had suffered from inadequate funding and lack of political commitment since 2008.

In 2007, investigators reported that the global goal to reduce measles deaths by 50 per cent by 2005, compared with 1999, had been achieved. Later, WHO member states decided on a more ambitious target of 90 per cent reduction between 2000 and 2010.

Situation in Southeast Asia

Southeast Asia, excluding India, had 79 per cent vaccine coverage in 2010. The global coverage for measles vaccination overall was 85 per cent. Over 1 billion doses of measles vaccine were delivered through supplementary mass vaccination campaigns in the past decade, and were the main driver behind the huge fall in mortality.

Measles eradication is biologically feasible and while no formal eradication goal has yet been set, progress on the mortality reduction goal will lead to consideration for an eradication goal.

Millennium Development Goals that aims to reduce child mortality by two-thirds by 2015 will be missed if measles outbreaks continue to spread. The challenges, however, include competing public health priorities, weak immunization systems, sustaining high routine vaccination coverage and plugging the $298 million funding gap for global anti-measles efforts. Measles virus is spread by airborne droplets through coughing and sneezing. It begins with fever and is followed by cough, running nose, conjunctivitis, and body rashes.

Global Efforts

Global efforts to cut the number of deaths from measles have fallen short of World Health Organization (WHO) targets.

An analysis published in the Lancet said deaths had fallen by 74 per cent between 2000 and 2010, but the target was 90 per cent.

Outbreaks in Africa and delays in vaccination programs in India have stalled progress. A new campaign to tackle the disease has been launched, which will combine measles and rubella jabs.

In 2000, there were 535,300 deaths from measles. This fell to 139,300 deaths in 2010.


Warning to Europe

European countries need to act now to tackle measles outbreaks, the WHO warns. The WHO report states that there were over 26,000 measles cases in 36 European countries from January to October 2011. Western European countries reported 83 percent of those cases, with 14,000 in France alone.

In England and Wales, there were just under 1,000 confirmed measles cases in that period - compared with just 374 in the whole of 2010. Altogether, measles outbreaks in Europe have caused nine deaths, including six in France, and 7,288 hospitalizations.

France has now launched a nationwide campaign to raise awareness about the need for MMR vaccination.

France can simply not afford to have deaths, painful and costly hospitalizations, disruptions to work and school from a completely vaccine-preventable disease.

Ninety per cent of European cases were amongst adolescents and adults who had not been vaccinated or people where it was not known if they had been vaccinated or not. And measles from Europe has been linked to outbreaks in several other countries including Brazil, Canada and Australia.


Points To Remember

* A highly infectious viral illness

* Causes a fever, coughing and distinctive red-brown spots on the skin

* Contracted by breathing in tiny droplets created when an infected person coughs or sneezes

* Possible complications include pneumonia, ear and eye infections, and croup

* Serious complications include inflammation of the brain (encephalitis), which can be fatal

* Infection during pregnancy can cause miscarriage, premature labor or low birth weights