It's no surprise there's a global measles outbreak. But the numbers are 'staggering'
Measles is on the rise around the world, and even experts who saw it coming say the increase is "staggering."
The World Health Organization said in December that its European region (which extends into parts of western and central Asia) saw an "alarming" increase in measles cases – from under a thousand in 2022 to more than 30,000 last year.
John Vertefeuille, directorof the U.S. Centers for Disease Control and Prevention's Global Immunization Division, said in a statement that the numbers are "staggering."
The WHO's most recent global numbers, released in November, reveal that measles cases increased worldwide by 18% to about 9 million, and deaths rose 43% to 136,000, in 2022 compared to 2021. Some 32 countries had large, disruptive outbreaks in 2022, and that number ticked up to 51 in 2023, Dr. Natasha Crowcroft,WHO's senior technical adviser for measles and rubella control, told NPR.
The worrying uptick in measles outbreaks and deaths is, "unfortunately, not unexpected given the declining vaccination rates we've seen in the past few years," noted John Vertefeuille of the CDC in his statement. "Urgent, targeted efforts are critical to prevent measles disease and deaths."
Measles is one of the most contagious infectious diseases, and also one of the most preventable: two doses of vaccine in childhood is 97% protective. WHO estimates that some 61 million doses were missed or delayed in 2021. In 2022, about 83% of the world's children received one dose of measles vaccine by their first birthday – the lowest proportion since 2008, when the rate was also 83%.
"We're going to see outbreaks any time we have an accumulation of people who haven't been vaccinated," says Cyndi Hatcher, unit lead for measles elimination in the African Region at the CDC. "When you have immunization disruptions, measles is always going to be one of the first epidemics that you see."
Low-income countries continue to have the lowest vaccination rates – five sub-Saharan African countries have rates below 50% for the first dose.
"Measles is called the inequity virus for good reason. It is the disease that will find and attack those who aren't protected
," says Dr. Kate O'Brien, WHO director for immunization, vaccine and biologicals.
In Ethiopia, for example, conflict and weaknesses in the rural health system have taken a toll on vaccination rates, says Dr. Ngozi Kennedy, UNICEF's Ethiopia health manager.
"We have a lot of pastoral communities that are often on the move so they may not know how to, or may not be able to, get to health centers for the vaccine. Also, as a result of the protracted conflicts, services are often disrupted with populations and even some health-care workers being displaced," she says.
Children who don't get their vaccines on schedule are at risk of death and serious illness, particularly children under age 5 who are at highest risk for severe complications including pneumonia, encephalitis (brain swelling) and death. Measles can also put children at higher risk for other potentially fatal childhood diseases – such as diarrheal diseases and meningitis – because the virus can cause the immune system to forget its learned defenses against other pathogens.
"I think that people may have forgotten how dangerous measles can be if they haven't seen cases before," Hatcher says.
But global health experts didn't forget, and many predicted that outbreaks would be coming.
"During the pandemic, when everything was locked down, there wasn't much measles being spread ... because no one was going anywhere," says WHO measles and rubella senior technical adviser Dr. Natasha Crowcroft. "It's the usual human thing that no one does anything until the problem starts. It's really hard to sell prevention."
Last year a coalition including the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance, launched "The Big Catch-Up" – an effort to get vaccination rates back up to at least their pre-pandemic levels. (Editor's note: The Gates Foundation is one of the funders of NPR and this blog.)
Kennedy says efforts continue in Ethiopia to shore up vaccination rates. Health workers there have begun to track childhood immunizations electronically in hopes of keeping more children current, and the country has prioritized 14 "equity zones" to catch kids up on their shots.
But the CDC's Cyndi Hatcher says much more needs to be done.
"I think we need to be very honest with ourselves at the global level," she says. "Are we truly committed to making [measles] a public health priority and do we have the resources that we need to make full immunization a reality at the global level, the regional level but especially at the country and community level?"
Fran Kritz is a health policy reporter based in Washington, D.C., and a regular contributor to NPR. She also reports for the Washington Post and Verywell Health. Find her on X (Twitter): @fkritz
Copyright 2024 NPR. To see more, visit https://www.npr.org.
Haishangazi kwamba kuna mlipuko wa tauni ulimwenguni pote. "Hata hivyo, idadi ya watu wanaokabili ugonjwa wa surua inaongezeka sana ulimwenguni, na hata wataalamu ambao waliona ugonjwa huo ukifika wanasema kwamba ongezeko hilo ni ""la kushangaza.""" Shirika la Afya Duniani (WHO) limesema eneo lake la Ulaya (ambalo linaenea katika sehemu za magharibi na kati ya Asia) liliona ongezeko la "kuogopesha" la visa vya ugonjwa wa surua kutoka chini ya elfu moja mnamo 2022 hadi zaidi ya 30,000 mwaka jana. John Vertefeuille, mkurugenzi wa Idara ya Chanjo ya Ulimwenguni ya Kituo cha Udhibiti na Kuzuia Magonjwa cha Marekani, alisema katika taarifa yake kwamba idadi hiyo ni ya kushangaza. Takwimu za hivi karibuni za WHO, zilizotolewa mnamo Novemba, zinaonyesha kuwa visa vya surua vimeongezeka ulimwenguni kote kwa 18% hadi karibu milioni 9, na vifo viliongezeka kwa 43% hadi 136,000 katika 2022 ikilinganishwa na 2021. "Nchi 32 zilikuwa na milipuko mikubwa ya ugonjwa wa kipindupindu mwaka wa 2022 na idadi hiyo iliongezeka hadi 51 mwaka wa 2023,"" alisema Natasha Croft, mshauri mwandamizi wa WHO wa udhibiti wa surua na rubella." "Kupungua kwa idadi ya watu wanaosumbuliwa na ugonjwa wa surua na vifo vya watu wanaosumbuliwa na ugonjwa huo ni jambo la kushangaza, kwa sababu ya kupungua kwa viwango vya chanjo ambavyo tumekuwa tukiona katika miaka michache iliyopita, ""alisema John Vertefeuille wa CDC." "Jitihada za haraka, zenye kulenga ni muhimu ili kuzuia ugonjwa na vifo vya surua". Ukimwi ni moja ya magonjwa ya kuambukiza ya kuambukiza zaidi, na pia moja ya magonjwa yanayoweza kuepukwa zaidi: dozi mbili za chanjo katika utoto ni 97% ya kinga. WHO inakadiria kuwa dozi milioni 61 zilikosa au kucheleweshwa mnamo 2021. Mwaka 2022, karibu asilimia 83 ya watoto duniani walipokea chanjo moja ya homa ya surua kabla ya siku yao ya kuzaliwa, kiwango cha chini zaidi tangu mwaka 2008, wakati kiwango hicho kilikuwa asilimia 83 pia. "Tunaweza kuona milipuko wakati wowote tunapokuwa na mkusanyiko wa watu ambao hawaja chanjo, ""alisema Cyndi Hatcher, kiongozi wa kitengo cha kuondoa surua katika Mkoa wa Afrika katika CDC." "Wakati una usumbufu wa chanjo, surua daima itakuwa moja ya magonjwa ya kwanza unayoona". Nchi zenye mapato ya chini zinaendelea kuwa na viwango vya chini zaidi vya chanjo - nchi tano za Afrika Kusini mwa Jangwa la Sahara zina viwango chini ya 50% kwa chanjo ya kwanza. "Ugonjwa wa surua unaitwa virusi vya ukosefu wa usawa kwa sababu nzuri. "Ugonjwa huo utapata na kushambulia wale ambao hawajahifadhiwa, ""alisema Daktari Kate O'Brien, mkurugenzi wa chanjo, chanjo na dawa za kibiolojia za WHO." "Kwa mfano, katika nchi ya Ethiopia, mgogoro na udhaifu katika mfumo wa afya wa vijijini umesababisha kiwango cha chanjo kupungua, ""anasema Daktari Ngozi Kennedy, meneja wa afya wa UNICEF nchini Ethiopia." "Tuna jamii nyingi za wachungaji ambao mara nyingi wanahama kwa hivyo wanaweza kuwa hawajui jinsi ya, au hawawezi, kufika kwenye vituo vya afya kwa chanjo. """ Pia, kutokana na migogoro ya muda mrefu, huduma mara nyingi hukatizwa na watu na hata baadhi ya wafanyakazi wa huduma za afya kuhamishwa, "anasema. Watoto ambao hawapati chanjo zao kwa wakati wana hatari ya kufa na magonjwa mazito, hasa watoto chini ya umri wa miaka 5 ambao wana hatari kubwa ya matatizo makubwa ya ugonjwa wa mapafu, encephalitis (kuvimba kwa ubongo) na kifo. Ugonjwa wa surua pia unaweza kuwafanya watoto wawe na hatari kubwa ya kupatwa na magonjwa mengine ya utotoni ambayo yanaweza kuwa na hatari ya kifo, kama vile magonjwa ya kuhara na meningitis, kwa sababu virusi hivyo vinaweza kusababisha mfumo wa kinga kusahau ulinzi wake uliojifunza dhidi ya vimelea vingine. "Nafikiri kwamba huenda watu wamesahau jinsi ugonjwa wa surua unavyoweza kuwa hatari ikiwa hawajawahi kuona visa hivyo hapo awali", Hatcher asema. Lakini wataalamu wa afya duniani hawakuisahau, na wengi walitabiri kwamba milipuko ingekuja. "Wakati wa janga hilo, wakati kila kitu kilipokuwa kimefungwa, hakuna janga kubwa lililokuwa likisambaa... kwa sababu hakuna mtu aliyekuwa akienda mahali popote, ""alisema mshauri mwandamizi wa WHO wa janga la janga na rubella, Dk Natasha Crowcroft." "Ni jambo la kawaida la kibinadamu kwamba hakuna mtu anayefanya chochote mpaka tatizo lianze. Ni vigumu sana kuuza kinga". Mwaka jana, muungano wa mashirika ya Bill & Melinda Gates Foundation na Gavi, Vaccine Alliance, ulizindua kampeni ya 'The Big Catch-Up' ili kupunguza kiwango cha chanjo hadi kiwango cha kabla ya janga. (Kumbuka: Gates Foundation ni moja ya wafadhili wa NPR na blogi hii.) "Kennedy alisema: ""Nchi ya Ethiopia inaendelea kufanya juhudi za kuongeza viwango vya chanjo." Wafanyakazi wa afya nchini humo wameanza kufuatilia chanjo za watoto kwa njia ya elektroniki kwa matumaini ya kuwafanya watoto wengi wawe na chanjo, na nchi hiyo imeweka kipaumbele katika maeneo 14 ya usawa ili kuwawezesha watoto kupata chanjo. Lakini Cyndi Hatcher wa CDC anasema mengi zaidi yanahitaji kufanywa. "Nafikiri tunahitaji kuwa wanyoofu sana kwetu wenyewe katika ngazi ya kimataifa", anasema. "Je, tunajitolea kweli kufanya [kugua kwa chanjo] kipaumbele cha afya ya umma na tuna rasilimali tunazohitaji kufanya chanjo kamili kuwa ukweli katika ngazi ya kimataifa, ngazi ya kikanda lakini hasa katika ngazi ya nchi na jamii?""" Franck ni mwandishi wa habari wa sera za afya na mwandishi wa kawaida wa NPR. Yeye pia ripoti kwa ajili ya Washington Post na Verywell Afya. "Kama unavyoona kwenye ukurasa wa Twitter, ""Fake News"" ni jina la mtangazaji wa habari wa NPR wa mwaka wa 2024." Kwa maelezo zaidi, tembelea www.nl.org.