As families pack up for their summer trip abroad, or the kids go off to camp, public health officials around the world have this warning: Everyone should be fully vaccinated against measles, or risk infection.
For the first time in years measles outbreaks are in the news almost every week. More than twelve thousand Europeans have suffered measles this year as the worst outbreaks in more than a decade persist. By May in the UK there were more measles cases than in all of 2010. The United States is experiencing its biggest measles outbreak since 1996. In Auckland New Zealand, public health officials are trying to stop an outbreak that was traced back to one unvaccinated child, before it spreads to the rest of the country or the Pacific Islands.
Outbreak control is incredibly expensive. Stopping a measles outbreak that infected just seven people in the State of Arizona in 2008 cost almost half a million pounds. Containing one case in Iowa State- an unvaccinated university student who had traveled to India - set taxpayers back £89,000. Costs include hospitalisation, reviewing airline flight passenger lists, tracking people who may have been exposed, holding vaccination clinics, and enforcing quarantine orders. In New Zealand, people with measles are being asked to stay home for up to 14 days - that's two weeks of no work and no school. The costs of containing measles outbreaks are only one issue.
Measles causes disability and it can kill. For most people, the disease is uncomfortable but mild. But for some, especially people with weaker immune systems, complications from measles include diarrhea, pneumonia, ear infections and encephalitis. They face permanent blindness, hearing loss, brain damage and yes, death. One or two out of 1,000 people who are infected with measles will die.
Prevention is simple: two doses of measles-containing vaccine. Most of the people in the UK, continental Europe, US and New Zealand who have been recently infected had never been vaccinated. In most of these outbreaks, the virus entered across a border by car, train or plane in an infected passenger, and being highly contagious, spread quickly to people who were not protected, including young children.
Measles vaccine is a wonder of modern public health. Vaccination programs in the 60s, 70s and 80s resulted in rapid and staggering reductions in measles incidence. The vaccine worked so well that endemic measles was eliminated from all of the Americas in 2000. But it was still killing three-quarters of a million people, mostly children, every year in Africa and parts of Asia.
Spurred by the potential to eliminate measles everywhere, international organisations, donors, NGOs and the private sector came together and formed the Measles Initiative. It has since helped to fund measles campaigns in the countries they are most needed and has delivered well over 900 million measles vaccines to children.
These aggressive vaccination efforts reduced annual measles deaths from an estimated 733,000 to 164,000 between 2000 and 2008. That's an incredible 78% reduction, and a total of more than four million child deaths averted in under a decade. Families could breathe easier knowing their children were protected.
So why are we still talking about measles?
With thousands of children born each day, vaccination campaigns must continue. However, funding for measles vaccination in poorer countries has recently dropped from a high of £93 million in 2007 to £42 million in 2010. As a result, the countries that want to organize measles campaigns have had to cancel or postpone them. These delays rob children of their right to be protected from measles and are robbing families of their children. Political commitment is also a serious issue in some countries, where leaders are simply not investing enough in the health of their citizens. As a result, cases of measles are increasing again and threaten to reverse the gains of the last decade.
As you read this, there are growing measles tragedies on the African continent. In the Democratic Republic of the Congo more than 100,000 people have been infected and more than 1,000 have died this year. The Ministry of Health and its partners are planning an urgent vaccination campaign but because they are about £1.9 million short, they have to delay in some provinces while the measles outbreaks continue. Measles are also a serious threat to families in the drought-affected areas of the Horn of Africa including in the crowded camps where people are seeking food and shelter.
In total, 19 countries in Asia and Africa are planning measles campaigns for the last half of 2011. They are faced with a £6 million shortfall - a small amount of money in global terms. The recent generous donor pledges to the Global Alliance for Vaccines and Immunisation don't cover these campaigns.
Funding these measles efforts can quickly put a stop to measles. Our experience around the world demonstrates that vaccination works, fast. Experts believe that through vaccination, the measles virus can be eradicated from earth. We must urgently work towards this goal together.
While we act against the measles threat now in our home countries and bring our immunisation records up-to-date, let's also remember the families in countries where measles is endemic and vaccine is not available. Helping them to stop measles will save millions of lives. Ultimately, in this interconnected world, stopping measles will help all of us.