Basic facts
- Measles is a highly contagious and dangerous airborne disease caused by a virus that can lead to severe complications and death.
- Thanks to measles vaccination, 57 million deaths were avoided between 2000 and 2022.
- Despite the availability of a safe and highly effective measles vaccine, it is estimated that in 2022 there will be approximately 136,000 deaths due to the disease in the world, most of which will occur among children under the age of five who are unvaccinated or under-vaccinated.
- In 2022, approximately 83% of the world's children will have received one dose of measles vaccine by their first birthday by routine health services – the lowest percentage since 2008.
Overview
Measles is a highly contagious disease caused by a virus that spreads easily when an infected person breathes, coughs or sneezes. It can cause severe illness, complications and even death.
Measles can infect anyone but is most common among children.
Measles infects the respiratory system and then spreads throughout the body. Its symptoms include high fever, cough, runny nose, and the spread of a rash throughout the body.
Vaccination is the best way to prevent measles infection or transmission to other people, knowing that the measles vaccine is safe and helps the body fight the virus.
Before the introduction of the measles vaccine in 1963 and its widespread vaccination, major epidemics spread approximately every two or three years and caused deaths estimated at about 2.6 million deaths annually.
It is estimated that the year 2022 witnessed the death of about 136,000 people due to measles - most of them children under the age of five, despite the availability of a safe and highly effective vaccine against the disease.
Accelerated immunization activities undertaken by countries, WHO, the Measles and Rubella Partnership (formerly known as the Measles and Rubella Initiative) and other international partners successfully prevented an estimated 57 million deaths between 2000 and 2022. Vaccination also reduced the number of deaths resulting from measles from an estimated number of 761,000 deaths in 2000 to 136,000 deaths in 2022 (1) .
Impacts of the COVID-19 pandemic
The COVID-19 pandemic has set back surveillance and immunization efforts. The suspension of immunization services and the decline in immunization and surveillance rates around the world have exposed millions of children to immunization-preventable diseases such as measles.
No country is immune to measles, and virus circulation rates are high in areas with low immunization rates, increasing the likelihood of outbreaks of the disease and putting all unvaccinated children at risk of infection.
We must get progress back on track and work to reach regional targets for measles elimination despite the COVID-19 pandemic. Immunization programs within primary health care should be strengthened, and efforts to ensure that all children receive two doses of measles vaccine should be accelerated. Countries must also implement robust surveillance systems to identify and close gaps in immunity.
Signs and symptoms
Measles symptoms usually begin 10 to 14 days after exposure to the virus. One of the most prominent signs of the disease is the appearance of a rash on the body.
Early symptoms of the disease usually last between 4 and 7 days, and include the following:
- Runny nose
- Cough
- Eye redness and tears
- Small white spots appear on the cheeks.
The rash begins to appear approximately 7 and 18 days after exposure to the virus, and usually appears on the face and upper neck. It eventually spreads to the hands and feet after about 3 days, and usually lasts for 5-6 days before fading.
Most deaths resulting from measles are due to complications resulting from the disease.
Its complications may include:
- blindness
- Encephalitis (an infection that causes swelling and potentially damage to the brain)
- Severe diarrhea and resulting dehydration
- Ear infections
- Severe breathing problems, including pneumonia.
If a woman contracts measles during pregnancy, the disease can be dangerous for her and can cause her baby to be born prematurely with low birth weight.
The disease commonly causes complications in children under the age of five and adults over the age of 30. Its complications are likely to appear in children who suffer from malnutrition, especially those who do not get enough vitamin A or who suffer from a weakened immune system due to the human immunodeficiency virus or other diseases. Measles itself weakens the immune system and can cause the body to “forget” how to protect itself against infections, putting children at serious risk.
Who is at risk of the disease?
The disease can infect anyone who is unimmunized (unvaccinated or under-vaccinated but has not developed the necessary immunity), noting that young children and unvaccinated pregnant women are most at risk of developing severe complications from measles.
Measles remains a common disease, especially in parts of Africa, the Middle East and Asia. The vast majority of deaths occur in countries with low per capita income or weak infrastructure that struggle to reach all children with immunization.
Routine immunization efforts are hampered by damaged health infrastructure and services in countries experiencing or recovering from natural disasters or conflicts, and the risk of infection is increased in densely populated residential camps. Children who suffer from malnutrition or other causes that weaken their immune systems are most at risk of dying from measles.
Disease transmission
Measles is one of the most contagious diseases in the world and is spread through contact with infectious nasal or throat secretions (through coughing or sneezing) or inhaling the air breathed by a person infected with measles. The virus remains active and infectious in the air or on contaminated surfaces for up to two hours. For this reason, it is a highly contagious disease, and one infected person can spread it to nine out of 10 unvaccinated close contacts. Anyone with the infection can spread it to another person within a period of four days before the rash appears and four days after it appears.
Measles outbreaks can cause severe complications and death, especially among young, malnourished children. Measles cases imported from other countries continue to be a major source of infection in countries that have nearly eliminated it.
disease treatment
There is no specific treatment for measles. Care delivery should focus on alleviating symptoms so that the patient feels comfortable and prevents complications.
Drinking sufficient amounts of water and taking dehydration treatments can compensate the patient for the fluids he loses due to diarrhea or vomiting. It is also necessary to eat nutritious foods as part of a healthy diet.
Doctors may resort to using antibiotics to treat pneumonia and ear and eye infections.
All children or adults with measles should receive two doses of oral vitamin A supplements, given 24 hours apart. This treatment restores vitamin A levels to the normal levels that occur even in well-nourished children, and can also help prevent eye damage and blindness. Vitamin A supplements may also reduce the number of deaths from measles.
Disease prevention
Community-based vaccination is the most effective way to prevent measles. All children should be vaccinated against measles, knowing that the vaccine is safe, effective, and inexpensive.
Children should receive two doses of the vaccine to ensure immunity against the disease. The first dose is usually given to a child at 9 months of age in countries where measles is common and between 12 and 15 months of age in other countries. The child should be given a second dose of the vaccine later in childhood, usually between 15 and 18 months of age.
The measles vaccine is given alone or often in combination with vaccines against mumps, rubella and/or varicella.
Routine measles vaccination, along with mass immunization campaigns in countries with high rates of disease and mortality, are essential to reduce measles deaths worldwide. The measles vaccine has been in use for about 60 years, and its cost is less than one US dollar per child. The measles vaccine is also used during emergencies to stop the spread of outbreaks of the disease. The risk of measles outbreaks is particularly high among refugees, who should be vaccinated against the disease as quickly as possible.
Combining vaccines increases the cost slightly but allows the costs of implementing and administering the vaccine to be shared; Most importantly, it adds the benefit of protection against rubella, the most common vaccine-preventable infection that can infect babies in utero.
In 2022, 74% of children have received both doses of measles vaccine, while approximately 83% of the world's children have received one dose of measles vaccine by their first birthday. It is recommended to give two doses of the vaccine to ensure that children are provided with the necessary immunity and to prevent outbreaks of the disease, because taking a single dose of the vaccine does not generate the necessary immunity in all children.
Nearly 22 million infants will miss out on receiving at least one dose of measles vaccine through routine immunization efforts in 2022.