b'INFECTIOUS DISEASE GUIDE|region, a trend of measles cases in sub-Saha- the Initiative has worked to vaccinate nearly ran Africa, where vaccination rates are tradi- three billion children worldwide, saving an tionally low, develops to account for aroundestimated 21 million lives through increased half of all cases worldwide. coverage, monitoring and evaluation, and In 2018, four of the five most affected coun- working to build public demand for access to tries (or countries with the highest measlesimmunization.incidence rate) were in that region of theIt is a tragedy that the world is seeing world. Democratic Republic of the Congoa rapid increase in cases and deaths from a (DRC), Liberia, Madagascar, and Somaliadisease that is easily preventable with a vac-accounted for almost half of all measles casescine, said Dr Seth Berkley, CEO of Gavi, the worldwide, along with Ukraine, an EasternVaccine Alliance. While hesitancy and com-European nation and formerly part of theplacency are challenges to overcome, the larg-Soviet Union. est measles outbreaks have hit countries with Yes, the greatest impacts take place inweak routine immunization and health sys-poorer, developing countries, but first-world Those who aretems. We must do better at reaching the most nations havent escaped unscathed. Wealthiervulnerable, and that will be a fundamental nations have battled outbreaks as well, to dif- fortunate enoughfocus of Gavis next five-year period.fering effects. The following information on disease esti-In 2018, the United States reported itsto survive after amates is directly from the World Health highest number of cases in 25 years, whileOrganization:four countries in EuropeAlbania, Czechia,case of the measles2019s modelling shows that there were Greece and the United Kingdomlost theirstill are likely to9,769,400 estimated measles cases and measles elimination status in 2018 following142,300 related deaths globally in 2018, protracted outbreaks of the disease. Measlesendure long-termdecreasing from 28,219,100 cases and 535,600 elimination status occurs when (obviously)deaths in 2000. In 2017, there were 7,585,900 a disease is declared to be eliminated in ahealth complicationsestimated cases and 124,000 estimated nation or region, but that status is jeopardizeddeaths.when the disease re-emerges. If transmissionas a result.By region in 2018, WHO estimates:of the condition persists in the affected regionin the African region, there were for one year or longer, elimination status is1,759,000 total cases and 52,600 deaths;revoked. and deserves this life-saving vaccine. We mustin the Region of the Americas, 83,500 turn this trend around and stop these pre- cases;THE NEXT STEP ventable deaths by improving measles vaccinein the Eastern Mediterranean Region, Of course, measles is preventable throughaccess and coverage. 2,852,700 cases and 49,000 deaths;vaccination. So why have global rates of vac- WHO recommends 95 percent or greaterin the European region, 861,800 cases cination stagnated or even declined in somevaccine coverage is required worldwide and inand 200 deaths;cases over the past decade? each individual community to prevent furtherin Southeast Asia, 3,803,800 cases and The United Nations Childrens Fundspread or outbreak of the disease. 39,100 deaths;(UNICEF), in collaboration with WHO, esti- and in the Western Pacific, 408,400 mate that over 85 percent of children world- M&RI cases and 1300 deaths.wide have received their first dose of measlesThe Measles & Rubella Initiative is in collabo- While estimates provide a useful indication vaccine through their respective countrysration with Gavi, the Vaccine Alliance, to helpof measles impacts and longer-term trends, services, but that the number drops below 70individual countries respond to outbreaksreported cases provide real-time insights and percent when it comes to receiving the secondthrough emergency vaccination campaigns. comparisons. There were a total of 353,236 recommended dosage. The Measles & Rubella Initiative (M&RI)cases reported to WHO in 2018. In 2019, as Weve had a safe and effective measlescombines the resources of the American Redof mid-November, there had already been vaccine for over 50 years, said Dr. RobertCross, CDC, UNICEF, the United Nationsover 413,000 cases reported globally, with an Linkins, Branch Chief of Accelerated DiseaseFoundation, and WHO to rapidly immunizeadditional 250,000 cases in DRC (as reported Control and Vaccine Preventable Diseaseagainst measles whileincluding and increas- through their national system.)nSurveillance at the CDC and Chair of theing efforts to reduce the risk of death through Measles & Rubella Initiative. These estimatestimely treatment, especially for related com- SOURCE:CDC, WHO, Gavi, Measles & remind us that every child, everywhere needsplications like pneumonia. Founded in 2001,Rubella Initiative18 INFECTIOUS DISEASE GUIDE|2020| www.elitecme.com'