Because of several measles outbreaks in the UK, Greece, Czech Republic, and Albania, these Four European states are no longer considered "measles-free.”
Measles is considered eliminated when there is no endemic disease transmission for 12 months or more in a specific geographic area, and this is no longer the case for these countries.
Measles is highly contagious and dangerous. Common complications include diarrhea and vomiting (which can lead to dehydration) middle ear infection (otitis media), inflammation of the voice box (laryngitis), infections of the airways and lungs, and fits caused by fever (febrile seizures). Measles is also potentially fatal. Other severe complications include blindness and, for pregnant women, miscarriage.
"Re-establishment of measles transmission is concerning. If high immunization coverage is not achieved and sustained in every community, both children and adults will suffer unnecessarily and some will tragically die," warned Gunter Pfaff, the head of the WHO's European Regional Verification Commission for Measles and Rubella Elimination.
Close to 365,000 cases have been reported worldwide this year according to the WHO -- almost three times as many as in the first half of 2018. There were 89,994 cases of measles in 48 European countries in the first six months of 2019, more than double the number in the same period in 2018. Already, there have been more than the 84,462 cases reported for all of 2018.
The UK reported 953 cases in 2018 and 489 for the first six months of 2019. In the same period of time, Greece reported 2,193 (vs 28 in 2018), Albania 1,466, and the Czech Republic 217. Based on 2018 data, the disease can no longer consider eliminated in the UK, Greece, the Czech Republic and Albania. The main reason for this is the insufficient vaccination rate -- most people get vaccinated, but not everyone, which raises the potential for spreading the disease.
"Each of these countries are examples that have extremely high national vaccination coverage. So these are not examples of countries that have particularly weak systems," said Kate O'Brien, director of the WHO's Immunization Department. "This is the alarm bell that is ringing around the world: being able to achieve high national coverage is not enough, it has to be achieved in every community, and every family for every child," she said.
While the disease is highly contagious, it can be entirely prevented through a two-dose vaccine. According to the WHO, more than 20 million deaths have been prevented around the globe between 2000 and 2016 thanks to measles vaccination.
UK Prime Minister Boris Johnson has called on health leaders to address the issue. Current statistics show that current second-round vaccinations for children in the UK are at only 87.2%. The first doe is only partially effective -- it's the second one that renders the body immune to the disease. Mary Ramsay, of the government agency Public Health England, states, "Anyone who has not received two doses of MMR vaccine is always at risk."
The resurgence of a preventable disease
Globally, the picture is also concerning. Worldwide, the number of cases for January 1 to July 31 this year tripled to 364,808, compared with 129,239 during the same seven months last year. The highest numbers of cases were reported in the Democratic Republic of Congo, Madagascar, and Ukraine. The United States also registered its highest number of cases in 25 years. The numbers are especially worrying as 90% of all cases go unrecorded worldwide, according to WHO.
The disease had been officially eliminated in many countries with advanced healthcare systems, with numbers steadily decreasing until 2016 when a resurgence began. Austria and Switzerland were confirmed to have elimination status in 2018. Measles has been eliminated in 35 of the 53 countries in the WHO's European region for 2018, from 37 in 2017. Early this year, Sri Lanka has been declared measles-free.
Across the Atlantic, Americans have already suffered a record high measles outbreak in 2019. The Center for Disease Control and Prevention recently published a report showing that there were 1,172 cases so far with 124 hospitalizations and 64 reported serious health complications.
According to the WHO, the reasons for people not being vaccinated vary significantly between communities and countries, with a lack of access to quality healthcare or vaccination services hindering some from getting the jabs, while others may be misinformed about vaccines and the need to vaccinate. Some aren't following up on their shots because they believe that measles no longer poses any risk. In situations when a disease like measles is eradicated, people start to think the disease isn't around anymore.