Alarming global surge of measles cases a growing threat to children UNICEF

Ten countries accounted for approximately threequarters of the total increase in measles in 2018, including significant outbreaks in Brazil, Madagascar, the Philippines, Ukraine, and Yemen

UNICEF warned today that global cases of measles are surging to alarmingly high levels, led by ten countries accounting for more than 74 per cent of the total increase, and several others that had previously been declared measles free.

Countries with ten highest increases in cases between 2017 & 2018[1]

41. Ukraine: 30,338

42. Philippines: 13,192

43. Brazil: 10,262

44. Yemen: 6,641

45. Venezuela: 4,916

46. Serbia: 4,355

47. Madagascar: 4,307

48. Sudan: 3,496

49. Thailand: 2,758

50. France: 2,269

Globally, 98 countries reported more cases of measles in 2018 compared to 2017, eroding progress against this highly preventable, but potentially deadly disease.

Ukraine, the Philippines and Brazil saw the largest increases in measles cases from 2017 to 2018. In Ukraine alone, there were 35,120 cases of measles in 2018. According to the government, another 24,042 people were infected just in the first two months of 2019. In the Philippines so far this year, there have been 12,736 measles cases and 203 deaths[2], compared to 15,599 cases in the whole of 2018.

"This is a wakeup call. We have a safe, effective and inexpensive vaccine against a highly contagious disease a vaccine that has saved almost a million lives every year over the last two decades," said Henrietta H. Fore, UNICEF's Executive Director. "These cases haven't happened overnight. Just as the serious outbreaks we are seeing today took hold in 2018, lack of action today will have disastrous consequences for children tomorrow."

Measles is highly contagious, more so than Ebola, tuberculosis or influenza. The virus can be contracted by someone up to two hours after an infected person has left a room. It spreads through air and infects the respiratory tract, potentially killing malnourished children or babies too young to be vaccinated. Once infected, there is no specific treatment for measles, so vaccination is a lifesaving tool for children.

In response to these outbreaks, UNICEF and its partners are supporting governments to urgently reach millions of children in countries around the globe. For example:

In Ukraine, UNICEF has provided ongoing support to accelerate routine immunization across the country and address vaccine hesitancy, including additional efforts to stop the most recent outbreak that has claimed 30 lives since 2017. In February, the Ministry of Health, with UNICEF's support, launched an immunization drive at schools and clinics in the worsthit Lviv region in western Ukraine, where negative attitudes toward immunization, and previous shortages in vaccine supply, have resulted in low vaccination rates.

In the Philippines, the government, with support from UNICEF and partners, will conduct a campaign to vaccinate 9 million children against polio and measles across 17 regions. Using social media, campaigners plan to encourage apprehensive parents, and health workers.

In Brazil, from August to September 2018, the government carried out a campaign against polio and measles, targeting more than 11 million children under five. UNICEF encouraged people to get vaccinated, and trained health monitors working in migrant shelters for Venezuelans. UNICEF has included the measles vaccine as part of the Municipal Seal programme that covers 1,924 municipalities.

In Yemen, where years of conflict led to an outbreak, local authorities with support from UNICEF, WHO and GAVI vaccinated more than 11.5 million children in February.

In Madagascar, from 3 September to 21 February, 76,871 people were infected by measles and 928 died, a majority of which were children. In January, the government, with support of partners including UNICEF, launched an immunization campaign to target all 114 districts. Over 2 million children were immunized in 25 districts. In February, 1.4 million children were vaccinated, with another 3.9 million more to follow in March.

Notable reported measles cases in 2018 in countries with no reported cases in 2017

1. Brazil : 10,262

2. Moldova: 312

3. Montenegro: 203

4. Colombia: 188

5. TimorLeste: 59

6. Peru: 38

7. Chile: 23

8. Uzbekistan: 17

Poor health infrastructure, civil strife, low community awareness, complacency and vaccine hesitancy in some cases have led tohile these outbreaks in both developed and developing countries. For example, in the United States, the number of measles cases increased sixfold between 2017 and 2018, reaching 791 cases. More recently, the U.S. has seen outbreaks in New York and Washington state.

"Almost all of these cases are preventable, and yet children are getting infected even in places where there is simply no excuse," said Fore. "Measles may be the disease, but, all too often, the real infection is misinformation, mistrust and complacency. We must do more to accurately inform every parent, to help us safely vaccinate every child."

To fight measles, UNICEF is issuing an urgent appeal to governments, health care providers, and parents to do more to contain the disease by:

Understanding that vaccines are safe and effective and can save a child's life

Vaccinating all children between the ages of six months to five years during outbreaks

Training and equipping health workers so they can provide quality services

Strengthening immunization programmes to deliver all lifesaving vaccines

Source: UN Children's Fund