2019–2020 measles outbreaks

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The 2019 measles outbreaks refer to a substantial global increase in the number of measles cases reported, relative to 2018. [1] As of April 2019, the number of measles cases reported worldwide represented a 300% increase from the number of cases seen in the previous year, constituting over 110,000 measles cases reported in the first three months of 2019. [1] [2] In the first half of 2019, the World Health Organization received reports of 364,808 measles cases from 182 countries, up 182% from the same time period of 2018 when 129,239 confirmed cases were reported by 181 countries.

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Countries affected

In the United States, the number of measles cases was set to reach a 25-year high by the middle of the year, [3] beginning with a large concentration of cases in the Pacific Northwest followed by another in New York, [4] as well in the U.S. state of California with two quarantines ordered at two colleges in Los Angeles on April 28, 2019. [5] Other countries reporting large increases included Brazil, Nigeria, [6] Israel, [7] Ukraine, Madagascar, India, [3] and the Philippines. However, the largest and most fatal outbreak of measles in 2019 occurred in the Democratic Republic of the Congo. [8] Other notable outbreak locations include the 2019 Kuala Koh measles outbreak, [9] 2019 Philippines measles outbreak in Asia; [10] the 2019 Pacific Northwest measles outbreak [11] and 2019 New York measles outbreak in the United States; [12] 2019–2020 New Zealand measles outbreak, [13] and 2019 Samoa measles outbreak in Oceania. [14]

Contributing factors

In some countries, this outbreak has been fueled by lack of access to the measles vaccine, while in others it has been exacerbated by opposition to vaccination. [1] As one such example, the outbreak in the Philippines was attributed by Health Secretary Francisco Duque III to lowered trust in the government's immunization drive due to a controversy regarding administration of a dengue vaccine. [15] The outbreak prompted President Donald Trump to shift away from his previous skepticism regarding vaccination, and to insist that parents must vaccinate their children. [16] The Trump Administration also took a forceful position of requiring vaccination, with Trump's Surgeon General Jerome Adams calling for limitations on exemptions to vaccination. [17]

See also

Related Research Articles

<span class="mw-page-title-main">Vaccination</span> Administration of a vaccine to protect against disease

Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. However, some diseases, such as measles outbreaks in America, have seen rising cases due to relatively low vaccination rates in the 2010s – attributed, in part, to vaccine hesitancy. According to the World Health Organization, vaccination prevents 3.5–5 million deaths per year.

<span class="mw-page-title-main">Measles</span> Viral disease affecting humans

Measles is a highly contagious, vaccine-preventable infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than 40 °C (104 °F), cough, runny nose, and inflamed eyes. Small white spots known as Koplik's spots may form inside the mouth two or three days after the start of symptoms. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Common complications include diarrhea, middle ear infection (7%), and pneumonia (6%). These occur in part due to measles-induced immunosuppression. Less commonly seizures, blindness, or inflammation of the brain may occur. Other names include morbilli, rubeola, red measles, and English measles. Both rubella, also known as German measles, and roseola are different diseases caused by unrelated viruses.

<span class="mw-page-title-main">Vaccine hesitancy</span> Reluctance or refusal to be vaccinated or have ones children vaccinated

Vaccine hesitancy is a delay in acceptance, or refusal, of vaccines despite the availability of vaccine services and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain about their use, or using certain vaccines but not others. The scientific consensus that vaccines are generally safe and effective is overwhelming. Vaccine hesitancy often results in disease outbreaks and deaths from vaccine-preventable diseases. Therefore, the World Health Organization characterizes vaccine hesitancy as one of the top ten global health threats.

A vaccination policy is a health policy adopted in order to prevent the spread of infectious disease. These policies are generally put into place by State or local governments, but may also be set by private facilities, such as workplaces or schools. Many policies have been developed and implemented since vaccines were first made widely available.

<span class="mw-page-title-main">Measles vaccine</span> Vaccine used to prevent measles

Measles vaccine protects against becoming infected with measles. Nearly all of those who do not develop immunity after a single dose develop it after a second dose. When rate of vaccination within a population is greater than 92%, outbreaks of measles typically no longer occur; however, they may occur again if the rate of vaccination decrease. The vaccine's effectiveness lasts many years. It is unclear if it becomes less effective over time. The vaccine may also protect against measles if given within a couple of days after exposure to measles.

<span class="mw-page-title-main">Epidemiology of measles</span>

Measles is extremely contagious, but surviving the infection results in lifelong immunity, so its continued circulation in a community depends on the generation of susceptible hosts by birth of children. In communities which generate insufficient new hosts the disease will die out. This concept was first recognized by Bartlett in 1957, who referred to the minimum number supporting measles as the critical community size (CCS). Analysis of outbreaks in island communities suggested that the CCS for measles is c. 250,000. Due to the development of vaccination against measles, the world has seen a 99% decrease in measles related cases compared cases before the vaccine was developed.

In early months of 2019, a measles outbreak occurred in the Portland metropolitan area, including the Clark County, Washington suburbs, in the United States. At the time, the outbreak was the largest outbreak in more than two decades; outbreaks in 2019 in areas including Brooklyn and Rockland County, New York have since seen far greater numbers of cases.

<span class="mw-page-title-main">2019 measles outbreak in the Philippines</span> Disease outbreak in the Philippines

The 2019 Philippines measles outbreak began in early 2019. An outbreak of measles was officially declared in February 2019 in select administrative regions in Luzon and Visayas including Metro Manila by the Philippine government. The outbreak is attributed to lower vaccination rates, from a high of 88% 10 to 15 years previous to 74% at the time of the outbreak, allegedly caused by the Dengvaxia controversy.

<span class="mw-page-title-main">Measles resurgence in the United States</span> Sharp increase in measles cases between 2010 and 2019

Measles was declared eliminated from the United States in 2000 by the World Health Organization due to the success of vaccination efforts. However, it continues to be reintroduced by international travelers, and in recent years, anti-vaccination sentiment has allowed for the reemergence of measles outbreaks.

The 2019 New York City measles outbreak was a substantial increase in the number of measles cases reported in the state of New York, primarily in New York City and neighboring Rockland County, New York in 2019, relative to the previous year.

<span class="mw-page-title-main">2019–2020 New Zealand measles outbreak</span> Measles epidemic affecting New Zealand

The 2019–2020 New Zealand measles outbreak was an epidemic that affected New Zealand, primarily the Auckland region. The outbreak was the worst epidemic in New Zealand since an influenza epidemic in 1999, and is the worst measles epidemic since 1938.

<span class="mw-page-title-main">Vaccination policy of the United States</span> Overview of the vaccination policy in the United States of America

Vaccination policy of the United States is the subset of U.S. federal health policy that deals with immunization against infectious disease. It is decided at various levels of the government, including the individual states. This policy has been developed over the approximately two centuries since the invention of vaccination with the purpose of eradicating disease from the U.S. population, or creating a herd immunity. Policies intended to encourage vaccination impact numerous areas of law, including regulation of vaccine safety, funding of vaccination programs, vaccine mandates, adverse event reporting requirements, and compensation for injuries asserted to be associated with vaccination.

<span class="mw-page-title-main">2019–2021 polio outbreak in the Philippines</span>

The 2019–2021 polio outbreak in the Philippines was an epidemic. For the previous 19 years, the Philippines was free of any polio-related diseases. On September 14, 2019, the disease began to resurface through a positive test result done to a 3-year-old girl from Mindanao. After the confirmation of a second case from tests done on a 5-year-old boy, the government of the Philippines publicly declared a polio outbreak on September 19, 2019. On June 11, 2021, the WHO announced that the outbreak has ended.

<span class="mw-page-title-main">2019–2020 measles outbreak in the Democratic Republic of the Congo</span> Measles epidemic in the DRC in 2019

In 2019, a measles epidemic broke out in the Democratic Republic of the Congo (DRC). The epidemic started in early 2019 in the southeast corner of the DRC and then spread to all provinces. By June 2019 the epidemic was reported to have exceeded the death toll of the concurrent Ebola epidemic. By April 2020, it had infected more than 341,000 people and claimed about 6,400 fatalities. This has primarily affected children under the age of five, representing 74% of infections and nearly 90% of deaths.

<span class="mw-page-title-main">2019 Samoa measles outbreak</span> Measles epidemic in Samoa in late 2019

The 2019 Samoa measles outbreak began in September 2019. As of 6 January 2020, there were over 5,700 cases of measles and 83 deaths, out of a Samoan population of 200,874. Over three per cent of the population were infected. The cause of the outbreak was attributed to decreased vaccination rates, from 74% in 2017 to 31–34% in 2018, even though nearby islands had rates near 99%.

Taylor Winterstein is an Australian-Samoan online influencer and conspiracy theorist best known for her public anti-vaccination stance. Winterstein has been heavily criticised in several South Pacific, and Australasian countries for her anti-vaccination rhetoric and her seminars have been called "irresponsible" by the Australian Medical Association and a "public health threat" by the Samoan Ministry of Health. She claims she has not encouraged non-vaccination, rather, "informed consent" and "freedom of choice".

<span class="mw-page-title-main">2019 Tonga measles outbreak</span> Measles epidemic in Tonga in late 2019

The 2019 Tonga measles outbreak began in October 2019 after a squad of Tongan rugby players came back from New Zealand. As of 5 January, 2020, there have been 612 cases of measles.

The COVID-19 pandemic in American Samoa is part of the ongoing worldwide pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2. The COVID-19 pandemic was confirmed to have reached the unincorporated United States territory of American Samoa on 9 November 2020.

The Immunisation Advisory Centre (IMAC) is a New Zealand-wide organisation which provides information and training about immunization and vaccine-preventable diseases to health care professionals, government bodies, and individuals. It co-ordinates the nation's immunisation programmes, policy advice and research. It was launched in 1997, and is based at The University of Auckland.

<span class="mw-page-title-main">Disneyland measles outbreak</span> Event at Disneyland Resort, California

The Disneyland measles outbreak began at the Disneyland Resort, California, in December 2014, and spread to seven states in the United States, Mexico, and Canada, before it was declared over in mid-April 2015.

References

  1. 1 2 3 Fore, Henrietta H.; Ghebreyesus, Tedros Adhanom (April 15, 2019). "Measles cases are up nearly 300% from last year. This is a global crisis". CNN.
  2. ↑ Soucheray, Stephanie (August 12, 2019). "Global measles outbreaks make 2019 a record-setting year". CIDRAP. Retrieved January 24, 2020.
  3. 1 2 Cohen, Elizabeth (April 15, 2019). "Measles reaches 2nd-highest level in U.S. in 25 years". Pittsburgh Post-Gazette.
  4. ↑ Scutti, Susan (January 30, 2019). "Measles outbreaks in Washington and New York challenge public health systems". CNN.
  5. ↑ Drash, Wayne (April 28, 2019). "Measles quarantine issued at two California universities". CNN.
  6. ↑ "Global Measles Outbreaks". www.cdc.gov. January 9, 2020. Retrieved January 24, 2020.
  7. ↑ "Measles - NYC Health". www1.nyc.gov.
  8. ↑ Catesby Holmes (October 19, 2019). "Outbreaks of measles: compounding challenges in the DRC". The Conversation. Retrieved November 22, 2019.
  9. ↑ Fong, Loh. "Another six measles cases confirmed in Kg Kuala Koh, bringing total to 43". Toronto Star. Retrieved June 28, 2021.
  10. ↑ Beaubien, Jason. "The Philippines Is Fighting One Of The World's Worst Measles Outbreaks". NPR. Retrieved June 28, 2021.
  11. ↑ Galvin, Gaby. "Measles Outbreak Hits 40 Cases". US News. Retrieved June 28, 2021.
  12. ↑ Soucheray, Stephanie (September 3, 2019). "US measles cases hit 1,234 as Brooklyn outbreak called over". Center for Infectious Disease Research and Policy. Retrieved June 28, 2021.
  13. ↑ "New Zealand measles outbreak rises above 1,000 cases". BBC News. September 5, 2019. Retrieved June 28, 2021.
  14. ↑ Forani, Jonathon (December 30, 2019). "Samoa ends state of emergency after 5,667 cases of measles". CTV News. Retrieved June 28, 2021.
  15. ↑ "Measles outbreak declared in 3 more regions". ABS-CBN News. February 7, 2019. Retrieved February 9, 2019.
  16. ↑ Vazquez, Maegan (April 26, 2019). "Trump now says parents must vaccinate children in face of measles outbreak". CNN.
  17. ↑ "US Surgeon General visits Washington as measles outbreak spreads". KING. March 7, 2019.
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