Measles deaths down by 74% worldwide over last decade: Study

By Dr. Ananya Mandal, MDApr 24 2012

According to a new study by the World Health Organization (WHO) the number of measles deaths worldwide has apparently dropped by about three-quarters over a decade. However most of these deaths were in India and Africa, where not enough children are being immunized the report said.

The study was funded by the U.S. Centers for Disease Control and Prevention and was published Tuesday in the journal, Lancet. Measles is one of the most infectious diseases that exists and mostly affects children. It causes a fever, cough and a rash all over the body. The disease kills about one to two children for every 1,000 it infects and can also cause pregnant women to have a miscarriage or premature birth. Humans are the only known natural hosts of measles.

Health officials estimate about 9.6 million children were saved from dying of measles from 2000 to 2010 after big vaccination campaigns were rolled out more than a decade ago. Researchers guessed the number of deaths fell during that time period from about 535,300 to 139,300, or about 74 percent. The WHO target was to cut measles deaths by 90 percent by 2010. However this report was compiled based on data from 65 countries. For the 128 others, they used mathematical modelling to come up with their estimates.

“This is still a huge success,” said Peter Strebel, a measles expert at WHO and one of the authors of the study. “You don't reduce measles deaths by three quarters without significantly accelerating efforts.” He noted that the global 85 percent vaccination coverage rate was the highest ever recorded.

In India the numbers dipped by 26% during the same period. The study blamed India's relatively low measles vaccine coverage (74%) as the reason why the disease remained a major cause of death in the country. Dr Peter Strebel said, “Delayed implementation of accelerated disease control in India stalled momentum towards the 2010 global measles mortality reduction goal.”

India in 2010 recorded nearly 30,000 new cases of measles, and recorded 65,500 deaths. South-east Asia, excluding India, had 79% vaccine coverage in 2010. The global coverage for measles vaccination overall was 85%. Over 1 billion doses of measles vaccine were delivered through supplementary mass vaccination campaigns in the last decade, and were the main driver behind the huge fall in mortality.

Speaking on disease eradicated like Small pox, Nancy Leys Stepan, author of a book on disease eradication and a professor at Columbia University said, “I am cautious about adopting too many eradication campaigns at once.” She was not linked to the study. Stepan said problems like getting good data and the challenges of eradication make it more reasonable to stick to deadlines for reducing measles rather than trying to eliminate it.

Despite vaccination last year was the worst year for measles in the U.S. in 15 years, with 222 cases — mostly imported by foreign visitors or by U.S. residents infected overseas.

Daniel Berman, a vaccines expert at Medecins Sans Frontieres, noted there has been a massive increase in measles across Africa in the last two years, largely because of backsliding on immunization campaigns and declining funds. “The challenge is to find ways to make measles campaigns happen in countries with weak systems,” he said. Berman said it would be hard to dramatically improve the 74 percent drop in measles deaths and that it would probably plateau.

Strebel from WHO said just maintaining the decline in measles still requires a major effort. He added experts are not ready to set any eradication deadlines. “Let's wait until we get a bit closer to the top of the mountain before we say if we can get there,” he said. According to him, Millennium Development Goals that aims to reduce child mortality by two-thirds by 2015 will be missed if measles outbreaks continue to spread.

Dr Walter A Orenstein from the Emory University, Atlanta, said, “Measles eradication is biologically feasible and while no formal eradication goal has yet been set, progress on the mortality reduction goal will lead to consideration for an eradication goal.”