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

NEW YORK and TORONTO, 1 March 2019 – 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. 

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

Countries with ten highest increases in cases between 2017 & 2018 
1. Ukraine: 30,338
2. Philippines: 13,192
3. Brazil: 10,262
4. Yemen: 6,641
5. Venezuela: 4,916
6. Serbia: 4,355
7. Madagascar: 4,307
8. Sudan: 3,496
9. Thailand: 2,758 
10. France: 2,269

“Vaccines work. They save millions of lives a year and are an important reason why more children today survive,” said David Morley, President and CEO of UNICEF Canada. 

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 , compared to 15,599 cases in the whole of 2018.

“This is a wake-up 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 life-saving tool for children. 

In response to a recent outbreak of measles in British Columbia, Morley added: “Canada must invest in comprehensive monitoring and reporting to close the data gap in vaccination rates and identify populations at risk during outbreaks. We applaud the commitment in mid-February by Canada's Chief Public Health Officer, Dr. Theresa Tam, to tackle misinformation around vaccinations.” 

UNICEFs global response

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 worst-hit 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 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. 

“As one of the largest donors of vaccines in the world, Canada has long shown its leadership for immunizing children, which plays a key role in preventing life-threatening illnesses such as polio, pneumonia, tetanus and diarrheal disease,” added Morley. 

Notable reported measles cases in 2018 in countries with no reported cases in 2017
Brazil: 10,262 
Moldova: 312
Montenegro: 203
Colombia: 188
Timor-Leste: 59
Peru: 38
Chile: 23
Uzbekistan: 17

Poor health infrastructure, civil strife, low community awareness, complacency and vaccine hesitancy in some cases have led to these outbreaks in both developed and developing countries. For example, in the United States, the number of measles cases increased six-fold 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 life-saving vaccines

Notes to editors

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About the Measles and Rubella Initiative
UNICEF is part of the Measles and Rubella Initiative, a private-public partnership of five global partners including WHO, CDC, United Nations Foundation and American Red Cross that has been spearheading a global push towards measles and rubella elimination.