Alarming global surge of measles cases a growing threat to children

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

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

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

“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 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 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. 
• Viet Nam had 1,177 confirmed measles cases in 2018, twice as many cases as in 2017. Most of the measles cases related to the lack of vaccination due to parents deciding to delay vaccination of their children. In late 2018, the Ministry of Health launched an additional measles-rubella vaccination campaign for 4.2 million children aged between 1 and 5 in vulnerable areas in 57 cities and provinces. UNICEF called on parents to make an extra effort to consult health official to ensure that their children’s immunization status is up to date to protect their children against the disease. UNICEF also advocated health authorities to sustain investment to build trust among the population and to focus on reaching the poorest, most marginalized communities, including internal migrant populations.

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. Timor-Leste: 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 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

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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.

For more information, please contact:

• Sabrina Sidhu, UNICEF New York, +1 917 4761537, ssidhu@unicef.org 
• Nina Sorokopud, UNICEF Ukraine, +380503882951, nsorokopud@unicef.org 
• Zafrin Chowdhury, UNICEF Philippines, +63 9178678366, zchowdhury@unicef.org 
• Elisa Meirelles Reis, UNICEF Brazil, +5561981661649, ereis@unicef.org 
• Thaiza Castilho, UNICEF Yemen, +967 712 223 001, tcastilho@unicef.org 
• Fanjaniaina Saholiarisoa Alida, UNICEF Madagascar, +261 202354045, falida@unicef.org 
• Louis Vigneault-Dubois, UNICEF Việt Nam +84-4-38500241; +84-966539673; email : lvigneault@unicef.org 
• Nguyễn Thị Thanh Hương, UNICEF Việt Nam, 84-4-38500225; +84-904154678; email: ntthuong@unicef.org 

[1] Note: The analysis is based on WHO’s global measles and rubella data of 194 countries for the year 2017 and 2018. To know more, click here. The analysis is based on the total confirmed cases of measles.

[2] Until 23 February 2019.