India accounts for almost half the global measles mortality, according to results from a model surveillance data published by British medical journal The Lancet. India accounted for 47 per cent of estimated global measles mortality of 139,300 in 2010, while it was 36 per cent in the African region.
On the global level, there was a marked decrease in the mortality – 74 per cent from 535,300 deaths in 2000. According to the study, ‘delayed implementation of accelerated disease control in India and continued outbreaks in Africa’ stalled efforts to achieve the 2010 global measles mortality reduction goal set by World Health Organisation and its partners. ‘Intensified control measures and renewed political and financial commitment’ are needed to achieve the targets.
“A three-quarter drop in measles deaths worldwide shows just how effective well-run vaccination programmes can be,” said Dr. Margaret Chan, Director General of WHO. “Now we need to take the next logical step and vaccinate children against rubella too.”
Sub-Saharan Africa made the most progress with an 85 per cent drop in measles deaths between 2000 and 2010, according to the study. As a whole, the African region account for 36 per cent of global measles mortality in 2010, down from 63 per cent in 2000. India’s small decline in measles mortality (26 per cent) led to an increase in the country’s share of global measles mortality from 16 per cent in 2000 to 47 per cent in 2010. In the remaining 10 countries of the WHO southeast Asia region, the mortality decreased by 78 per cent during 2000-10.
Measles remains widespread in India because of delayed implementation of supplemental immunization activities (SIA) (i.e., mass vaccination campaigns aimed at immunizing 100 of a predefined population within several days or weeks) and restricted improvement in measles containing vaccine coverage. If India wants to substantially reduce measles mortality by 2015, it should undertake planned immunization activities targeting 134 million children and the introduction of a routine second dose in some states during 2011-13, says experts.
“Recent measles outbreaks have affected children in the world unevenly, with the poorest and youngest children the most at risk of death or disability,” said UNICEF Executive Director Anthony Lake. “This new Strategic Plan stresses that measles and rubella vaccinations must be delivered to children deep in the poorest and hardest to reach communities.”
The new Plan presents a five-pronged strategy to cut global measles deaths by at least 95 per cent by 2015 compared with 2000 levels and to achieve measles and rubella elimination in at least five WHO regions by 2020. The strategies include:
- high vaccination coverage;
- monitoring spread of disease using laboratory-backed surveillance;
- outbreak preparedness and response and measles case management;
- communication and community engagement; and
- research and development.
“Measles continues to kill children around the world and rubella is the leading infectious cause of congenital malformations in newborn infants; these are avoidable tragedies,” says Thomas R. Frieden, Director of Centres for Disease Control and Prevention Administrator, USA. “This new plan outlines strategies we know work. It is time to partner with key countries to implement the plan in order to save our children from these terrible diseases.”
Measles is one of the most infectious diseases known to humankind and an important cause of death and disability among children worldwide. Those unvaccinated against the disease are at risk of severe health complications such as pneumonia, diarrhoea, and encephalitis and blindness. The disease can be fatal. The vast majority of measles deaths occur in developing countries.
Rubella, transmitted through airborne droplets, is generally a mild illness. But when a pregnant woman becomes infected, particularly during the first trimester of pregnancy, serious consequences can occur including miscarriages, still births, and infants born with birth defects known as Congenital Rubella Syndrome (CRS). The most common congenital defects include lifelong heart problems, deafness or blindness (cataracts). An estimated 112 000 cases of CRS occur each year and are preventable through vaccination. (Image courtesy: Wikimedia)