UK expected to lose measles-free status as cases surge

They highlighted that even among high-income countries such as the UK, where no measles outbreaks have been detected to date, measles outbreaks are still occurring and, in some cases, increasing.

“The measles virus is highly contagious and gaps in vaccination coverage pose a potential risk of outbreaks.”

patrick o'connor

The warning was issued by who (WHO) researchers European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress in Barcelona this week.

Dr Patrick O'Connor from WHO Headquarters in Geneva gave an overview of the global measles situation at the conference.

He told delegates that the number of infections so far in 2024 appears to be on track to at least match the provisionally reported number of 321,582 infections in 2023.

In 2024, some 94,481 cases had been reported by early April, but the actual number is probably much higher due to reporting lags, he noted.

Of these 2024 cases, 42,767 or 45% occurred in the WHO European Region. Yemen, Azerbaijan, and Kyrgyzstan have the highest incidence of measles in the world.

The UK first eliminated measles in 2016, but in 2018 an uncontrolled outbreak that lasted more than 12 months re-established measles transmission and therefore lost its elimination status.

The UK has once again been measles-free in 2021 after halting an outbreak of measles during the Covid-19 pandemic.

However, transmission has now been re-established. UK Health and Safety Executive Data shows England will have 368 cases in 2023 and 1,001 cases in various locations in 2024 so far by April 25. There is.

Dr. O'Connor of the WHO European Regional Verification Committee for Measles and Rubella Elimination will review all 2023 national measles and rubella reports for elimination from 10 to 12 September 2024.

“The UK is therefore likely to lose its verified measles elimination status again,” he said.

“The situation in the UK shows that measles elimination will be difficult to achieve and maintain, requiring continued efforts and responses to outbreaks and ensuring high routine immunization coverage.”

UK coverage estimates show that MMR vaccine coverage is 90% with one dose and 87% with two doses, down from 92% and 88% respectively in 2017.

While this vaccination rate is relatively high, Dr O'Connor said: “The measles virus is highly contagious, and gaps in immunization coverage pose a potential risk of outbreaks.” Coverage must therefore be broad, but also uniform and fair. It won't. ”

He said the number of countries, not just the UK, experiencing major or devastating measles outbreaks, defined as 20 cases per million people over a 12-month period, is worrying. He warned that the number of cases is increasing rapidly.

“Vaccine hesitancy is just one factor that may contribute to low uptake rates.”

Hannah Nohinec

In contrast, he highlighted the significant global gains achieved through measles vaccination, with an estimated 57 million deaths averted worldwide between 2000 and 2022.

Approximately 1.5 million of these cases are in Europe, where the annual number of measles deaths has decreased by 98% from 3,584 in 2000 to 70 in 2022.

He said: “Over the past 20 years, great progress has been made towards measles and rubella elimination. To consolidate and sustain that progress, we need to ensure high, uniform and equitable routine immunization coverage. effective outreach and rapid outbreak response.”

Professor Hanna Nohinek from the Finnish Institute of Health and Welfare in Helsinki also spoke at the event.

She said: “Transmission of all airborne viruses, including measles, has decreased during the COVID-19 pandemic, when society was shut down and human contact was restricted.

“During the pandemic, many children remain unvaccinated and additional vaccinations are not reaching them,” she said. “So we are now seeing cases rising again in different parts of the world.”

Professor Nohinek added: “Countries should use measles cases and outbreaks as a follow-up to identify weaknesses in their immunization programs and to guide program planning to identify and address these weaknesses. Yes,” he added.

“Vaccine hesitancy is just one factor that can contribute to low uptake; misinformation about vaccines, access to immunization services and on-time vaccinations are contributing to gaps in immunization. “It's causing it,” she pointed out.