Why the US, the UK are losing their measles-free status

School-going children in the United States and the United Kingdom are falling sick in hordes. It is not a mystery illness but measles. The disease has made a comeback and is spreading fast, putting everyone from parents to schools and health authorities on the edge.

We take a look at what is behind the latest measles outbreak.

Why is measles spreading in the US?

In the US, Florida and Philadelphia are seeing an alarming tide of measles. Cases have also been reported in Ohio (the first in Montgomery County since 2005), California, and Maryland.

The outbreaks in Florida and Philadelphia hit the headlines after the disease spread into the wider community from children.

In Florida’s Broward County, a third-grade student with no history of international travel was detected with the disease and spread it to others. There were at least eight cases of the virus, including one in a child below five reported recently.

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Most cases have been diagnosed in one school but it is unknown what connection the youngest measles patient has with that. However, the spread was expected as state officials defied federal guidance asking children to remain at home to contain the outbreak.

Florida’s surgeon general, Joseph Ladapo, a well-known COVID-19 vaccine sceptic, disrupted efforts to contain the disease when he told parents they could ignore the US CDC’s (Centers for Disease Control and Prevention) advice to keep unvaccinated children home for 21 days. He sent a letter to parents saying he “is deferring to parents or guardians to make decisions about school attendance”, according to a report in the Guardian.

The CDC recommends that unvaccinated children exposed to measles be isolated for three weeks. Less than 92 per cent of children in Broward County had received recommended immunisations against diseases such as measles when the CDC recommends a 95 per cent immunisation threshold to prevent outbreaks.

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Cases are “not going to stay contained just to that one school, not when a virus is this infectious,” Dr. David Kimberlin, co-director of the division of pediatric infectious diseases at the University of Alabama at Birmingham was quoted as saying by NBC News.

In Philadelphia, cases of measles rose last month after an infant who caught the disease while travelling abroad was sent to daycare contrary to the doctor’s advice.

According to the CDC, as of last Friday, there have been at least 35 measles cases in 15 states this year, most of them linked to international travel. The outbreak in Florida is the largest right now.

Since the mid-20th century, measles vaccination in the US has been so successful that some doctors have never even encountered the disease. Measles was eliminated in the country in 2000. However, it has re-emerged since alongside vaccine misinformation, reports The Guardian.

The rise in cases of measles is not restricted only to the US. Other Western nations like the United Kingdom are also reporting outbreaks.

How bad is the measles outbreak in the UK?

Last week, Northern Ireland reported its first case of measles in seven years. Across Britain, there has been a rise in the disease.

At least 169 cases have been recorded in England in the last month. The total number of confirmed cases since the start of last October has been more than 580. In comparison, there were only two confirmed cases of measles across the whole of the UK in 2021 and 54 in 2022, according to a report in Al-Jazeera.

Unlike, the US, in Britain, the disease spread is not confined to children. A man in his 40s died in neighbouring Ireland after contracting the virus during a visit to the West Midlands in England, where the disease is most prevalent. Last week’s case was also found in an adult.

Dr Vanessa Saliba from the UK Health Security Agency (UKHSA) has attributed the uptick in cases to a “worryingly low MMR [measles, mumps and rubella] vaccine uptake in some areas across the country”, Al-Jazeera reports.

In 2017, WHO declared that the UK had eliminated the disease. But now the country is no longer measles-free.

In the last few months, hundreds of children have fallen sick because of measles. Officials believe that 3.4 million under-16s are at risk of contracting the virus.

“We’re at a point where there’s a very large susceptible population of children,” Prof Sir Andrew Pollard, chair of the Joint Committee on Vaccination and Immunisation, told the Guardian in January. “To keep measles at bay, we need to have over 95 per cent of children vaccinated. The NHS figures suggest that we’re at about 85 per cent.”

Europe has also seen a dramatic rise in the disease. Cases grew nearly 45-fold in 2023 compared to a year earlier, according to WHO.

Has there been a fall in vaccination rates?

Yes. Measles cases have been increasing across most regions mainly due to missed vaccinations during the COVID-19 years when health systems were overwhelmed and fell behind on routine vaccinations for preventable diseases.

“What we are worried about is this year, 2024, we’ve got these big gaps in our immunisation programmes and if we don’t fill them really quickly with the vaccine, measles will just jump into that gap,” the WHO’s Natasha Crowcroft, a senior technical adviser on Measles and Rubella, told a Geneva press briefing last week. “We can see, from data that’s produced with WHO data by the CDC that more than half of all the countries in the world are going to be at high or very high risk of outbreaks by the end of this year.”

In the US, the CDC pointed out in a 25 January alert that most cases were identified in children and adolescents who had not been vaccinated against the disease. Data shows a dangerous drop in vaccination among schoolchildren both in the US and Europe, reports PBS News Hour.

“We’re not just seeing cases, we’re seeing transmission, which means vaccine levels aren’t what we’d like them to be,” Saskia Popescu, an assistant professor of epidemiology and public health at the University of Maryland School of Medicine, was quoted as saying by PBS News Hour.

Misinformation is to be blamed. During the COVID-19 pandemic, false claims about vaccines were made by people who thought they were unsafe and also by others with political and financial gains. Misinformation about the new virus shaped people’s perceptions of the need to get vaccinated against other diseases, like measles, according to Heidi Larson of the Vaccine Confidence Project., and may leave more long-lasting effects on public health.

Also read: Why anti-COVID vaccine rhetoric is on rise after American football star’s sudden collapse on field

How dangerous is measles?

Measles is one of the most contagious viruses today. Common symptoms include high fever, cough, sneezing and sore eyes, with red body rash.

People recover within seven to 10 days but serious cases can lead to pneumonia, seizures, complications leading to blindness and even death.

Children are the most at risk but it can also affect adults. Cases last year were already up 79 per cent to over 300,000, according to WHO data, thought to represent just a fraction of the total. It can be prevented by two doses of vaccine and more than 50 million deaths have been averted since 2000.

_With inputs from agencies
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