Not just in Italy, not only in Europe: the measles it risks going back to being a global problem. This is suggested by the data just released by a report edited by the World Health Organization and the US Centers for Disease Control and Prevention (Cdc). Between 2016 and 2017, the number of reported cases of measles worldwide increased by 31% and the incidence of the disease increased in 5 of the 6 WHO regions. Approximately 6.7 million cases are estimated, just under 110 thousand worldwide deaths, most of them children under 5 years of age. Data that endangers the achievements made in recent years for a disease far from trivial.
The good news
The focus of the report, even before the critical issues, is related to the progress made towards the elimination of measles worldwide in the years between 2000 and 2017. Because to widen the gaze on a broader time window it is discovered that progress has been made.
Beginning with vaccination coverage: in 17 years those for the first dose (the measles vaccine medication is given in two doses) coverage according to the WHO and Cdc estimates increased from 72% to 85%.
In the same years those for the second dose of the vaccine went from 15% in 2000 to 67% in 2017. In parallel, the reported incidence of the disease on an annual basis decreased by 83%, from 125 to 25 cases per million inhabitants .
The number of estimated annual deaths related to the disease has also fallen in similar percentages, going from 545174 to 109638. But perhaps the most impressive figure, able to give an idea of the progress made, is that related to the effects of vaccinations that have prevented 21 millions of deaths according to estimates. But something in recent times risks undermining the progress made.
To narrow the look to the last year, to 2017, something seems to suggest a dangerous inversion of tendency. Not only because of the increase in deaths, once again exceeded the threshold of 100 thousand victims after last year it was greeted for the first time the passage of quota (90 thousand were those estimated for 2016). The global figure for the 31% increase between 2016-2017 hides growth spikes in almost all the WHO regions (with increases of more than 6000% for the Americas for 2016-2017) except for the Western Pacific area (which records a decrease of 82%).
At the same time, according to the report, the percentage of countries supplying data with fewer than 5 cases per million passed from 69% in 2016 (almost doubled compared to 2000) al 65% in 2017. Even the data of the same covers it is not comforting: we are firm, for the first dose, to the values of84-85% from 2010 (at 67% for the second). The only region to have reached and maintained for years the covers above the threshold of 95%, the one recommended by experts to ensure the raw effect. And I'm almost 21 million children not vaccinated even with the first dose. "The increase in cases of measles is of concern, with the presence of prolonged outbreaks in the regions, and in particular in the countries that have obtained or were very close to obtaining the elimination of measles ", commented Soumya Swaminathan, WHO Deputy Director General for Programs.
But what does eliminating measles mean? There is talk of elimination in the absence of endemic transmission of the measles virus in an area for more than 12 months, while the loss of the free measles status is in contrast when the transmission continues for more than a year. It was declared free of measles, for example, the region of the Americas, in 2016. Yet recently the endemic transmission in Venezuela of the disease, and the importation of some cases in neighboring countries, puts the area's measles free status at risk.
Among the critical points highlighted by the report, the case could not have appeared Europe, where the increase in incidence of cases for 2017 was 400% (with Italy in the first rows with 5000 cases, about twice as many as reported so far for 2018) compared to the previous year and the vaccination coverage is less than 95% in many countries.
"These epidemics underline the fragility of the achievements made to achieve global and regional goals. Continuing to increase coverage for both vaccine doses is crucial for the achievement and sustainability of these objectives ", reads the report. "The lack of concern about the disease and the spread of false beliefs about vaccines in Europe, a collapsing health care system in Venezuela and areas of fragility and low immune coverage in Africa are being combined to lead to a global rebirth of measles after years of progress – commented Seth Berkley, CEO of Gavi, the Vaccine Alliance – We need to change the current strategies: more efforts are needed to increase the wheel cover of immune systems and strengthen health systems. Or we will continue to pursue one epidemic after another ".
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