Environmental Disease

LETTER TO EDITOR
Year
: 2018  |  Volume : 3  |  Issue : 4  |  Page : 88--89

Implementing measures to minimize the measles-associated deaths and accomplish global elimination


Saurabh RamBihariLal Shrivastava1, Prateek Saurabh Shrivastava2,  
1 Department of Community Medicine, Vice Principal Curriculum, Member of the Medical Education Unit & Institute Research Council, Kancheepuram, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India




How to cite this article:
Shrivastava SR, Shrivastava PS. Implementing measures to minimize the measles-associated deaths and accomplish global elimination.Environ Dis 2018;3:88-89


How to cite this URL:
Shrivastava SR, Shrivastava PS. Implementing measures to minimize the measles-associated deaths and accomplish global elimination. Environ Dis [serial online] 2018 [cited 2022 May 22 ];3:88-89
Available from: http://www.environmentmed.org/text.asp?2018/3/4/88/250877


Full Text



Dear Editor,

Measles is ranked as one of the most frequent causes of death among young children.[1] It is noteworthy that the disease is extremely common in developing nations, especially in the nations in the African and Asian regions.[1] In addition, it has been reported that, in contrast to the developed nations, 95% of the reported deaths are from developing nations, clearly indicating the role of weak health infrastructure.[1] This becomes a serious and an alarming cause of concern for all the stakeholders, as a safe and cost-effective vaccine for decades together is available.[1],[2],[3]

Acknowledging the cost-effectiveness of the vaccine in reducing the number of child deaths, global leaders and the World Health Organization (WHO) have envisioned a world free of measles.[1],[2] Keeping measles elimination in mind, three targets (viz., augment routine coverage with the first dose of measles by more than 90% and 80% at national and every district level respectively; decrease and sustain annual disease incidence by <5 cases/million; and decrease disease-associated deaths by more than 95% in comparison with the findings of 2000) were set in 2010 to be achieved by 2015.[1],[2] This has been followed by setting up of the target to eliminate measles in four WHO regions by 2015 and in five regions by 2020.[2],[4] Subsequently, in the current date, all the WHO regions have now set a goal to eliminate the disease either before or by 2020.[1],[2]

However, the recent estimates reflect only 85% and 64% coverage with the first and second doses, respectively, of vaccine globally, which is very much less than the required coverage.[2] It is really shocking that close to 21 million children fail to receive even the first vaccine dose, and more than 50% of the unvaccinated children are concentrated in six developing nations.[1],[2] Further, more than 89,000 disease-associated deaths have been reported worldwide in 2016.[2] On an encouraging note, due to the administration of the vaccine, a significant decline of close to 85% in the disease-attributed deaths has been reported between 2000 and 2016 across the globe.[1],[4] In the same period, in excess of 20 million deaths have been averted due to the vaccine.[1],[4]

The observed gains have been due to the constant efforts of the health workers, national governments, and the international welfare agencies.[1],[3] In addition, due to the sustained efforts and financial support for polio eradication, simultaneous benefits have been achieved even in increasing the coverage of measles vaccine worldwide.[2] Nevertheless, there is a definite risk of reversal of progress after polio eradication is achieved, so we cannot be complacent.[2] Further, owing to the extremely contagious nature of the disease with a high secondary attack rate, large outbreaks have been reported even in high-income nations.[1],[5]

It is important to understand that the status of disease elimination can be achieved only if the vaccine reaches every child universally.[3] In order to move forward and reduce the incidence of cases and deaths, there is an immense need for sustained political commitment, additional investment in the health systems, strengthening of surveillance systems and routine immunization services, and involvement of private sectors.[1],[2],[3],[4],[5]

To conclude, even though the global leaders have succeeded in reducing the measles-associated death rates, a lot needs to be done, and there is a great need to bridge the existing gap in immunization coverage.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1World Health Organization. Measles – Fact Sheet No. 286; 2018. Available from: http://www.who.int/mediacentre/factsheets/fs286/en/. [Last accessed on 2018 Nov 07].
2CDC, GAVI, UNICEF, WHO. Substantial Decline in Global Measles Deaths, but Disease Still Kills 90 000 per Year; 2017. Available from: http://www.who.int/mediacentre/news/releases/2017/decline-measles-death/en/. [Last accessed on 2018 Nov 08].
3Shrivastava SR, Shrivastava PS, Ramasamy J. Enormous need to improve the global measles vaccination coverage: World Health Organization. MAMC J Med Sci 2016;2:109-10.
4Dabbagh A, Patel MK, Dumolard L, Gacic-Dobo M, Strebel PM, Mulders MN, et al. Progress towards regional measles elimination – Worldwide, 2000-2016. Wkly Epidemiol Rec 2017;92:649-59.
5Shrivastava SR, Shrivastava PS, Ramasamy J. The 2015 measles outbreak in America: Identified shortcomings and recommendations to the health authorities. Ann Afr Med 2016;15:42-3.