Worldwide deaths from measles across all age groups dropped by 74% between 2000 and 2007, from an estimated 750,000 to 197,000 deaths annually.
The most striking reduction during this time period occurred in the Eastern Mediterranean region (including Pakistan, Somalia, and the Sudan), where deaths from measles fell by 90%, from an estimated 96,000 to 10,000 deaths annually. In doing so, the region has already achieved the United Nations goal of reducing measles deaths by 90% by 2010.
The measles statistics were presented at a press conference by representatives of the Measles Initiative, a collaboration of the American Red Cross, the Centers for Disease Control and Prevention, the United Nations Foundation, UNICEF, and the World Health Organization. The data were also published in the CDC's Morbidity and Mortality Weekly Report (MMWR 2008;57:1303-6) and the WHO's Weekly Epidemiological Record (Wkly Epidemiol. Rec. 2008;83:441-8).
Routine childhood immunization for measles increased globally from 72% in 2000 to 82% in 2007, said Dr. Peter Strebel of the World Health Organization.
About 90% of the 197,000 deaths in 2007 occurred in children aged younger than 5 years, he said. Most of the remaining 10% occurred in children aged 5-15 years, although a small number occurred in individuals older than 15 years.
Nevertheless, the organizations and governments working to reduce deaths from measles can't rest on their laurels, he emphasized. “Routine health services need to be expanded, but while this is being done, countries must plan and budget for periodic nationwide vaccination campaigns.”
Dr. Steve Cochi of the CDC said that the progress being made internationally “is a reminder to us in the United States that measles is still an ever-present disease … and a reminder to parents and pediatricians of the importance of continuing to vaccinate against measles to maintain [protection] for the children of the United States.”
In 2007, the United States had about 135 cases of measles, which is the highest level in the country since 1996, Dr. Cochi added.
Dr. Julie Gerberding, director of the CDC, said the success of the Measles Initiative has resulted from a combination of disease prevention and surveillance.
The key strategy of the initiative is to prevent measles by increasing routine immunization as part of childhood medical care. Based on the current data “the vast majority of children on a global scale are receiving the appropriate measles vaccine at the appropriate age,” she said.
Another 600 million children were not reached for routine vaccinations, but 3.6 million deaths were prevented between 2000 and 2007 by supplemental activities such as vaccination campaigns involving governments and local volunteers to get people to vaccination centers, she added.
The Measles Initiative's strategy also involves identifying outbreaks quickly so that an immunization campaign can focus on the area of the outbreak and prevent the spread of disease.
In addition, the program provides vitamin A supplements and other care to prevent deaths from measles in those children who become ill, Dr. Gerberding said. “The success of the last few years indicates that when we can apply these strategies, we save lives.”
But about 540 children die from measles worldwide each day, she added. The goal of the Measles Initiative is to reduce measles deaths by 90% worldwide by 2010, compared with 2000.
“We have to refocus our efforts in countries where the immunization rates are low,” Dr. Gerberding said.
The Southeast Asia region (as defined by the WHO) is “the hot spot for measles transmission,” she said. According to the WHO, about 130,000 of the estimated 136,000 measles deaths in that region occurred in India, when about 8.5 million children did not receive a measles vaccine through routine immunization services. Of the estimated 136,000 deaths from measles in the region in 2007, about 130,000 occurred in India, according to the WHO.
The Measles Initiative was launched in 2001 with the goal of reducing deaths from measles worldwide. In addition to the five health organizations, the initiative is supported by funding from other business and charitable partners including the Bill and Melinda Gates Foundation, the Kessler Family Foundation, and Merck & Co.
A Pakistani child is vaccinated; she is one of 66 million immunized during the nationwide measles campaign. ©Stacey Winston/IFRC