Washington (AFP)

After decades of dramatic progress, the fight against measles is stagnating and the number of deaths is rising again in 2018, the World Health Organization (WHO) and US health authorities warned on Thursday. place from the Pacific to Europe.

It is one of the most contagious viruses, which can stay in a room two hours after an infected person has passed, and has caused epidemics on five continents since 2018, exploding in cities or neighborhoods where too few people are vaccinated.

The small Samoa islands in the South Pacific are currently fighting the epidemic and counting their deaths: 62 since October. Almost all were children under four years old. The authorities cut off access to the archipelago and operated a door-to-door vaccination campaign on Thursday.

Five countries have concentrated almost half of cases in 2018: Democratic Republic of Congo, Liberia, Madagascar, Somalia and Ukraine, according to a report published by the Centers for Disease Control and Prevention (CDC).

But the virus travels easily. Israel has seen the importation of a hundred cases from elsewhere, the Philippines and Ukraine ... From there, some infected travelers have transmitted the disease in the Jewish neighborhoods of New York and contributed to the largest epidemic in the United States since 1992.

In rich countries, measles kills little or nothing. But in the DRC, measles kills twice as much as Ebola: 5,000 deaths this year.

In total, 142,000 people died in the world in 2018. This is four times less than in 2000, but up 15% from 2017.

Most of the dead are children.

"Everyone knows that there is a safe, effective measles vaccine available everywhere for 50 years," said Kate O'Brien, director of immunization at WHO, in a press conference.

"It's really a collective failure to see these outbreaks."

- Sub-vaccination -

One figure illustrates this failure: since 2010, the proportion of the world's population receiving the first dose of vaccine (out of two recommended) has stagnated at around 86%. To prevent epidemics, the goal is 95%.

"There has been no progress on measles immunization coverage for a decade," Kate O'Brien says.

But the averages are misleading. Only 61% of countries reached the 90% mark for the first dose. There were more in 2013.

Europe is almost the target on average, which has not prevented outbreaks because it is sufficient that a community is under-vaccinated for the virus to implant. AFP went to the tiny Dutch village of Urk, where only 60% of the population is vaccinated and an epidemic struck in June.

In Africa three-quarters of the population are vaccinated, but this hides strong regional disparities. Less than one in three African countries has vaccinated at least 90% of its population. Health infrastructures remain insufficient.

In developed countries, the mistrust of vaccines has contributed to the resurgence of the disease.

Perhaps people have forgotten that before the vaccine appeared in the 1960s, measles also killed in New York and Paris. The United States almost lost the status, won in 2000, of countries where measles has been officially eradicated (no continued transmission for 12 months in a particular geographical area).

But Britain, Greece, Albania or the Czech Republic lost this status in August. The year 2019 saw a doubling of the number of measles cases in Europe.

© 2019 AFP