Geneva (dpa) - After major success in the fight against measles, they are currently spreading worldwide again. About 140,000 people died last year from the highly contagious disease, mostly children under the age of five, according to World Health Organization (WHO) estimates.
Although the death toll has fallen in the long-term comparison, in 2000, more than 535,000 people succumbed to the disease. Recently, however, the numbers are rising again. According to the WHO estimates, there were around 16,000 measles deaths in 2018 over 2017. Especially in the Congo, measles spread in many places. One reason, according to WHO, is that the vaccination coverage is too low. Experts complain, among other things, gaps in the supply of vaccines.
Like the death toll, the estimated infections, which have also risen again after a drastic decline, have changed recently. According to WHO estimates, there were just under 9.8 million cases of measles in 2018, almost 7.6 million the year before.
The symptoms of measles include a rash of the oral mucosa and the characteristic brownish-pink patches of skin. The infection temporarily weakens the immune system, making it easier to get middle ear infection, bronchitis, pneumonia or diarrhea. A particularly dreaded consequence is certain brain inflammations that can be fatal.
As there is no reporting requirement in many countries, according to the WHO, only a fraction of measles cases are known. By far the most contagion was reported from the Congo in mid-November 2019. The authorities assume that more than 5,000 people have died of measles there alone - far more than in the Ebola outbreak since the summer of 2018, with around 2,200 deaths so far.
In Europe, there was a major outbreak in Ukraine with almost 57,000 reported cases. Also in Liberia, Madagascar and Somalia there are big problems with the measles. In the end, these five states account for almost half of all reported measles cases. Even in the US - which was once considered to be free of maser - the tendency is rising again, the country recorded more cases than in 25 years no longer. Only last week, at least 53 people died in a measles outbreak in the Polynesian island state of Samoa.
"Health systems are very weakened in some countries. Then there are often gaps in the supply chain, especially in measles vaccine, "said Marcus Bachmann, for the organization" Doctors Without Borders "recently several times head of operations in the Congo, the German Press Agency. The measles vaccine needs to be permanently refrigerated until administration, which is a major challenge in many countries.
Especially in the Congo is also the fight against Ebola in the center, which is also financially noticeable. "Local people can not understand this imbalance. They are very worried about the measles because they often kill their children, "said Bachmann. For the coming year, there is little reason for optimism, said Bachmann. The typical problems in some countries - poor monitoring and slow checking of new cases, lack of vaccinations and, in principle, insecurity due to conflicts - could not be solved "overnight".
"The fact that a child dies from a disease such as measles, which can be prevented by vaccination, is frankly an outrage and a collective failure to protect the most vulnerable," said Tedros Adhanom Ghebreyesus, WHO Director-General. According to the organization, vaccination rates have remained constant throughout the world over the past decade.
The WHO estimates that 86 percent of children receive a first vaccine, but only about 70 percent receive the recommended second dose. According to WHO, a vaccination coverage of 95 percent with two doses is needed in each country to protect the population from the disease.
According to the Robert Koch Institute, 501 measles cases were counted in Germany from January to the end of November - in 2018 there were 528 cases. However, the numbers in Germany vary a lot from year to year. Over the past ten years, they have ranged from 165 to 2465 cases per year.
For greater protection against the disease, the Bundestag passed a law on compulsory vaccination in November. It is expected to come into force on March 1, 2020. Parents must then prove that their children have been vaccinated before admission to day-care centers or schools. For children who are attending kindergarten or school, proof must be provided by 31 July 2021. In the case of violations, fines of up to 2500 euros are imminent. The obligation to vaccinate should also apply to teachers and nurses as well as to staff in medical facilities.
Robert Koch Institute on Measles in Germany
WHO on measles in general