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Fifty years after measles vaccine, disease cannot be ignored

Saturday December 7, 2013
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Fifty years after the approval of an extremely effective vaccine against measles, one of the world’s most contagious diseases, the virus still poses a threat to domestic and global health security, according to a CDC report.

On an average day, 430 children — 18 every hour — die of measles worldwide. In 2011, there were an estimated 158,000 measles deaths.

In an online article published Dec. 5 in JAMA Pediatrics, the CDC’s Mark J. Papania, MD, MPH, and colleagues report that U.S. measles elimination, announced in 2000, has been sustained through 2011. Elimination is defined as absence of continuous disease transmission for greater than 12 months.

Papania and colleagues warn, however, that international importation continues, and that American clinicians should suspect measles in children with high fever and rash, “especially when associated with international travel or international visitors,” and should report suspected cases to the local health department.

Before the U.S. vaccination program started in 1963, measles was a year-round threat in this country. Nearly every child became infected; each year 450 to 500 people died, 48,000 were hospitalized, 7,000 had seizures and about 1,000 suffered permanent brain damage or deafness.

People infected abroad continue to spark outbreaks among pockets of unvaccinated people, including infants and young children. It remains a serious illness, with hospitalization resulting for one in five children with measles. Usually there are about 60 cases per year, but 2013 saw a spike in American communities — about 175 cases and counting — with virtually all linked to people who brought the infection home after foreign travel.

A larger issue

“The steady arrival of measles in the United States is a constant reminder that deadly diseases are testing our health security every day,” CDC Director Tom Frieden, MD, MPH, said in a news release. “Someday, it won’t be only measles at the international arrival gate, so detecting diseases before they arrive is a wise investment in U.S. health security.”

Eliminating measles worldwide has benefits beyond the lives saved each year. Actions taken to stop measles can also help stop other diseases in their tracks. The CDC and its partners are building a global health security infrastructure that can be scaled up to deal with multiple emerging health threats.

Only one in five countries can rapidly detect, respond to or prevent global health threats caused by emerging infections, according to the CDC. Improvements overseas, such as strengthening surveillance and lab systems, training disease detectives and building facilities to investigate disease outbreaks make the world — and the U.S. — more secure, the agency stated.

“There may be a misconception that infectious diseases are over in the industrialized world,” Frieden said. “But in fact, infectious diseases continue to be, and will always be, with us. Global health and protecting our country go hand in hand.”

Today’s health security threats come from at least five sources, according to the CDC: the emergence and spread of new microbes; the globalization of travel and food supply; the rise of drug-resistant pathogens; the acceleration of biological science capabilities and the risk that these capabilities may cause the inadvertent or intentional release of pathogens; and continued concerns about terrorist acquisition, development and use of biological agents.

“With patterns of global travel and trade, disease can spread nearly anywhere within 24 hours,” Frieden said. “That’s why the ability to detect, fight, and prevent these diseases must be developed and strengthened overseas, and not just here in the United States.”

Report: http://archpedi.jamanetwork.com/article.aspx?articleid=1787786


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