The Philippines is in the midst of a growing measles crisis, with at least 70 deaths, mainly of children, in the past month.

In January, there were 4,302 reported cases of measles in the country, an increase of 122% on the same period last year. The outbreak has been blamed on a backlash against vaccinations.

The outbreak has continued into February. Last week, a measles outbreak was declared in Metro Manila – populated by 12 million people with many living in poverty-stricken slums. This follows 196 reported cases in January, compared to just 20 recorded in the same period last year. In Manila, 55 children under the age of four have died of measles since the beginning of the year.

The department of health has subsequently also declared a “red alert” outbreak in the regions of Luzon and parts of the Visayas

“We are declaring an outbreak as cases have increased in the past weeks and to strengthen surveillance of new cases and alert mothers and caregivers to be more vigilant,” said Francisco Duque, the health secretary, in a statement.

It follows on from reports from the department of health and the World Health Organisation (WHO) which showed that, as of December 2018, there were more than 20,000 reported measles cases in the Philippines, a 500% increase on the year before.

Measles is a highly contagious disease, but population immunity can be achieved if more than 95% of the population is vaccinated. However, in the Philippines, vaccinations are currently only at 55% according to UNICEF, down 15% on last year. This has been blamed mainly on fear-mongering over inoculations.

Lotta Sylwander, UNICEF Representative in the Philippines, said UNICEF was “deeply concerned” about the outbreak.

“Immunisation in the Philippines has declined sharply from 88% in 2014 to 73% in 2017, leaving 2.5 million children under five who are not vaccinated for measles,” said Sylwander. “There has been a notable unwillingness on the part of parents to vaccinate their children on time.”

UNICEF said following the growing outbreaks in the Philippines they were assisting both local and national government in an emergency national vaccination drive. “Child death and illnesses from measles, a vaccine-preventable disease, are unacceptable,” added Sylwander.

The measles crisis in the Philippines has been mounting since early last year, after a scandal around a dengue vaccination made parents hesitant about vaccinating their children. Dengvaxia, which was given to school children across the country, was accused of making children at risk of contracting a more serious form of the disease. Links were made to the deaths of several children, though nothing was ever proven.

According to data from the Epidemiology Bureau, of the 70 who have died from measles since the beginning of the year, 79% were not vaccinated.

The outbreak in the Philippines follows an alarming wave of measles cases worldwide, which has been blamed mainly on conspiracies and misinformation around vaccinations, particularly in Europe and the US. There has been a 30% increase on measles cases worldwide since 2016, according to WHO.

Overall, south-east Asia is one of the few regions where measles vaccinations are on the rise but other countries in the region have seen recent outbreaks similar to the Philippines. In November last year, a measles crisis was declared in the majority-muslim southern regions of Thailand, which have high levels of poverty, even though the disease was said to be almost eradicated in Thailand. There were 4,000 measles cases reported in Thailand last year, causing the deaths of at least 22 children.