Measles kills 37 in first half of 2019 as number of cases tops figure for whole of last year

The dramatic surge in measles across Europe is putting lives at risk, experts have said, as official figures showed the number of cases in the first half of 2019 outstripped that for the whole of last year.

Data released by the World Health Organization (WHO) revealed nearly 90,000 cases and 37 deaths were reported across 48 of the 53 countries in the WHO European region in the first six months of 2019.

There were 84,462 cases in the region in the whole of 2018, with 44,175 by the end of June that year. In 2016 there were only 5,273 cases.

Ukraine appears to be particularly affected, with more than 54,000 cases and 18 deaths in the first six months of 2019.

There are other signs that progress on measles has deteriorated. Early this month the UK lost its “measles-free” status, which Public Health England said was down to the recent boom in cases and the lengthy presence of one particular strain.

In the first six months of 2019, 489 cases of measles were reported in the UK, 69 of which have been confirmed as imported from abroad.

The new report adds that three other countries – Albania, Czech Republic and Greece – have also had their measles elimination status removed.

“Re-establishment of measles transmission is concerning,” said Dr Günter Pfaff, the chair of the European Regional Verification Commission for Measles and Rubella Elimination (RVC), which produced the report. “If high immunisation coverage is not achieved and sustained in every community, both children and adults will suffer unnecessarily and some will tragically die.”

Andrew Pollard, a professor of paediatric infection and immunity at Oxford University, said the report was a wake-up call for Europe. “The loss of our status tells us that we have lost control of immunisation against measles,” he said, although he added that the situation was salvageable and not as bad as it was in the 1960s, before a measles vaccine was available.

Some countries have shown improvements: Austria and Switzerland have gained measles-free status, while Belgium and Kazakhstan are experiencing an interruption in endemic transmission, which needs to last for 36 months for a country to be deemed measles-free.

But overall the number of countries judged to have eliminated the disease fell from 37 to 35 between 2017 and 2018.

Prof Martin Marshall, vice-chair of the Royal College of GPs, decried the latest figures. “It is disheartening to see these findings at a time when we and other countries across Europe were on the way towards completely eradicating measles, a potentially deadly but entirely preventable disease,” he said.

Measles is a highly infectious disease, but the MMR (measles, mumps and rubella) vaccination offers protection. In the UK the first injection is given to children shortly after their first birthday and the second before they start school – an important step, as not everyone responds to the first dose.

Some children – for example those who have cancer or immune-system problems – cannot be vaccinated. To protect them and produce so-called “herd immunity”, 95% of the population needs to be immunised with both doses of MMR.

“We talk a lot about the unvaccinated and the people not taking the vaccine, and the risks to them and to their children, but actually the biggest risks are in those who can’t be vaccinated,” said Pollard. “They absolutely rely on society to make sure that the virus is kept away and to protect them and also potentially to save their lives.”

According to the latest statistics, covering 2017/18, just 87.2% of children in England had both doses of the MMR vaccine by their fifth birthday, a fall from 87.6% the year before.

MMR vaccine: one in seven five-year-olds in England may not be immunised Read more

Across the European region as a whole, the WHO says there is 91% coverage of full immunisation. A 2017 study said that a 5% drop in coverage could result in a threefold increase of measles cases.

The WHO has revealed it is developing a strategic response plan for the whole region, as well as focusing on specific countries including Ukraine. Since May it has classed the circulation of measles in Europe as a grade 2 emergency.

Experts say inadequate vaccination rates are linked to the anti-vaxxer movement, which has been fuelled by false claims over the safety of the MMR vaccine.

“It is clear that we are still suffering from entirely debunked claims around MMR that were perpetuated in the 90s and are now resurgent on social media and other online platforms,” said Marshall.

This month Boris Johnson urged parents to make sure their children were vaccinated and said social media companies needed to do more to combat the spread of misinformation. Some platforms have already taken action: Pinterest announced on Wednesday that it had tightened its rules to fight vaccine myths.

Pinterest makes aggressive new move in fight against vaccine misinformation Read more

Dr Tedros Adhanom Ghebreyesus, the director general of the WHO, said vaccines were estimated to save at least 2 million lives a year.

“Social media platforms are the way many people get their information and they will likely be major sources of information for the next generations of parents. We see this as a critical issue and one that needs our collective effort to protect people’s health and lives,” he said, adding that governments must also build health systems that could be trusted and respond to parents’ concerns and needs.

Marshall stressed that it was never too late to have the MMR jab. “They can do this for free at their GP practice, and we urge them to do – particularly if they are planning to visit another area of the world where diseases like measles are still prevalent.”