Measles is a highly contagious viral disease and a significant cause of death among young children, despite the fact that a safe and cost-effective vaccine is available. WHO estimated that nearly 135,000 people died from the disease in 2015. Almost all measles deaths occur in children less than five years of age and in low income countries.
In high-income countries, most people infected with measles recover within two to three weeks, and mortality rates are low. In developing countries, however, the mortality rate can be between 1 and 15 per cent, rising to 20 per cent where people are more vulnerable. Death is usually due to complications such as severe respiratory infection, persistent diarrhoea, malnutrition and encephalitis (inflammation of the brain).
Large-scale vaccination campaigns have signiﬁcantly decreased the number of cases and deaths due to measles. From 2000 to 2015, an estimated 20.3 million deaths were prevented thanks to accelerated immunisation activities, with annual mortality decreasing by approximately 75 per cent over the same period. However, large numbers of people are left susceptible to the disease, especially in countries with weak health systems, where outbreaks are frequent and where there is limited access to health services.
For more information: WHO measles fact sheet
- Transmission: The measles virus is highly contagious and is spread by coughing and sneezing, close personal contact or direct contact with nasal or throat secretions.
- Signs and symptoms: High fever usually begins about 10 or 12 days after contracting the measles virus, and runny nose, cough, red and watery eyes and small white spots inside the cheeks can develop during the initial stage. After several days, a rash erupts usually on the face and upper neck. Over about three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days, and then fades. and spreads to the hands and feet.
- Diagnosis: Suspected measles cases are diagnosed using clinical signs and symptoms and confirmed by laboratory tests for measles-specific antibodies.
- Treatment: There is no specific antiviral treatment for measles; however, supportive care including good nutrition, adequate fluid intake and treatment for dehydration can help avoid severe complications from the disease. Vitamin A supplements can help prevent eye damage and blindness in children.
- Prevention and control: The measles vaccine has been used for over 50 years. Safe, effective and inexpensive, routine measles vaccination for children and mass immunisation campaigns in countries with high case and death rates are key to reducing global measles deaths.
Outbreaks of measles are common in places where people are forced to live in unsanitary conditions such as refugee camps, or where routine vaccinations have been interrupted. Vaccination is the best form of protection against measles; even after the disease has begun to spread it can still reduce the number of cases and deaths. The difficulty lies in the fact that at least 95 per cent of people need to be immune in order to prevent new outbreaks.
Extremely high mortality rates during a 2015 measles epidemic in the Katanga region of the Democratic Republic of Congo illustrate how deadly the disease can be for populations with limited access to healthcare and where measles is coupled with malnutrition and other diseases, such as malaria. There have been measles epidemics every few years in Katanga, owing to insufficient routine vaccination and the shortage of healthcare in remote parts of the region. MSF teams carried out vaccinations and supported measles treatment for patients at over 100 health centres across the region in 2015 – vaccinating over 962,000 children against measles and supporting the treatment of nearly 30,000 who had caught the disease. MSF vaccinated hundreds of thousands more people in response to outbreaks the same year in countries such as Liberia, Pakistan, South Sudan and Sudan.
In early 2016, MSF supported a measles vaccination campaign in refugee camps in Calais and Dunkirk, France, after three people were confirmed with measles in the ‘Jungle’ camp in Calais. Later in the year, MSF conducted a vaccination campaign for children six weeks to 15 years of age at the Elliniko refugee camp in Greece; 950 children were immunised against measles, as well as tetanus, pertussis, influenza, polio, hepatitis B and certain forms of pneumonia.
MSF treated 45,600 patients for measles and vaccinated 1,537,400 people in response to outbreaks in 2015.