Worldwide Measles Spotlight: March 19, 2019

According to various governments and news reports, the worldwide measles outbreak continues to expand during 2019. 

As of March 19, 2019, the 3 leading measles hot-spots around the world are as follows: 

• Ukraine: 11 people have died and more than 30,500 have been infected during 2019.
• Philippines:  315 people have died, and a total of 21,396 measles cases were reported from January to March 14, 2019. 
• Brazil:  12 people have died and a total of 10,334 confirmed measles cases have been reported during 2019.

During 2018, 98 countries around the world reported an increase in measles cases, with 136,000 deaths attributed to the disease, reported the World Health Organization.

As of March 19, 2019, the following countries published updated measles information.

The Americas:  

• Argentina: One international traveler has been confirmed with measles during 2019.
• Bahamas: Minister of Health Dr. Duane Sands revealed that another case of measles has been reported. “We can now confirm that the brother of the first patient has developed signs and symptoms of measles, but that child was quarantined and has posed no threat to any additional persons.” 
• Brazil: During 2019, there were 10,334 confirmed measles cases reported, including 12 deaths. In the state of Amazonas, between 6 February 2018 and 26 February 2019, there were 11,422 suspected cases reported, including 6 deaths. And, the CDC reaffirmed a Level 1 Travel Alert regarding Brazil’s ongoing measles outbreak for 2019.
• Canada: In Canada, 3 new cases of measles were reported in week 9, 2019.  There are 22 cases of measles reported in Canada in 2019. These cases have been reported by Québec, British Columbia, the Northwest Territories, and Ontario.
• Chile: During 2019, there were approximately 26 confirmed measles cases, of which 8 were imported and 18 were import-related.
• Columbia: Between EW 10 of 2018 and EW 9 of 2019, there were 241 confirmed measles cases. The CDC reaffirmed a Level 1 Travel Alert regarding an outbreak of measles in Colombia.
• Costa Rica: There are 3 confirmed measles cases during 2019, the country’s first since 2014. The three were then isolated for treatment in a hospital in Puntarenas on the country’s Pacific coast as the authorities began checking on anyone with whom they may have made contact.  The CDC suggests various vaccines prior to visiting Costa Rica.
• Honduras: The CDC has reaffirmed its vaccine suggestions for visitors to Honduras for 2019.   
• Venezuela: Between 1 January and 27 February 2019, there were 40 confirmed measles cases. The CDC reaffirmed Venezuela’s Level 3 Travel Alert for 2019.

Worldwide: As of January 31, 2019, 881 measles cases were reported by 19 countries. Germany did not report measles data for January 2019. 

• Austria: Austria reported 25 cases in January 2019  
• Australia: There have been 14 confirmed cases of measles in 2019, with the Health Department warning “more cases are expected over the coming weeks.”
• Bulgaria: The number of measles cases in Bulgaria has reached 124, chief national health inspector Dr. Angel Kunchev told Focus News Agency.
• Czech Republic: During 2019, the number of measles cases has reached close to 100 cases, with 70 cases registered in Prague. In 2007 the Czech Republic had an immunization rate of 98 percent. However, since 2013 it has dropped steadily. In 2017 it was just 84 percent. And now it is reported to be as low as 73 percent in some areas. According to Hana Cabrnochová, the deputy chair of the Czech Immunization Association, parents are seriously underestimating the risk of refusing to get their children vaccinated.
• Republic of the Congo: Congolese President Denis Sassou N’Guesso launch the vaccination program on March 5. Over 2.2 million children will be vaccinated.
• England: During January 2019, the UK reported 43 measles cases. Across England, the ‘take-up’ of the vaccine has fallen, said NHS chief executive Simon Stevens. The latest figures show that in West Sussex, between April and September 2018, 90.9% of children turning five had received the recommended two measles, mumps and rubella (MMR) jabs. Across England, the proportion of five-year-olds fully immunized with the MMR vaccine has dropped from 88.5% in 2014 to 86.3% during 2018. The US CDC has maintained its Level 1 Travel Alert regarding the UK’s measles outbreak for 2019.
• Ethiopia: Measles is endemic in Ethiopia with outbreaks reported annually. Ethiopia has introduced measles vaccine second dose (MCV2) vaccination into the routine immunization programme. Around 3.3 million children throughout the country will receive measles vaccine second dose annually. The CDC suggests various vaccinations prior to visiting Ethiopia.
• France: A total of 350 cases of measles and 1 related death have been reported in France so far 2019. But 100 patients have had to be hospitalized, Santé publique said on March 18, 2019. Measles vaccinations are mandatory in France for all children born after January 1, 2018. The CDC reaffirmed a Level 1 Travel Alert for France for 2019.   
• Georgia: 312 cases of the measles disease have been identified during 2019, concentrated in Imereti, Samegrelo, and Kakheti.
• Greece: The CDC reaffirmed a Level 1 Travel Alert for 2019. Travelers to Greece should make sure they are vaccinated against measles with the MMR vaccine.
• Hong Kong: The Centre for Health Protection of the Department of Health on March 18, 2019, said it is investigating a case of measles infection.
• India: According to the latest study, the measles vaccine campaigns helped save 41,000 to 56,000 children in India from 2010 to 2013, reported eLife.
• Indonesia: The CDC issued a Level 1 Travel Alert for 2019, saying travelers to Indonesia should make sure they are vaccinated against measles with the MMR vaccine.
• Israel: The Ministry of Health notified of possible exposure to measles at the shopping mall near Ad Halom junction, March 11, 2019, 0830-14:00. The Ministry of Health would like to clarify the alerts regarding possible exposure to measles: there is no risk of contracting measles in said locations outside of the time frame specified in the alerts. The CDC reaffirmed a Level 1 Travel Alert for 2019, saying ‘Travelers to Israel should make sure they are vaccinated against measles with the MMR vaccine.’
• Ireland: Seven of the 25 cases of measles reported in 2019 relate to the Donegal area. Overall, 13 of the 25 cases have been confirmed, eight are possible and four are probable. There were 73 confirmed cases of measles in Ireland during 2018.
• Italy: Italy reported 165 measles cases in January 2019. The CDC reaffirmed a Level 1 Travel Alert for 2019.   
• Japan: The measles outbreak in Japan has reached 222 cases, reports the Japan National Institute of Infectious Diseases in Tokyo. And, the CDC issued a Level 1 Travel Alert for Japan on February 27, 2019, regarding the 2019 measles outbreak.
• Kazakhstan: The CDC issued a Level 1 Travel Alert regarding measles on January 22, 2019.
• Madagascar: Since October 2018, measles already claimed the lives of 1,141 individuals, and 70 percent of the deaths are of children, 14 and under. The CDC reaffirmed a Level 1 Travel Alert for 2019.
• New Zealand: The Canterbury District Health Board confirmed 25 cases, adding in a statement that it was likely the number of infections would rise. A vaccination program would see 100,000 doses of the MMR vaccine distributed for free.
• Nigeria: Health officials have reported 4,838 measles cases since the beginning of 2019. And, 15 measles-related deaths have been reported to date.
• Philippines: A total of 21,396 measles cases including 315 deaths were reported from  January and 14 March 2019.
• Poland: 133 measles cases were confirmed in January 2019.
• South Korea: According to the Korean CDC, 38 measles cases have been confirmed as of January 21, 2019.
• Thailand: Data from the Department of Disease Control revealed that around 300 infected measles cases were reported, with four deaths, during 2019. 2,758 measles cases were confirmed in Thailand during 2018.  The CDC suggests travelers to Thailand receive the MMR vaccine.
• Turkey: Turkey’s Health Minister Fahrettin Koca has once again urged parents to get their children vaccinated to prevent potential measles cases. Turkey has donated a total of 100,000 doses of MMR vaccine to Georgia, which is currently grappling with a measles outbreak.
• Ukraine: 11 people have died and more than 30,500 have been infected during 2019, the European country worst hit by the disease. Authorities said shortages of vaccine in previous years and anti-vaccination sentiment were the main reasons behind the outbreak. And, the CDC reaffirmed a Level 1 Travel Alert regarding measles outbreaks in Ukraine during 2019.
• Taiwan: The TCDC confirms 4 new measles cases, making a total of 27 so far in 2019. Of the 27 cases reported in 2019, Taiwan has confirmed 14 domestic cases, and 13 from abroad, with six from Vietnam, five from the Philippines, and one each from Japan and Indonesia.
• Vietnam: Measles has been reported in 664 patients in 2019. Vietnam reported 1,963 measles patients in 2018, up 13 times compared to 2017, according to its Health Ministry. Most cases of measles are related to the inadequate vaccination of children.
• Yemen: A nationwide measles vaccination campaign in Yemen reached more than 11.6 million (90%) children aged 6 months–16 years. The US CDC suggests various vaccinations prior to visiting Yemen.

According to the US Centers for Disease Control and Prevention (CDC), measles is often brought into the USA by unvaccinated people who become infected abroad.

These international travelers then spread measles upon their return, which cause outbreaks in the USA. International travelers can request a pre-trip vaccine counseling appointment at Vax-Before-Travel. 

To notify international travelers, the CDC updated 17 country Travel Alerts, on March 11, 2019.   

In the USA, from January 1 to March 14, 2019, 268 individual cases of measles have been confirmed in 15 states; Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington.

Three of these states, New York, Washington, and Texas have reported 388 measles cases during 2019.

In the USA, there are 2 approved measles vaccines, MMR-II and ProQuad. And, measles vaccine discounts can be found here. 

Vaccines, similar to medications, can cause side effects, says the CDC. Significant vaccine side effects should be reported to the CDC.