In February, we were concerned about typhoid in war-torn Syria, now measles.  At the beginning of June, the World Health Organization issued a press release expressing concern regarding the growing number of communicable diseases including measles cases in Syria.. Approximately 7,000 known cases have been reported so far in Northern Syria. Vaccination campaigns have been negatively impacted due to widespread violence and the fear of airstrikes. Many hospitals are going out of service, and so far 70 percent of healthcare providers have fled the country. As a result, vaccination coverage went down from 95 percent in 2010 to approximately 45 percent in 2013. On top of that, with the rising summer heat, epidemics thrive (WHO). Not to forget that thousands of Syrians are crossing borders to find safe haven in neighboring countries, displaced individuals with measles (besides other communicable diseases spreading in the region) put populations in the host countries at risk of an outbreak, too.

Albeit with varying levels of severity, measles has been reported simultaneously in different parts of the world. Since February 9, 2013, measles killed 36 people in Nigeria and infected 4,000 others, as reported by the National Emergency Management Agency. The highest percentage of these cases is children. The epidemic was ranked third out of the top ten natural disasters in the region. Flood season and the lack of sanitary water were offered by Benue State Ministry of Health as an explanation for the high number of measles cases in Nigeria. Trained public health individuals are taking part in educating the public on how to protect themselves against the disease and on the importance of maintaining good personal hygiene. Mothers are urged to take their children to go to the nearest facility to vaccinate their children and make sure they are protected.

Measles is caused by measles virus (MeV), a member of the genus Morbillivirus. As a disease, measles is a highly contagious respiratory illness. It is associated with very serious complications and, in some cases, death. Symptoms usually appear 7-18 days post exposure and include: fever, running nose, cough, watery eyes and blotchy rash all over the body. About 30 percent of infected patients develop one or more complications, such as ear infections, pneumonia or encephalitis. Most patients that develop complications have compromised immune systems (e.g. children with Leukemia or HIV). Also malnourished children and children under the age of five are highly susceptible to complications from measles (CDC). More than 95 percent of these complicated cases and deaths come from developing countries with weak health infrastructure. Parts of the developed world, on the other hand, are setting goals to eliminate measles by the year of 2015. But will they be able to succeed? The World Health Organization had warned in May of this year that recent outbreaks of measles in countries like the United Kingdom and Germany constitute a threat to these plans of elimination (BBC).

In April 2013, England recorded its highest number of measles cases in one month since 1994. As of January of this year, measles has been a cause for growing concern in England. Just last year, according to Public Health England, there were “2,016 laboratory confirmed cases of measles, the highest annual total since 1994.” Germany reported 323 measles cases since the beginning of 2013. More than 82 percent of these cases are coming from the states of Berlin and Bavaria. In 2001 there were only 51 cases in Germany.  Collectively, in Europe there were 8,499 cases of measles reported in the period from March 2012 to February 2013, out of which seven cases were complicated by acute encephalitis. Four countries accounted for 95 per cent of the total cases; these were Italy, Romania, Spain and the United Kingdom. Even in the United States -a country that declared complete elimination of measles in the year 2000- 508 cases were recorded in 2011, largely a result of travel.  

At this point, with this growing threat of the measles virus, the world is completely dependent on prevention measures in the fight against measles. Still today we lack an adequate antiviral medication to treat already established cases of measles. In other words, we can only prevent infections, but once the disease is settled in and complications take place, there is not a way to treat the infected individual with a specific drug. Fortunately, hard-hitting research programs are conducted around the globe to understand the behavior of the virus and the way it binds to host’s body proteins. Thus, we will soon come to develop a medication that would help make global measles outbreaks easier to manage.



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