After decades of progress against one of the most contagious human viruses, the world is seeing measles stage a slow, steady comeback.
The World Health Organization and the CDC say in a new report that there were nearly 10 million cases of measles last year, with outbreaks on every continent.
An estimated 140,000 people died from measles in 2018, WHO says, up from an all-time low of 90,000 in 2016.
And so far 2019 has been even worse.
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In Samoa a measles outbreak has shut down that nation's schools indefinitely. Government offices in the Pacific island nation have been closed for the last two days as part of a national immunization drive. In the Democratic Republic of Congo, measles has claimed more than 5,000 lives since January — as many people as have died in that country's ongoing Ebola outbreak.
"In 2018 there's been an increase in both the cases and the deaths that have occurred from measles. In other words, we're backsliding," says Kate O'Brien, WHO's top executive on immunization, speaking in a video statement accompanying the new report.
"The reason we're having increases in cases and deaths of measles has to do fundamentally with people not getting vaccinated."
There are various reasons for the drop-off. O'Brien denounces misinformation about vaccines that's gained traction on some social media networks. In other places the health systems are so poor that vaccines simply don't reach the kids who need them.
To halt a measles outbreak in any given community, health officials say they need to get 95% of the population immunized against the virus.
Xavier Crespin, UNICEF's chief of health in the Democratic Republic of Congo, says only 50% of Congolese kids have had measles shots through routine childhood checkups. When measles outbreaks flare up, Crespin says, armed conflicts in parts of the country make it extremely difficult to respond.
"Because of the security issue, we cannot go everywhere we need to go," Crespin says from the capital Kinshasa. "There are some hot spot measles areas but it is very difficult for local teams to move toward these areas and to vaccinate children."
Most measles deaths are among children under age 5. Kids tend to get more complications than adults if they contract the disease. A common cause of death is when children who catch measles go on to develop pneumonia.
And because measles is so contagious — the virus can live in the air for two hours after someone who is sick coughs or sneezes --it's one of the first diseases to make a comeback when health systems start to break down. "Measles is the canary in the coal mine," says Robert Linkins, head of the Accelerated Disease Control and Surveillance Branch at the Centers for Disease Control and Prevention. He says the current resurgence of measles reveals problems in basic health-care delivery systems.
"[Measles] indicates that there are problems in a community with other vaccine preventable disease coverage," he says. "And in many respects, it's a signal that we've got to pay more attention to where measles is occurring."
And currently that is all around the world.
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