#Measles - #Bangladesh (WHO, D.O.N., April 23 '26)

 

Situation at a glance

On 4 April 2026, the National International Health Regulations (IHR) Focal Point for Bangladesh notified WHO of a nationwide increase in measles cases, geographically affecting 58 out of 64 districts across all eight divisions in Bangladesh. 

A total of 19 161 suspected measles cases and 2897 laboratory-confirmed measles cases have been reported between 15 March and 14 April 2026, including 166 measles related deaths (CFR 0.9%). 

The majority (79%) of the reported cases are children aged under 5 years. 

A targeted measles-rubella (MR) vaccination campaign started on 5 April, and various outbreak response measures are ongoing including strengthening nationwide surveillance and epidemiological analysis to enhance case detection and reporting. 

Based on currently available information, WHO assesses the risk at the national level as high due to ongoing transmission across multiple divisions, the large number of susceptible children, documented immunity gaps, and the occurrence of suspected measles-related deaths.

Description of the situation

On 4 April 2026, the National IHR Focal Point of Bangladesh notified WHO of a significant increase in measles cases, driven by sustained domestic transmission. 

Since January 2026, Bangladesh has experienced a marked increase in measles cases. 

Geographically, cases have been reported across all eight divisions, in 58 out of 64 districts (91% of districts), indicating widespread transmission nationally.  

Since 15 March 2026 and as of 14 April, a total of 19 161 suspected measles cases and 2973 laboratory-confirmed measles cases have been reported. 

Moreover, 166 suspected measles-related deaths (CFR 0.9%) and 30 confirmed measles-related deaths (CFR= 1.1%) have been recorded. 

A total of 12 318 hospital admissions and 9772 hospital discharges have also been reported. 

The highest cumulative burden of suspected measles cases since 15 March 2026 has been reported in Dhaka (8263 cases), Rajshahi (3747 cases), Chattogram (2514 cases), and Khulna (1568 cases). 

In Dhaka, cases are concentrated in densely populated informal settlements, including Demra, Jatrabari, Kamrangirchar, Korail, Mirpur, and Tejgaon industrial and slum clusters.  (HEOC, DGHS, 15 April 2026).

Children aged under 5 years account for the majority of reported cases (79%), including children aged under 2 years (66%) and infants aged under 9 months (33%). 

A total of 166 suspected deaths have been reported (CFR 1%), mainly among unvaccinated children aged under 2 years.

Epidemiology

Measles is a highly contagious acute viral disease which affects individuals of all ages and remains one of the leading causes of death among young children globally. The mode of transmission is airborne or via droplets from the nose, mouth, or throat of infected persons.

Initial symptoms, which usually appear 10-14 days (range 7-23 days) after infection, include high fever, usually accompanied by a runny nose, bloodshot eyes, cough and tiny white spots inside the mouth. The rash usually appears 10-14 days after exposure and spreads from the head to the trunk to the lower extremities. A person is infectious from four days before up to four days after the appearance of the rash. There is no specific antiviral treatment for measles, and most people recover within 2-3 weeks.

Measles is usually a mild or moderately severe disease. However, measles can lead to complications such as pneumonia, diarrhoea, secondary ear infection, inflammation of the brain (encephalitis), blindness, and death. Postinfectious encephalitis can occur in about one in every 1000 reported cases. About two or three deaths may occur for every 1000 reported cases.

Vaccination with measles containing vaccine is safe and effective, providing protection against measles and its complications for all eligible populations. WHO recommends two doses of Measles Containing Vaccine (MCV) to be provided through the routine immunization schedule. Strong routine immunization systems are therefore critical foundations for achieving and sustaining high levels of population immunity to vaccine preventable diseases such as measles.

WHO further recommends the conduct of Supplementary Immunization Activities (SIAs) or mass immunization campaigns as an effective strategy for delivering vaccination to children who may have been missed by routine services. In protecting vulnerable populations against measles, mass vaccination campaigns can rapidly improve population immunity by reducing the number of susceptible individuals in the population.

Public health response

A nationwide measles-rubella (MR) vaccination campaign was approved by the National Immunization Technical Advisory Group (NITAG) on 30 March 2026, targeting children aged 6–59 months (with expanded coverage for 6–8 months), and started on 5 April in 30 upazilas (sub-districts) of 18 priority districts. A nationwide campaign commenced on 20 April. 

Vitamin A campaign was held throughout the country on 15 March 2025.  During this outbreak response, Vitamin A supplementation is provided to all suspected and confirmed measles cases as an essential component of standard treatment and case management. 

District Rapid Response Teams (RRTs) have been activated, and vaccine procurement fast-tracked by the Ministry of Health. Other outbreak response actions include strengthening routine immunization to prevent further spread of the outbreak, enhancing hospital preparedness, ensuring availability of vitamin A, strengthening isolation capacity, and reinforcing infection prevention and control measures. 

Strengthening nationwide surveillance and epidemiological analysis, is also ongoing including measures to improve case detection and reporting. Trainings are being conducted at health facilities to improve case detection and reporting, and weekly situation reports produced to support evidence-based decision-making. 

National and divisional guidelines have been issued to guide response activities, including vaccination, clinical management, infection prevention and control, patient care pathways, and procurement. 

WHO risk assessment

Measles is a highly contagious viral disease that affects susceptible individuals of all ages and remains one of the leading causes of death among young children globally. Measles can cause serious illness in at-risk groups, including children under 5 years of age, those who are malnourished especially those with vitamin A deficiency and people with weakened immune systems. Measles complications include hearing loss, diarrhoea, pneumonia and blindness. Severe complications of measles include encephalitis, brain damage, and death. 

The current outbreak in Bangladesh is occurring in the context of suboptimal population immunity. A substantial proportion of cases occurred among children who were either unvaccinated or had received only one dose of measles-containing vaccine. In addition, some children were infected before reaching the age of eligibility for vaccination at 9 months. Most cases (91%) occurred among children aged 1 to 14 years, indicating substantial immunity gaps in this age group. 

Before this outbreak, Bangladesh had made substantial progress towards measles elimination. Reported coverage with the first dose of measles-containing vaccine increased considerably between 2000 (89% - WUENIC) and 2016 (118% - WUENIC), while coverage with the second dose also improved between its nationwide introduction in 2012 (22% - WUENIC) and 2024 (121% - WUENIC). During the same period, confirmed measles incidence declined sharply. However, recent declines in MR1 and MR2 coverage due to nationwide stockout of MR vaccine between 2024-2025, combined with routine immunization gaps and the absence of regular nationwide supplementary measles-rubella campaigns since 2020, have increased the number of susceptible children and contributed to the current outbreak. 

The risk at the national level is assessed as high due to ongoing transmission across multiple divisions, the large number of susceptible children, documented immunity gaps, and the occurrence of suspected measles-related deaths. The concentration of cases among unvaccinated and under-vaccinated children including infants too young to be vaccinated, raises concern for continued uninterrupted transmission and severe disease outcomes. 

Overall, the outbreak suggests a reversal from Bangladesh’s previous progress towards measles elimination and highlights increasing vulnerability to sustained transmission. Continued spread is likely unless urgent measures are implemented to strengthen surveillance, rapidly detect and respond to cases, and close immunity gaps through high-quality vaccination activities. 

There are considerable risks of cross-border spread, facilitated by cross-border population movement, with major urban centres such as Dhaka, Chattogram, Sylhet, and Cox’s Bazar being important international travel and transit hubs increasing the likelihood of national and international spread, particularly among unvaccinated or inadequately vaccinated travelers. 

Measles is endemic across the South-East Asia region. The risk is assessed as high at regional level.

Bangladesh shares extensive land borders with India and Myanmar, and population mobility across these borders may facilitate continued transmission. In Myanmar there is a considerable number of unvaccinated/zero dose children. With ongoing conflict and humanitarian crisis, surveillance and response capacities are limited. India, despite achieving high vaccination coverage, has reported a rise in case count over the past six months. Cities with high incidence such as Jashore and Chapainawabganj (an identified hotspot) share busy land crossings with India, thereby increasing the risk of introduction across the border. Despite Bangladesh’s progress towards measles elimination the current outbreak highlights the vulnerability of the population and underscores the fragility of immunization gains.

The risk at the global level is assessed as moderate due to high levels of population mobility, combined with ongoing widespread measles transmission and immunity gaps.

WHO advice

WHO recommends maintaining sustained homogeneous coverage of at least 95% with the first and second doses of the MCV vaccine in all municipalities and strengthening integrated epidemiological surveillance of measles and rubella to achieve timely detection of all suspected cases in public, private, and social security healthcare facilities.  

WHO recommends strengthening epidemiological surveillance in high-traffic border areas to rapidly detect and respond to highly suspected measles cases. Providing a rapid response to imported measles cases to avoid the re-establishment of endemic transmission through the activation of rapid response teams trained for this purpose and by implementing national rapid response protocols when there are imported cases. Once a rapid response team has been activated, continued coordination between the national, sub-national, and local levels must be ensured, with permanent and fluid communication channels between all levels. During outbreaks, it is recommended to establish adequate hospital case management to avoid nosocomial transmission, with appropriate referral of patients to isolation rooms (for any level of care) and avoiding contact with other patients in waiting rooms and/or other hospital rooms.  

WHO recommends vaccination of at-risk populations (without proof of vaccination or immunity against measles and rubella), such as healthcare workers, persons working in tourism and transportation (hotels, airports, border crossings, mass transportation, and others), and international travelers. Implementing a plan to immunize migrant populations in high-traffic border areas, prioritizing those considered at-risk, including both migrants and residents, in these municipalities increases vaccination coverage to increase population immunity.  

In all settings, consideration should be given to providing susceptible contacts with post-exposure prophylaxis (PEP), including a dose of MCV or normal human immunoglobulin (NHIG) (if available) for those at risk and in whom the vaccine is contraindicated. In well-resourced settings, MCV should be provided to susceptible contacts within 3 days. For contacts for whom vaccination is contraindicated or is not possible within 3 days post-exposure, consideration can be given to providing NHIG up to 6 days post-exposure. Infants, pregnant women, and the immunocompromised should be prioritized.  

WHO recommends maintaining a stock of the MR and/or measles, mumps, rubella (MMR) vaccine, and syringes/supplies for control actions of imported cases. Facilitating access to vaccination services according to the national scheme to those from other countries or people from the same country who perform temporary activities in countries with ongoing outbreaks; displaced populations; indigenous populations, or other vulnerable populations.  

WHO does not recommend any restriction on travel and trade based on the information available on the current outbreak.  

Further information

-- World Health Organization. Measles [Internet]. Geneva: World Health Organization; [cited 2026 Apr 6]. Available from: https://www.who.int/health-topics/measles 

-- World Health Organization. Measles fact sheet [Internet]. Geneva: World Health Organization; 2025 Nov 28 [cited 2026 Apr 6]. Available from: https://www.who.int/news-room/fact-sheets/detail/measles  

-- World Health Organization. Immunization dashboard [Internet]. Geneva: World Health Organization; [cited 2026 Apr 6]. Available from: https://immunizationdata.who.int/  

-- World Health Organization. Measles outbreak guide [Internet]. Geneva: World Health Organization; 2022 Aug 31 [cited 2026 Apr 6]. Available from: https://www.who.int/publications/i/item/9789240052079  

-- Directorate General of Health Services (Bangladesh). Press releases [Internet]. Dhaka; [cited 2026 Apr 6]. Available from: https://dghs.gov.bd/pages/press-releases/  

-- Measles vaccines: WHO position paper – April 2017; https://www.who.int/publications/i/item/who-wer9217-205-227

-- Measles: Vaccine Preventable Diseases Surveillance Standards; https://www.who.int/publications/m/item/vaccine-preventable-diseases-surveillance-standards-measles

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Citable reference: World Health Organization (23 April 2026). Disease Outbreak News: Measles in Bangladesh. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON598

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON598

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Simultaneous #outbreaks of #Ebola, #cholera, #mpox, and #measles in #DRC in 2025

 

{Excerpt}

On Sept 4, 2025, the DR Congo Government and Ministry of Health announced a new Ebola virus disease outbreak in the Bulape health zone (Kasai province), marking the end of over 15 years without any reported cases of Ebola virus disease in this region. As of Sept 14, 2025, there were 35 confirmed Ebola virus disease cases and 16 deaths, representing a case fatality rate of 45·7%.1,2 This unexpected resurgence in a region with insufficient preparedness capacity raises serious concerns about potential regional spread, including towards neighbouring Angola.

At the same time, DR Congo is experiencing one of the most severe cholera outbreaks of the past decade, with a total of 48 139 cases and 1443 deaths reported between Jan 1 and Aug 24, 2025, resulting in a case fatality rate of 3%.3 By epidemiological week 33, high case fatality rates were reported in the provinces of Kwilu (76 cases, 26 deaths; 44%), Sankuru (42 cases, 6 deaths; 14%), and Equateur (224 cases, 19 deaths; 8%).3

DR Congo also continues to be the global epicentre of mpox. Between Jan 1 and Sept 14, 2025, DR Congo has reported 16 879 confirmed mpox cases and 43 deaths.4 Response efforts have been challenged by factors such as persistent endemic conditions, gaps in surveillance, and poor access to vaccines.

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Source: The Lancet, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02100-2/fulltext?rss=yes

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Estimating #measles susceptibility and #transmission #patterns in #Italy: an epidemiological assessment

Summary

Background

Identifying measles transmission patterns and the most susceptible populations is crucial for anticipating and preventing outbreaks. The aim of this study was to assess the current epidemiology of measles in Italy to provide key metrics to anticipate and prevent future transmission risks.

Methods

In this epidemiological assessment study, we analysed measles epidemiological data from the National Integrated Measles and Rubella Surveillance System coordinated by the Department of Infectious Diseases of the Istituto Superiore di Sanità in Italy from Jan 1, 2013, to Dec 31, 2022. We analysed individual case records to assess the proportion of transmission that occurred in different settings; we also used pairs of measles cases to estimate the generation time and the proportion of transmission episodes between population groups defined by age and vaccination status. All suspected cases meeting the measles case definition were included in our analysis. Data, complemented with 2023 and 2024 incidence records, were used in a catalytic model to estimate the age-specific proportion of individuals susceptible to measles and the effective reproduction number (Re) in Italy in 2025 at the national level and for each Italian region.

Findings

During the study period, 14 946 measles cases (7426 females and 7520 males) were reported to the National Integrated Measles and Rubella Surveillance System. The mean generation time estimated from 795 measles infection episodes was 11·7 days (95% credible interval 11·3–12·0). 707 (88·9% [bootstrap 95% CI 86·8–91·1]) of 795 infection episodes originated in unvaccinated individuals, 265 (33·3% [30·1–36·7]) of 795 infection episodes involved individuals aged 20–39 years, and only 12 (8·5% [4·3–13·5]) of 141 transmission episodes with available information on setting were linked to school contacts. We estimated that, in 2025, 9·2% (95% prediction interval 8·9–9·3) of the Italian population remains susceptible to measles, including 11·8% (11·8–11·8) of individuals younger than 20 years. Despite marked geographical heterogeneities, immunity gaps among individuals aged 20–40 years (ie, those born in the 1980s and 1990s) were consistently observed across all regions. The average Re estimated for 2025 ranged from 1·31 to 1·78 across regions, consistent with reproduction numbers associated with national epidemics and local outbreaks between 2013 and 2019. Higher Re values were found in regions with a large fraction of susceptible adults (eg, Emilia-Romagna 1·78 [1·34–2·27]) or more than 15% susceptible individuals younger than 20 years (eg, South Tyrol 1·53 [1·11—2·02]).

Interpretation

Unvaccinated adults contribute substantially to measles transmission in Italy. Heterogeneous immunity gaps exist across regions, with some regions showing persistently low vaccine uptake in children and other regions showing a high proportion of susceptible adults. These results emphasise the need for tailored vaccination strategies, including catch-up campaigns for adults. By integrating routine surveillance data with modelling techniques, this study presents a resource-efficient approach to quantifying immunity and transmission risks, providing a scalable framework for countries aiming to refine their immunisation policies.

Funding

NextGenerationEU-MUR PNRR Extended Partnership Initiative on Emerging Infectious Diseases.

Source: Lancet Infectious Diseases, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00293-2/abstract?rss=yes

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#Measles - #Morocco (#WHO D.O.N., May 13 '25)

{Summary}

Situation at a glance

Since late 2023, Morocco has been experiencing a widespread measles outbreak. Cases have been recorded across all regions of the country, particularly among children and people who are unvaccinated. In response, the Ministry of Health and Social Protection (MOHSP), in collaboration with relevant sectors, activated the National Center for Public Health Emergency Operations, launched urgent catch-up vaccination campaigns, and strengthened surveillance, case management, and risk communication and community engagement efforts. Measles is a highly transmissible viral disease that can lead to severe complications and death. While Morocco has made significant progress toward measles elimination, the disease remains endemic in the country. The overall risk is assessed as moderate at the national level and moderate at the regional level, particularly given the risk of cross-border transmission in areas with low vaccination coverage.

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Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON568

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#Measles – Region of the #Americas (#WHO D.O.N., April 28 '25)

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Situation at a glance

As of 18 April 2025, a total of 2318 measles cases, including three deaths, have been confirmed in six countries in the WHO Region of the Americas, an 11-fold increase compared to the same period in 2024. 

The majority of cases have occurred among people between 1 to 29 years, who are either unvaccinated or have an unknown vaccination status. 

Additionally, most cases are imported or linked to importation. 

Measles is a highly contagious, airborne viral disease that can lead to severe complications and death. 

Although it is preventable with two doses of the vaccine, over 22 million children worldwide did not receive their first dose of the vaccine in 2023. This has contributed to a global rise in measles cases in 2024, which heightens the risk of imported infections, particularly from unvaccinated travellers arriving from areas where the virus is actively circulating. 

WHO is working closely with countries in the WHO Region of the Americas to prevent the spread and reintroduction of measles. 

The regional risk is currently assessed as high, while the global risk remains moderate.

Description of the situation

From 1 January to 18 April 2025, a total of 2318 measles cases, including three deaths, were confirmed in the WHO Region of the Americas, an 11-fold increase compared to the 205 cases of measles reported in the same period in 2024. 

The cases have been reported from six countries: 

- Argentina (n= 21 cases), 

- Belize (n= 2 cases), 

- Brazil (n= 5 cases), 

- Canada (n=1069 cases), 

- Mexico (n= 421 cases including one death), and 

- the United States of America (n=800 cases, including two deaths).

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Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON565

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Detection of #Measles in #Texas #Wastewater

Abstract

Measles outbreaks continue to pose significant public health challenges globally despite the availability of effective vaccines. In this study, we evaluated wastewater-based surveillance for detection of measles virus during an ongoing outbreak in Texas. Weekly wastewater samples collected from two Texas cities between January 2 and March 17, 2025 were analyzed using multiple RT-PCR assays targeting the nucleoprotein and matrix genes of the measles virus. Viral RNA was detected in multiple days from both cities, with City A showing positives from January 13 and City B from January 6, both predating the first confirmed case in the state on January 23. Sequencing of PCR amplicons confirmed the specificity of detection and phylogenetic analysis using global and U.S. measles genome databases further validated that the viral RNA belonged to the currently circulating genotype D8. Our findings demonstrate that wastewater surveillance can provide early evidence of measles virus circulation in communities before clinical cases are recognized and can support public health responses to these re-emerging infectious diseases.

Source: MedRxIV, https://www.medrxiv.org/content/10.1101/2025.04.08.25325475v1

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#Measles - #USA (WHO D.O.N., March 27 '25)

Situation at a glance

On 11 March 2025, the World Health Organization (WHO) received a report from the International Health Regulation (2005) (IHR) National Focal Point (NFP) of the United States of America (United States) on the ongoing measles outbreak in the country, notified under IHR because it is an unusual event with potential significant public health impact, with the number of cases and deaths in 2025 exceeding the numbers in previous years. Additionally, cases linked to the outbreak in the State of Texas, United States, have been reported in Mexico. Measles is a highly contagious, airborne viral disease that can lead to severe complications and death. From 1 January to 20 March 2025, 17 States have reported a total of 378 cases of measles, including two deaths - the first deaths related to measles in the United States in a decade. The majority of cases are in children who are unvaccinated or have unknown vaccination status, and the overall hospitalization rate is 17%. In 2025, within the larger public health event, there are three distinct measles outbreaks reported, accounting for 90% (341/378) of reported cases. The Centers for Disease Control and Prevention of the United States (US CDC) and other government agencies are working to control the outbreaks. In 2000, measles was declared eliminated in the United States, since then imported cases of measles have been detected in the country, as the disease remains endemic in many parts of the world. WHO is working closely with countries in the WHO Region of the Americas to prevent the spread and reintroduction of measles.

Description of the situation

On 11 March 2025, the NFP of the United States notified to WHO an ongoing outbreak of measles in the United States.

From 1 January to 20 March 2025, 378 cases have been reported from 17 States including: Alaska, California, Florida, Georgia, Kansas, Kentucky, Maryland, Michigan, New Jersey, New Mexico, New York State, Ohio, Pennsylvania, Rhode Island, Texas, Vermont, and Washington. Two deaths have also been reported, one confirmed in Texas and one under investigation in New Mexico. The majority of cases are in children who are unvaccinated or have unknown vaccination status. The hospitalization rate is 17%.  

Ninety percent of the 378 cases (341 cases) have been associated with three distinct outbreaks (defined as three or more related cases) reported in 2025, while the remainder are sporadic cases that are part of the larger outbreak.

From late January until 14 March 2025, the Texas Department of State Health Services reported 259 cases in the South Plains and Panhandle regions of Texas. Of these, 34 patients have been hospitalized, and 257 (99%) were unvaccinated or with unknown vaccination status. In February 2025, an unvaccinated school-aged child who lived in the Texas outbreak area died of measles. This was the first death in the United States related to measles in a decade.

As of 14 March, the New Mexico Department of Health reported 35 cases of measles. Of the 35 cases, 28 were unvaccinated, two were vaccinated, and five had unknown vaccination status.

From 1 January 2025 to 20 March 2025, the US CDC reported 128 measles DNA sequences. Texas submitted 92 identical DNA sequences in genotype D8; while 10 DNA sequences from New Mexico and one DNA sequence from Kansas were identical to those from Texas. Texas also reported three genotype D8 sequences (a total of 19 D8 sequences have been reported from the affected States) with single nucleotide substitutions. Additionally, a total of five distinct genotype B3 sequences were reported from the States of Alaska, California, Florida, Kentucky, New York, Rhode Island, Texas, and Washington.

The source of this outbreak is unknown. Currently, there is no evidence of decreased vaccine effectiveness or changes in the virus that would result in increased severity.

In 2000, measles was declared eliminated[1] in the United States and, since then, imported cases of measles have been detected in the country since the disease remains endemic in many parts of the world.  The United States last verified the ongoing elimination of measles in 2024. In 2023, the vaccination coverage rate for two doses of measles, mumps, and rubella (MMR) vaccine among children in kindergarten in the United States was 92.7%.

Epidemiology

Measles is a highly contagious acute viral disease which affects individuals of all ages and remains one of the leading causes of death among young children globally. The mode of transmission is airborne or via droplets from the nose, mouth, or throat of infected persons.

Initial symptoms, which usually appear 10-14 days after infection, include high fever, usually accompanied by a runny nose, bloodshot eyes, cough and tiny white spots inside the mouth. The rash usually appears 10-14 days after exposure and spreads from the head to the trunk to the lower extremities. A person is infectious from four days before up to four days after the appearance of the rash. There is no specific antiviral treatment for measles and most people recover within 2-3 weeks.

Measles is usually a mild or moderately severe disease. However, measles can lead to complications such as pneumonia, diarrhoea, secondary ear infection, inflammation of the brain (encephalitis), blindness, and death. Postinfectious encephalitis can occur in about one in every 1000 reported cases. About two or three deaths may occur for every 1000 reported cases.

Immunization against measles prevents measles and its complications.

Public health response

Federal, State, local health authorities and community partners in the United States are implementing the following public health measures to control the outbreak: US CDC escalated to a level 3 Incident Management Structure on 3 March 2025 to provide remote technical assistance on diagnostics, post-exposure prophylaxis, healthcare infection and prevention, case investigation and confirmation, and communication support. The Texas Department of State Health Services is leading the investigation in Texas. US CDC deployed subject matter experts to assist the response. WHO has issued epidemiological alerts and updates due to the increase in measles cases in several countries in the WHO Region of the Americas that started in 2024. WHO continues to monitor the situation and work closely with countries in the Region of the Americas to support their vaccination, surveillance and rapid outbreak response efforts to prevent the spread and reintroduction of measles and to protect the health of the entire population.

WHO risk assessment

Measles is a highly contagious viral disease that affects individuals of all ages and remains one of the leading causes of death among young children globally. The transmission mode is airborne or via droplets from the nose, mouth, or throat of infected persons. Initial symptoms, which usually appear 10-14 days after infection, include high fever, usually accompanied by a runny nose, bloodshot eyes, cough and tiny white spots inside the mouth. A rash develops several days later, usually starting on the face and upper neck and gradually spreading downwards. A patient is infectious four days before the start of the rash to four days after the appearance of the rash. There is no specific antiviral treatment approved for measles; most people recover within 2-3 weeks. Measles can also cause serious complications, including blindness, encephalitis, severe diarrhoea, ear infection, and pneumonia, which are more common in children under 5 years and adults more than 20 years of age. Measles can be prevented by immunization.

In 2016, the Region of the Americas was the first WHO Region to be declared free of the endemic transmission of measles by the International Expert Committee for Documenting and Verifying Measles, Rubella and the Congenital Rubella Syndrome in the Americas. Nevertheless, maintaining the Region free of measles is an ongoing challenge due to the permanent risk of importation and reintroduction of the virus.

The public health risk in the Region of the Americas for measles is considered high due to the persistence of the circulation of the virus from imported cases, which have resulted in a limited number of outbreaks, with several generations of cases and the appearance of cases associated with pre-existing outbreaks in new geographical areas. Additionally, an increase in the susceptible population due to persistently low vaccination coverage related to factors such as the COVID-19 pandemic, increased vaccine hesitancy in some communities and sectors of the population, and limited access to health services, particularly for vulnerable populations.

WHO advice

WHO recommends maintaining sustained homogeneous coverage of at least 95% with the first and second doses of the measles-containing vaccine (MCV) and strengthening integrated epidemiological surveillance of measles and rubella to achieve timely detection of all suspected cases in public and private healthcare facilities.

WHO recommends strengthening epidemiological surveillance and preparedness and response capacities in high-traffic border areas to rapidly detect and respond to suspected measles cases. Providing a rapid response to imported measles cases to avoid the re-establishment of endemic transmission through the activation of rapid response teams trained for this purpose and by implementing rapid response protocols when there are imported cases. Once a rapid response team has been activated, continued coordination between the national, sub-national and local levels must be ensured, with continuous and effective communication channels across all levels. During outbreaks, it is recommended to establish adequate hospital case management and infection prevention and control capacity to avoid health care-associated infection transmission, with appropriate referral of patients to airborne infection isolation rooms (for any level of care) and avoiding contact with other patients in waiting rooms and/or other hospital rooms.

WHO recommends providing broad access to measles, mumps and rubella (MMR) vaccination to maintain high vaccination rates of the general population and to ensure individuals at high risk of exposure are up-to-date on this vaccination, such as health and care personnel and international travellers. Individuals living in outbreak areas within the United States should follow local public health guidance. Globally, between 2000 and 2023, vaccination successfully prevented an estimated 60 million deaths[2] and decreased an estimated measles death from 800 062 in 2000 to 107 500 in 2023, which is an 87% decrease.[3]

In all settings, consideration should be given to providing susceptible contacts with post-exposure prophylaxis, including a dose of MCV or normal human immunoglobulin (NHIG) (if available) for those at risk and in whom the vaccine is contraindicated. In well-resourced settings, MCV should be provided to susceptible contacts within 3 days. For contacts for whom vaccination is contraindicated or is not possible within 3 days post-exposure, consideration can be given to providing NHIG up to 6 days post-exposure. Infants, pregnant women, and the immunocompromised should be prioritized.

WHO recommends maintaining a stock of the measles-rubella (MR) and/or MMR vaccine, and syringes/supplies for responding to imported cases. Facilitating access to vaccination services according to the national scheme to incoming and outgoing international travellers, including individuals due to perform activities, domestically or abroad, in areas with ongoing measles outbreaks, displaced populations, indigenous populations, or other vulnerable populations.

WHO advises international travellers to check and update their vaccination status against measles prior to departure, including when planning to travel to the United States. Unvaccinated individuals from areas in the United States experiencing measles outbreaks, with knowledge of exposure to measles cases and/or presenting signs and symptoms compatible with measles virus infection, should consult local health authorities before undertaking an international voyage. At present, no additional measures that significantly interfere with international traffic are warranted.

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Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON561

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#USA, #Texas announces first #death in #measles #outbreak

The Texas Department of State Health Services is reporting the first death from measles in the ongoing outbreak in the South Plains and Panhandle regions. 

The school-aged child who was not vaccinated was hospitalized in Lubbock last week and tested positive for measles.

As of Feb. 25, 124 cases of measles have been confirmed in the outbreak since late January. Most of the cases are in children. Eighteen people have been hospitalized over the course of the outbreak.

Measles is a highly contagious respiratory illness, which can cause life-threatening illness to anyone who is not protected against the virus. During a measles outbreak, about one in five people who get sick will need hospital care and one in 20 will develop pneumonia. Rarely, measles can lead to swelling of the brain and death. It can also cause pregnancy complications, such as premature birth and babies with low birth weight.

Measles can be transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. People who are infected will begin to have symptoms within a week or two after being exposed. Early symptoms include high fever, cough, runny nose, and red, watery eyes. A few days later, the telltale rash breaks out as flat, red spots on the face and then spreads down the neck and trunk to the rest of the body. A person is contagious about four days before the rash appears to four days after. People who could have measles should stay home during that period.

People who think they have measles or may have been exposed to measles should isolate themselves and call their health care provider before arriving to be tested. It is important to let the provider know that the patient may have measles and to get instructions on how to come to the office for diagnosis without exposing other people to the virus.

The best way to prevent getting sick is to be immunized with two doses of a measles-containing vaccine, which is primarily administered as the combination measles-mumps-rubella or MMR vaccine. Two doses of the MMR vaccine prevent more than 97 percent of measles infections. A small number of vaccinated people can occasionally develop measles. In these cases, the symptoms are generally milder, and they are less likely to spread the disease to other people. DSHS and the Centers for Disease Control and Prevention recommend children receive one dose of MMR at 12 to 15 months of age and another at 4 to 6 years. Children too young to be vaccinated are more likely to have severe complications if they get infected with the measles virus. However, each MMR dose lowers the risk of infection and the severity of illness if infected.

Health care providers can find recommendations for infection control and diagnostic testing in DSHS health alerts. Providers should report any suspected cases to their local health department immediately, preferably while the patient is still with the provider.

DSHS posts additional information about the outbreak cases on the News & Alerts page on Tuesdays and Fridays.

Source: Department of Health, https://www.dshs.texas.gov/news-alerts/texas-announces-first-death-measles-outbreak

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