Largest measles outbreak in more than 10 years

While health officials undertake vaccination campaigns across West Africa to control meningitis and polio epidemics, measles has overtaken both diseases in Burkina Faso in the biggest outbreak the country has seen in more than a decade, according to the Ministry of Health.

Considered the leading cause of death among children by the World Health Organization (WHO), the preventable measles virus is spread through coughing and sneezing.

Epidemiologist with Burkina Faso’s Health Ministry, Ousmane Badolo, told IRIN that as of 5 April more than 19,000 measles infections have been reported, with 150 deaths. This is 10 times more than the number of infections reported in any year since 1997. “We are worried because we are facing a growing caseload of measles.”

He said the last comparable outbreak was in 1997 with 32,000 reported cases.

Fenella Avokey, with a WHO inter-country support team based in Burkina Faso, told IRIN the current measles outbreak is an exception in a trend of declining infections worldwide. “We have not [seen] this for quite a while...what we are seeing now is a bit unprecedented compared to five years ago.”

In 2007 an estimated 197,000 children died worldwide because of measles – a 74-percent drop since 2000, according to WHO.

Prevention Fact
	Children missing routine and mass vaccinations increase the chance of an outbreak
Source: WHO

Formed in 2001 by WHO, UN Children’s Fund (UNICEF), American Red Cross, the US Centers for Disease Control and Prevention (CDC) and the UN Foundation, the Measles Initiative has tried to slash measles deaths through boosting money for vaccination and education in 47 at-risk countries, including Burkina Faso.

Burkina Faso’s last mass measles vaccination campaign was in December 2007 and reached more than three million children aged 9 months to 5 years, according to the government.

Infection cycles

When asked why the spike in measles infections this year, WHO’s Avokey told IRIN children missing routine and mass vaccination campaigns increase the chance of an outbreak. “We fail to vaccinate our children. And [then] we have a pool of susceptible [victims that] builds up and after a while they become easy prey for the measles virus.”

Countries that have immunised only about 80 percent of their populations through routine and mass vaccinations can expect to have large, sustained outbreaks every three to four years, while those that immunise at least 95 percent of the population – like Finland – have not reported any outbreaks in recent years, according to the Measles Initiative.

The most vulnerable will be vaccinated because we do not have unlimited vaccines  for the entire population

Burkina Faso will need to mass vaccinate soon, but the government needs to determine who is falling ill, their ages, and where they live in order to best control the spread, said the Health Ministry’s Badolo. “The most vulnerable will be vaccinated because we do not have unlimited vaccines for the entire population,” he said.

Routine measles immunisations that cost about US$1 are recommended at birth, to be followed by a booster shot to strengthen immunity, as 15 percent of one-time vaccinations prove ineffective, according to WHO.

The Measles Initiative estimates that 11 million people were saved from measles-related deaths in 2000-07 through government education and vaccination programmes.

pt/ bo/np