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"Collective Failure": The Deadly Comeback of Measles


            
              Thursday, 05. December 2019
              
                

            
              Sore throat, high fever and later large-blotch rash, these are typical measles symptoms. In many places, the disease was considered almost eradicated. But recently there are more infections and more deaths.
              After great successes in the fight against measles, they are currently spreading worldwide again. About 140,000 people died last year from the highly contagious disease, mostly children under the age of five, according to World Health Organization (WHO) estimates. Although the death toll has fallen in the long-term comparison, in 2000, more than 535,000 people succumbed to the disease. Recently, however, the numbers are rising again. According to the WHO estimates, there were around 16,000 measles deaths in 2018 more than in 2017. Similar to the death toll, the estimated infections, which have also risen again after a drastic decline, have recently changed. According to WHO estimates, there were nearly 9.8 million cases of measles in 2018, compared with almost 7.6 million in the previous year. The symptoms of measles include a rash in the oral mucosa and the characteristic brownish-pink skin patches. The infection temporarily weakens the immune system, making it easier to get middle ear infection, bronchitis, pneumonia or diarrhea. A particularly dreaded consequence is certain brain infections that can be fatal. New infections due to vaccine deficiency Since there is no obligation to register in many countries, according to the WHO, only a fraction of measles cases are known. By far the most contagion was reported from the Congo in mid-November 2019. The authorities assume that more than 5,000 people have died of measles there alone – far more than in the Ebola outbreak since the summer of 2018, with around 2,200 deaths so far. Low vaccination coverage and severe malnutrition cause the disease to spread very rapidly in some provinces, often ending in death. Experts complain, among other things, gaps in the supply of vaccines. In Europe, there was a major outbreak in Ukraine with almost 57,000 reported cases. Also in Liberia, Madagascar and Somalia there are big problems with the measles. In the end, these five states account for almost half of all reported measles cases. In the US – once considered to be free of measles – the trend is rising again, the country has recorded more cases than it has in 25 years. Last week, in the Polynesian island state of Samoa, at least 53 people died of measles outbreaks. "Health systems are very fragile in some countries, and there are often gaps in the supply chain, especially the measles vaccine," said Marcus Bachmann. for the organization "Doctors Without Borders" several times the head of operations in Congo. The measles vaccine must be cooled permanently until administration, which is a major challenge in many countries.In Germany, the case numbers vary greatlySpecial in the Congo is also the fight against Ebola in the center, which is also financially noticeable. "People on the ground can not understand this imbalance, they are very worried about the measles because they often kill their children," said Bachmann. For the coming year, there is little reason for optimism, said Bachmann. The typical problems in some countries – poor monitoring and slow checking of new cases, lack of vaccines and, in principle, insecurity due to conflicts – could not be resolved "overnight". The fact that a child dies from a disease such as measles, which can be prevented by vaccination is frankly an outrage and a collective failure to protect the most vulnerable, "said Tedros Adhanom Ghebreyesus, WHO Director-General. According to the organization, vaccination rates have remained constant throughout the world over the past decade. The WHO estimates that 86 percent of children receive a first vaccine, but only about 70 percent receive the recommended second dose. According to the WHO, a vaccination rate of 95 percent with two doses is needed in each country to protect the population from the disease. According to the Robert Koch Institute, from January to the end of November 501 measles cases were counted in Germany – 2018 528 cases during the same period. However, the numbers in Germany vary a lot from year to year. Over the past ten years, they have ranged from 165 to 2465 cases per year. For greater protection against the highly contagious disease, the Bundestag passed a law in November for a compulsory vaccination. It is expected to come into force on March 1, 2020. Parents must then prove that their children have been vaccinated before admission to day-care centers or schools. For children who are attending kindergarten or school, proof must be provided by 31 July 2021. In the case of violations, fines of up to 2500 euros are imminent. The obligation to vaccinate should also apply to teachers and nurses as well as to staff in medical facilities.

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