Measles outbreaks are back, and COVID-19 will make them worse
Researchers are warning that measles outbreaks will be another unexpected consequence of the COVID-19 pandemic. In a new article published by The Lancet, the experts call for urgent international action to prevent devastating epidemics that could emerge as soon as next year.
Many children have missed out on their vaccinations this year, making future measles outbreaks inevitable, explained study lead author Professor Kim Mulholland of the Murdoch Children’s Research Institute.
Professor Mulholland noted that while 2020 has been a quiet year for measles, partly due to travel restrictions, the economic impacts of the COVID-19 pandemic will lead to many cases of childhood malnutrition. As a result, the measles will lead to worse health outcomes and more deaths – considering that malnutrition worsens the severity of the infection.
“Children who die from measles are often malnourished, but acute measles pushes many surviving children into malnutrition,” said Professor Mulholland. “Malnutrition, along with measles-associated immune suppression, leads to delayed mortality, while co-existing vitamin A deficiency can also lead to measles-associated blindness.”
“The coming months are likely to see increasing numbers of unimmunized children who are susceptible to measles. Many live in poor, remote communities where health systems are less resilient, and malnutrition and vitamin A deficiency are already increasing.”
According to Professor Mulholland, the COVID-19 pandemic has had a profound effect on the control of vaccine preventable diseases, with vaccination campaigns paused in the early months of 2020 and routine immunization services greatly disrupted in many countries.
The WHO estimates that delayed campaigns in 26 countries led to a lack of vaccines for 94 million children by the end of October.
“All these factors create the environment for severe measles outbreaks in 2021, accompanied by increased death rates and the serious consequences of measles that were common decades ago,” said Professor Mulholland. “This is despite the fact that we have a highly cost effective way to prevent this disease through measles vaccination.”
Before COVID-19, the measles had already made a dramatic and devastating return in 2019 when 9.8 million cases emerged. Compared to 2016, measles deaths doubled to more than 200,000.
Major outbreaks in Madagascar and the Democratic Republic of the Congo were responsible for many of the fatalities in 2019. Measles also re-emerged in South America, where it was particularly prevalent among indigenous communities.
“The inadequate vaccination that led to the 2019 measles outbreaks has still not been adequately addressed, and the situation is now exacerbated by service disruptions during the COVID-19 pandemic so that high-risk, unimmunized children are clustered together in unreached communities,” said Professor Mulholland.
“Without concerted efforts now, it is likely that the coming years will see an increase in measles and its severe, frequently fatal, complications.”
The study is published in the journal The Lancet.