Madagascar Measles Outbreak

Between September 2018 and April 2019, Madagascar‘s measles outbreak has killed over 1,200 people. According to the World Health Organization, measles is a highly contagious viral disease that remains a significant cause of death among young children globally, despite the availability of vaccines.  Organizations are currently coming together to aid Madagascar against the outbreak and educate the public about the importance of vaccinations in protecting children from harm.

Recent Outbreak

Madagascar is facing the largest measles outbreak in its history, and only 58 percent of people on the island have been vaccinated against the disease. Dr. Dossou Vincent Sodjinou, a WHO epidemiologist in Madagascar, expressed concern about the expansion of the outbreak and the lack of vaccination.

“The epidemic unfortunately continues to expand in size, though at a slower pace than a month ago,” said Dr. Sodjinou. “Some cases of resistance to vaccinations exist because of the influence of religion or of traditional health practitioners but they are isolated ones.”

Measles is one of the leading causes of death for children, and WHO reports that 450 die each day worldwide due to the illness.

According to the Centers for Disease Control and Prevention, the symptoms of measles generally appear seven to 14 days after a person is infected. Measles begins with a fever, a cough, runny nose, a sore throat and red eyes. After a few days of symptoms, tiny white spots, medically known as Koplik’s spots, begin to appear inside the mouth.

The outbreak is complicated by the fact that nearly 50 percent of children in Madagascar are malnourished, which increases the likelihood of severe cases. Those whose immune systems have been weakened by HIV/AIDS or other diseases are also at risk.

Weak Healthcare and Shortage of Vaccines

According to United Nations Children’s Fund, once a child is infected, there is no specific treatment for measles, so vaccination is a life-saving tool for children.

“The Madagascar measles outbreak is a particularly precarious situation because many of the districts have weak health infrastructure and systems to begin with, which is now exacerbated with a shortage of vaccines,” said Michael L. Rich, a Harvard Medical School assistant professor and the chief clinical advisor at PIVOT, an organization partnering with the Madagascar Ministry of Health. “Without a reliable supply of vaccines, strong supply chains or facilities adequately staffed with trained personnel, an end to Madagascar’s ongoing measles crisis is difficult to foresee.”

Doing More to contain the outbreak

The United Nations Children’s Fund is issuing an urgent appeal to governments, health care providers, and parents to do more to contain Madagascar’s measles outbreak. Efforts against the outbreak include educating the public about the safety of vaccines, vaccinating all children between the ages of 6 months and 5 years, training and equipping health workers, and strengthening immunization programs.

PIVOT, an organization dedicated to providing healthcare to impoverished communities, aims to help Madagascar become a symbol of healthcare transformation. In the wake of the outbreak, PIVOT is aiding public systems and pushing for an era of medicine guided by the needs of the poor.

While organizations successfully fight measles in Madagascar, there is also hope around the world. Under the Global Vaccine Action Plan, the elimination of measles is a target in five WHO regions by 2020. WHO, as the lead agency responsible for achieving this goal, is giving children around the world hope for a healthier future.

– Carolina Chaves
Photo: Flickr


Great news from the world of life-saving vaccinations! According to UNICEF and the World Health Organization (WHO), the number of countries with 90 percent coverage of children receiving routine life-saving vaccinations has doubled between 2000 and 2014.

In 2012, 194 WHO Member States endorsed the Global Vaccine Action Plan (GVAP) and committed to delivering vital vaccinations, with the goal of 90 percent diphtheria-tetanus-pertussis (DTP3) vaccination coverage in all countries by 2015. GVAP sought to prevent millions of deaths by 2020 by expanding the access of vaccines. The plan resulted from DoV collaboration, which brought together development, health and immunization experts and stakeholders. It was also made possible with the leadership of organizations such as the Bill & Melinda Gates Foundation and with partnerships in all levels of government, across various segments of society.

The global immunization target has seen an incredible push forward, with 90 percent of children receiving the required three doses of DTP3 vaccines, in 129 countries as of 2014. Currently, DTP3 immunization coverage stands at 86 percent for all 3 doses, and at 91 percent for infants receiving at least one dose. This is a great improvement from 2000, when 21 million children did not receive the first dose of DTP3, which is now up to 12 million.

Another great improvement is India’s current immunization rate. India has the largest number of unvaccinated children and is now at 80 percent of DTP3 coverage. According to the WHO, India is one of the three countries where almost half of the world’s unvaccinated children live. The other two countries are Indonesia and Nigeria.

Improvements in meeting other immunization targets have been made. Hepatitis B, which is common in East Asia and sub-Saharan Africa, has seen an increase in vaccinations from 2000 to 2014, from 30 percent receiving 3 doses to 82 percent. The number of children protected from Hepatitis B is high and increasing.

Another improvement in meeting immunizations targets have occurred with the rotavirus, which is the most common cause of severe diarrhea in children and infants and is widespread in developing and under-developed countries in East Asia and sub-Saharan Africa. More countries are using vaccines against the rotavirus and pneumococcal conjugate vaccine.

Despite these incredible improvements, there is still more room for improvement. According to the WHO, 65 countries need to improve their strategies for meeting the GVAP goal. These include six countries with less than 50 percent coverage with DTP3: Central African Republic, Chad, Equatorial Guinea, Somalia, South Sudan and the Syrian Arab Republic.

We’re on the right path to meeting the global immunization targets considering it has doubled, we just need to develop better strategies to speed up the process to make sure we can get to 100 percent of all children receiving routine life-saving vaccinations.

Paula Acevedo

Sources: International Business Times, World Health Organization
Photo: International Business Times