Thirty times more cases of measles in 2023 in Europe, WHO calls for urgent measures

This is “an alarming increase”, with more than 30,000 cases of measles reported by 40 countries between January and October 2023 in the Europe zone of the World Health Organization (WHO). That is to say a number multiplied by more than 30 compared to the whole of 2022, when 941 cases were notified. Enough to worry the WHO, which specifies that “the increase in the number of cases has accelerated in recent months, and this trend is expected to continue if urgent measures are not taken”. The WHO therefore calls for “vaccination activities (...) to be carried out urgently to stop transmission and prevent the spread”.

Especially since many of these cases are serious: nearly 21,000 hospitalizations and 5 deaths linked to the disease in 2 countries have been reported. The cases concern all age groups, but in 2 cases out of 5 they concern children aged 1 to 4 years, and in 1 case out of 5 adults aged 20 years and over. Most of the cases recorded with the WHO concern 4 countries: Kazakhstan (12,304 cases), the Russian Federation (6131), Turkey (4602) and Kyrgyzstan (3639).

This is not the first time that measles has made headlines in Europe: in 2018, 41,000 people contracted the disease, and 37 died. the WHO recorded nearly 89,000 cases in 2018, and more than 104,000 in 2019. The epidemic then declined thanks to the Covid-19 pandemic (between confinement, barrier measures, cessation of travel, but also probably less good monitoring of the situation by health systems overwhelmed by the epidemic...) to seem to almost disappear in 2021. But it seems to want to start again with a vengeance.

This resurgence, specifies the WHO, is “largely attributable to the decline in vaccination coverage (...) between 2020 and 2022”. The Covid-19 pandemic played a large part in this, adding to a growing mistrust of vaccines. Vaccination is however extremely effective, and with 2 doses, it can prevent almost 100% of cases. This is why its generalization gives hope for the eradication of the disease. Provided that the rate of vaccinated people is very high, at least 95%: measles is a very contagious disease through coughing, sneezing and nasal secretions, and it is estimated that one contaminated person can infect 15 to 20 more! According to the WHO, two-dose vaccination coverage in the Europe region increased from 92 to 91% between 2019 and 2022, and more than 1.8 million infants were not vaccinated. Vaccination coverage was only 80% (for two doses) in 2010, but it now seems to have stagnated since 2017.

“Vaccination is the only way to protect children against this potentially dangerous disease,” said Dr Hans Kluge, WHO regional director for Europe, in a press release. It is essential that all countries are prepared to detect measles outbreaks early and respond in time as they could jeopardize progress towards measles elimination.” In 1980, before the generalization of vaccination, the annual number of deaths linked to measles in the world was estimated at 2.6 million, indicates Vaccination info service.

In France, the figures for 2023 have not yet been published but Public Health France noted last June that the Covid-19 pandemic had allowed “a significant reduction in the number of cases declared since April 2020, followed by almost non-existent viral circulation in 2021 which continued throughout 2022”, unlike other respiratory viruses. The public health agency saw this as a success of “the observed improvement in 2-dose MMR vaccination coverage in infants born since 2018 who are subject to compulsory vaccination and, on the other hand, by the immunity acquired during during recent epidemics. Fifteen cases, including 5 imported, of this notifiable disease were recorded in the country in 2022, and no deaths reported.

However, even if the vaccination coverage rate necessarily benefited from the fact that vaccination was made compulsory, in the entire population “the objective of 95% vaccination coverage at two doses is not yet achieved and there persists insufficiently vaccinated populations, worries Public Health France, particularly among adolescents and young adults or even within particular populations far from the health system.