Measles in Europe: record number of both sick and immunized
February 8th, 2019Copenhagen, 7 February 2019
More children in the WHO European Region are being vaccinated against measles than ever before; but progress has been uneven between and within countries, leaving increasing clusters of susceptible individuals unprotected, and resulting in a record number of people affected by the virus in 2018. In light of measles data for the year 2018 released today, WHO urges European countries to target their interventions to those places and groups where immunization gaps persist.
Measles killed 72 children and adults in the European Region in 2018. According to monthly country reports for January to December 2018 (received as of 01 February 2019), 82 596 people in 47 of 53 countries contracted measles. In countries reporting hospitalization data, nearly 2/3 (61%) of measles cases were hospitalized. The total number of people infected with the virus in 2018 was the highest this decade: 3 times the total reported in 2017 and 15 times the record low number of people affected in 2016.
The surge in measles cases in 2018 followed a year in which the European Region achieved its highest ever estimated coverage for the second dose of measles vaccination (90% in 2017). More children in the Region received the full two-dose series on time, according to their countries’ immunization schedules, in 2017 than in any year since WHO started collecting data on the second dose in 2000. Coverage with the first dose of the vaccine also increased slightly to 95%, the highest level since 2013. However, progress in the Region, based on achievements at the national level, can mask gaps at subnational levels, which are often not recognized until outbreaks occur.
“The picture for 2018 makes it clear that the current pace of progress in raising immunization rates will be insufficient to stop measles circulation. While data indicate exceptionally high immunization coverage at regional level, they also reflect a record number affected and killed by the disease. This means that gaps at local level still offer an open door to the virus,” says Dr Zsuzsanna Jakab. “We cannot achieve healthier populations globally, as promised in WHO’s vision for the coming five years, if we do not work locally. We must do more and do it better to protect each and every person from diseases that can be easily avoided.”
Preventable tragedy
While immunization coverage has improved overall in the Region, many people remain susceptible.
- Estimated coverage with the second dose of measles vaccine was below the 95% threshold to prevent circulation (that is, to achieve “herd immunity”) in 34 countries of the Region in 2017.
- Subnational coverage rates point to disparities even within countries.
- Suboptimal coverage for either dose sets the stage for transmission in the future.
The European Vaccine Action Plan 2015–2020 (EVAP) lays out a strategy endorsed by all 53 Member States to eliminate both measles and rubella. Most importantly, at least 95% of every population needs to be immune, through two doses of vaccination or prior exposure to the virus, to ensure community protection for everyone – including babies too young to be vaccinated and others who cannot be immunized due to existing diseases and medical conditions.
“In adopting EVAP, all countries in the European Region agreed that elimination of measles and rubella is possible, and is also a cost-effective way to protect people of all ages from avoidable suffering and death,” says Dr Nedret Emiroglu, Director of the Division of Health Emergencies and Communicable Diseases, WHO Regional Office for Europe.
Forty-three European countries interrupted transmission of endemic measles for at least 12 months as of the end of 2017. Some of them, also managed to limit the spread of the virus following importation to very few cases in 2017 and 2018, showing that elimination of the disease is well within reach for the whole Region. “Progress in achieving high national coverage is commendable. However, it cannot make us blind to the people and places that are still being missed. It is here that we must now concentrate increased efforts. We should never become complacent about our successes but continue to strive to reach the final mile. Together we can make this happen,” concludes Dr Emiroglu.
Closing the door on measles
Many factors contribute to suboptimal immunization coverage and the spread of measles. To prevent outbreaks and eliminate measles, countries need to sustain high national and subnational immunization coverage with two doses of measles-containing vaccine, as well as identify and address all pockets of underimmunization among their populations.
The Regional Office continues to work with countries in the Region to enhance their immunization and disease surveillance systems. This includes building capacities and providing guidance to:
- ensure that all population groups have equitable access to vaccination services and that these are convenient;
- identify who has been missed in the past and reach them with the vaccines they need;
- ensure that health workers are vaccinated to prevent transmission in health facilities, and that they have sufficient technical knowledge about vaccines and the immune system to feel confident in recommending vaccination to their patients;
- strengthen trust in vaccines and health authorities;
- secure access to a timely and affordable supply of vaccines;
- improve outbreak detection and response;
- listen and respond to people’s concerns, and respond to any health event that could be potentially related to vaccine safety.
Most of the countries struggling with suboptimal immunization coverage against measles in the Region are middle-income countries. The Regional Office is working with these countries to implement a coordinated strategy to address targeted programme areas.
NASA: 2018 was Fourth Warmest Year in Continued Warming Trend
February 8th, 2019
According to an ongoing temperature analysis conducted by scientists at NASA’s Goddard Institute for Space Studies, the average global temperature on Earth has increased by about 0.8° Celsius (1.4° Fahrenheit) since 1880. Two-thirds of the warming has occurred since 1975, at a rate of roughly 0.15-0.20°C per decade.
2/7/1904: The Great Baltimore Fire begins
February 7th, 2019“…..When the blaze finally burned down after 31 hours, an 80-block area of the downtown area had been destroyed and more than 1,500 buildings were completely leveled….”
https://www.youtube.com/watch?v=9_a8KgzWpYg
The most serious of a series of earthquakes emanating from the New Madrid Fault strikes the center of America on 2/7/1812
February 7th, 2019https://www.youtube.com/watch?v=dLYzd_DX0sE
Maduro has blocked a bridge on the Colombia-Venezuela border meant to be one of three collection points for the delivery of international aid.
February 7th, 2019https://www.youtube.com/watch?v=HFxCIgQ2n94
World influenza update as of 1 February 2019
February 7th, 2019
Summary
In the temperate zone of the northern hemisphere influenza activity continued to increase.
- In North America, influenza activity appeared to decrease slightly with influenza A(H1N1)pdm09 predominating.
- In Europe, influenza activity continued to increase, with both A viruses circulating.
- In North Africa, influenza A(H1N1)pdm09 detections sharply increased in Morocco.
- In Western Asia, influenza activity continued to increase in some countries and appeared to decrease across countries of the Arabian Peninsula.
- In East Asia, influenza activity continued to increase, with influenza A(H1N1)pdm09 virus predominating.
- In Southern Asia, influenza detections remained elevated overall. Influenza activity continued to increase in Iran (Islamic Republic of) with influenza A(H3N2) the predominant circulating virus.
- In the temperate zones of the southern hemisphere, influenza activity remained at inter-seasonal levels.
- Worldwide, seasonal influenza A viruses accounted for the majority of detections.
National Influenza Centres (NICs) and other national influenza laboratories from 110 countries, areas or territories reported data to FluNet for the time period from 07 January 2019 to 20 January 2019 (data as of 2019-02-01 04:30:14 UTC). The WHO GISRS laboratories tested more than 232136 specimens during that time period. 59457 were positive for influenza viruses, of which 58436 (98.3%) were typed as influenza A and 1021 (1.7%) as influenza B. Of the sub-typed influenza A viruses, 24559 (77.7%) were influenza A(H1N1)pdm09 and 7058 (22.3%) were influenza A(H3N2). Of the characterized B viruses, 85 (34.6%) belonged to the B-Yamagata lineage and 161 (65.4%) to the B-Victoria lineage.
The Flu in Europe, Week 4 (21-27 January 2019): Influenza activity continued to increase, with both A viruses circulating.
February 7th, 2019
India’s Emergency Response System
February 6th, 2019“…..Communities began to lead and fund their own health centers. In their first four years, village health centers saw 3.5 million patient visits, including those associated with a program to screen more than 100 thousand children for nutritional and physical wellbeing. These centers have become a training and employment ground for young people who otherwise would have moved to urban areas.
After just 12 years, the Emergency Management and Research Institute (EMRI), has deployed more than 10,000 ambulances and 45,000 skilled personnel to respond to 56.1 million emergencies, save 2.3 million lives, serve 18.9 million pregnant women, and assist in 480 thousand births.
They have done this through a centralized, call-in system that receives 150,000 calls and responds to nearly 25,000 emergencies each day. Users can call into a free, emergency 108 telephone number, which provides integrated medical, police, and fire emergency services. A single call center can provide service for up to fifty million people at a cost of $0.25 USD per person per year. The service is free to the user and costs the provider less than $15 USD per emergency. This is less than one percent of what an emergency call costs in the United States…..”
