Release date: 2015-03-25
As the Ebola outbreak has destroyed health services, experts are actively preparing to fight the deadly measles outbreak in West Africa.
As the Ebola epidemic fades, West Africa is brewing a second health crisis. The last case of Ebola appeared in Liberia a few weeks ago. However, in the region, as well as in Guinea and Sierra Leone, where the epidemic continues to ravage, the previously weak public health system was completely destroyed in the fight against Ebola, and child immunization was correspondingly reduced. Researchers have warned that the consequences could be disastrous: what is more terrible than Ebola is that a violent measles will kill thousands of lives in the worst case.
Epidemiologist Justin Lessler from the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, points out that the second effect of Ebola is equivalent to it. The direct impact is even more serious. Justin Lessler and his partner calculated deaf data based on the size of the measles outbreak after the potential Ebola outbreak.
In the affected areas, measles is by no means the only and not the biggest threat. For example, due to concerns about a sharp increase in the number of people infected with malaria, Doctors Without Borders began distributing drugs to treat parasitic diseases at the end of October. However, the appearance of measles is the first sign of damage to the health system, which occurs early and has serious consequences. As one of the most infectious viruses in the world, the measles virus, which is 5 to 10 times more infectious than the Ebola virus, is the first outbreak of the disease after the disaster. In the current situation of humanitarian crises in poor countries, measles infections can reach 20%, especially for people who are weak due to malnutrition and vitamin A deficiency.
Liberia, Guinea and Sierra Leone faced trouble even before the Ebola attack. According to the Demographic and Health Survey, in 2012 and 2013, only 62% to 79% of children in three countries were estimated to have received only one dose of measles vaccine. The measles virus spreads very rapidly, and 95% of the population must receive two doses of vaccination to prevent infection.
Steve Cochi, senior consultant for Disease Control and Prevention in Atlanta, a US division of the Global Immunization Department, said that in these three countries, although immunization against measles has been weak, last summer, Immunity is even more severe. Liberia planned a measles immunization campaign in late fall in 2014, but the plan was cancelled because of the blow from Ebola. In Guinea and Sierra Leone, the plan was also postponed.
Lessler and his partner plan to predict the severity of the measles outbreak in Ebola in their new study. The interdisciplinary team used statistical methods and geospatial positioning to identify the number, age, and location of measles-susceptible children before the Ebola attack. Next, they envisaged the consequences of various measles immunizations, with the dates of suspension being 6 months, 12 months and 18 months later.
The terrible prediction is that the regional measles epidemic after Ebola will almost double the number of patients (estimated at 227,000) compared to the number of infectious patients before Ebola (estimated at approximately 127,000). And increase the number of deaths by 2,000 to 16,000. In the end, the total number of deaths will probably exceed the total number of deaths (about 10,000) caused by Ebola to date. Lessler emphasizes that such deaths can almost be avoided by mass vaccination. He said that their research team only focused on measles research, not on other aspects, such as reducing maternal mortality, "because in this case we know where the research is focused and the costs are related to other interventions. Than lower."
Lessler admits that their vision is a little bit pessimistic. They believe that the total number of measles vaccinations (including routine immunization coverage and mass vaccination) after the Ebola outbreak has fallen by 75% and will not return to the previous level after 18 months.
“They themselves admit that the assumption of a cessation period (18 months) for routine vaccination is very arbitrary and will be controversial,†said Nicholas Grassly, an infectious disease scientist at Imperial College London. “But their conclusions and The call for action is well-founded and necessary."
At the end of 2014, Katrina Kretsinger, head of the measles team at Cochi's division, stated that the Centers for Disease Control and Prevention (CDC) had established its own susceptible population model. Although CDC made different assumptions, such as a 50% reduction in vaccination numbers, Kretsinger said that the model they built had achieved a very uniform result and made a brief report to CDC's director Tom Frieden in early January. She said: "This must be the result that he (Frieden) is eager to know."
However, the emergence of Ebola has made the difficulty of vaccination in areas that are difficult to start to rise to a new level. Cochi's question is: When so many health care workers are killed, who will vaccinate in the future? And will people be willing to accept the rumors and distrust of Western medicine? He said: "If you take measles vaccine Close to people, they may think this is the Ebola vaccine."
Nonetheless, with the help of the CDC and other international cooperation organizations, Liberia is working ahead to try to launch a measles suppression campaign as early as May, targeting all children between the ages of 9 months and 5 years. The implementation of the plan in Sierra Leone and Guinea is still far away, as the current targets in the two regions are still at the stage of suppressing the Ebola outbreak.
Source: Bio 360
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