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WHO and UNICEF concerned about measles outbreak in Eastern and Southern Africa

NAIROBI/ HARARE, 18 June 2010 – A steep increase in cases of measles in Eastern and Southern Africa has put recent gains in reducing mortality due to this highly contagious disease at risk of being reversed.

As of mid-June 2010, the outbreak has affected more than 47,907 children in 14 countries, resulting in 731 deaths. The most recent confirmed measles outbreaks were reported from Malawi, Mozambique and Zambia.

The measles control strategies being implemented in the region include: a first dose measles immunization through routine infant immunization programmes; a second opportunity measles vaccination to children during supplemental immunization activities (SIAs) or during a routine service delivery schedule during the second year of life; high quality disease surveillance supplemented with laboratory confirmation; and case management.

In order to ensure protection from outbreaks, at least 90 per cent of all children in each district and at national level need to be vaccinated through routine immunization. Two doses of the vaccine are recommended to ensure immunity, since about 15 per cent of children vaccinated at 9 months, fail to develop immunity from the first dose.  The African Region of the World Health Organization (WHO) has attained 92 per cent reduction in measles mortality between 2000 and 2008 through the implementation of these strategies, with the support from the Measles Initiative.

The current wave of measles outbreaks comes as a result of gaps in the implementation of the control strategies. These gaps have been caused by inadequate financial commitments from governments and partners. Due to these shortfalls, routine immunization coverage has declined and in some districts it was not possible to reach all children. Moreover, in some countries (Malawi, Mozambique, South Africa, Swaziland and Zimbabwe) certain groups of the population refuse to immunize their children. In 2009, more than 2.4 million children in the Eastern and Southern Africa sub-region (20 per cent of all children younger than one year) were not reached by routine immunization. 

Measles is among the world’s most contagious diseases, which can cause severe complications such as pneumonia, diarrhea and encephalitis, among others, and death. It can easily spread through coughing and sneezing.

With technical support from UNICEF, WHO and other partners and the generous financial support from the Central Emergency Response Fund (CERF), the UK Department for International Development (DFID), the European Union and other international and local partners, countries affected by the recent outbreaks are conducting proper outbreak investigations, providing appropriate case management, conducting response vaccination campaigns at various scales and working to strengthen routine immunization and disease surveillance.

Most countries have conducted limited response vaccination campaigns to stem the outbreaks. South Africa, for example, launched a measles vaccination campaign on 12 April 2010 for children aged 6 months to 15 years after facing a huge measles outbreak in 2009/2010, and Zimbabwe followed from 24 May to 2 June.

Other affected countries (Lesotho, Malawi and Zambia) are planning to conduct supplemental immunization activities as well, but funding has not yet been secured. Similarly, Comoros, Ethiopia and Madagascar have planned to schedule follow up supplemental immunisation activities in 2010. However, these countries are experiencing large funding gaps which will compromise the quality of the SIAs.

“Measles are easily preventable. In order to sustain our efforts and successes in combating the disease, we urgently need to fill the funding gaps. Otherwise, we will again see more measles deaths in the near future,” said UNICEF Regional Director for Eastern and Southern Africa, Elhadj As Sy.

"To eliminate the risk of resurgence, countries must continue follow-up vaccination campaigns every two to four years until their healthcare systems can routinely provide two doses of measles vaccination to all children and provide treatment for the disease," said WHO Regional Director for Africa, Dr Luis Gomes Sambo

The Measles Initiative was founded in 2001 and is led by the American Red Cross, The UN Foundation, the US Centres for Disease Control and Prevention, UNICEF and the World Health Organization (WHO).

Update on the measles outbreak in the affected countries in Eastern and Southern Africa (data as of 15 June 2010):
Zimbabwe  (8,173 cases, 517 deaths), Zambia (817 cases, 33 deaths), Tanzania (20 cases, 1 death) , Swaziland ( 529 cases,  0 death), South Africa  (15,520 cases, 18 deaths), Namibia (3,722 cases, 58 deaths), Mozambique (434 cases, 0 death), Malawi (11,461 cases, 68 deaths), Lesotho (2,406 cases, 28 deaths), Kenya (295 cases, 0 death) Ethiopia (2,108 cases, 8 deaths), Botswana (1,048 cases, 0 death).

For more information, please contact:
Dr.O.Walker, WHO IST ESA coordinator;

Michael Klaus, UNICEF ESARO,
Tel +254-20-762-2214,




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