Context: United States (US) is in the middle of its worst measles outbreaks since last 25 years. A paper, published in the Lancet, places India among seven countries that pose high risk for spread of the disease.

Observations made in the report:

• The rise of measles in US is mainly because of two things- one, Reintroduction of the virus at individual localities through travel from countries experiencing outbreaks and two, low vaccination rates fueled by non-medical exemptions (NMEs).
• These outbreaks are linked to travelers who brought measles back from other countries such as Israel, Ukraine and the Philippines — where large measles outbreaks are occurring.

The top countries ordered by risk (of spreading measles) posed are: India, China, Mexico, Japan, Ukraine, Philippines, and Thailand.

Measures suggested by the study:

Surveillance should be directed towards countries with high incoming passenger volume. Additionally, measures to improve public health in these countries should be considered. For instance, foundations that are committed to global health enhancement could allocate funding for vaccination efforts in these countries.

About Measles:

What is It? Measles is a highly contagious viral disease. It remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine.

Spread: Measles is transmitted via droplets from the nose, mouth or throat of infected persons.

Initial symptoms, which usually appear 10–12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.

Vulnerability: Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.

The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, and severe respiratory infections such as pneumonia.

Prevention: Routine measles vaccination for children, combined with mass immunization campaigns in countries with low routine coverage, are key public health strategies to reduce global measles deaths.

Preventive efforts: Under the Global Vaccine Action Plan, measles and rubella are targeted for elimination in five WHO Regions by 2020. WHO is the lead technical agency responsible for coordination of immunization and surveillance activities supporting all countries to achieve this goal.