Measles could kill more than Ebola in West Africa

Johns Hopkins Bloomberg School of Public Health researchers say that major disruptions in the health care systems in West Africa caused by the Ebola crisis have led to significant decreases in vaccinations for childhood diseases, increasing susceptibility to measles and other vaccine-preventable illnesses.

Disruption to health systems in West Africa due to the Ebola virus outbreak has meant a collapse in the number of children being vaccinated, which in turn could lead to a measles epidemic with the potential to kill more people than Ebola, US researchers say.

They estimate that between 2,000 and 16,000 additional measles deaths could occur in such an outbreak.

The scientists from Johns Hopkins Bloomberg School of Public Health say that for every month of interruption in the health care system an additional 20,000 children between the ages of nine months and five years become susceptible to the measles.

"The secondary effects of Ebola – both in childhood infections and other health outcomes – are potentially as devastating in terms of loss of life as the disease itself," says study leader Justin Lessler, an assistant professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health.

"While the downstream effects of Ebola are many, we can actually do something about measles relatively cheaply and easily, saving many lives by restarting derailed vaccination campaigns."

The current Ebola outbreak began in December 2013 in Guinea and since then there have been more than 14,200 confirmed cases in Guinea, Liberia and Sierra Leone, with more than 9,500 deaths blamed on the disease.

Measles epidemics often follow humanitarian crises, Lessler says.

The researchers estimated that before the Ebola outbreak there were about 778,000 children between nine months and five years old in the three countries who had not been vaccinated against measles – about 4% of the population. After 18 months of Ebola-related disruptions to the health-care system, the researchers estimate, there will be up to 1,129,000 unvaccinated children.

In the event of a large regional measles outbreak, the number of estimated cases was roughly 127,000 before Ebola and, after 18 months of interruption, an additional 100,000 cases would be estimated to occur. Most would likely be in young children who are at greater risk of complications.

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