Remarkable effectiveness of the US Measles vaccination campaign – Source CDC
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Although most people think of measles as a relatively mild, `childhood disease’, statistics from the World Health Organization show otherwise.
- Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available.
- In 2012, there were 122 000 measles deaths globally – about 330 deaths every day or 14 deaths every hour.
- Measles vaccination resulted in a 78% drop in measles deaths between 2000 and 2012 worldwide.
- In 2012, about 84% of the world's children received one dose of measles vaccine by their first birthday through routine health services – up from 72% in 2000.
- Since 2000, more than 1 billion children in high risk countries were vaccinated against the disease through mass vaccination campaigns ― about 145 million of them in 2012.
Earlier this year the WHO announced that Measles deaths reach record lows , attributing these gains to `a result of global routine measles immunization coverage holding steady at 84%1 and 145 countries having introduced a routine second dose of measles vaccine to ensure immunity and prevent outbreaks.’
While good news, the WHO also warned that these gains were fragile, with five of six WHO regions still experiencing large outbreaks, and that far too many people remain at risk due to lack of immunization.
Indeed, in 2011 we saw a number of large outbreaks (see WHO: Measles Outbreaks In The Americas, Europe & Africa) and in the fall of that year the ECDC declared Measles Eradication as their `theme’ For 2012.
Late last week it emerged that crewmembers aboard the Costa Pacifica cruise ship had come down with measles while in the Italian port of Civitavecchia. Being highly infectious (at least, among an unvaccinated population), and with an incubation period of 10 to 14 days, obviously this outbreak warrants serious scrutiny.
Today the ECDC released a Rapid Risk Assessment: Measles on a cruise ship, Mediterranean Sea (excerpts below), which assesses the risks of further spread, and discusses mitigation options. The bottom line, from their assessment, reads:
The Costa Pacifica regularly sails on seven-day cruises in the western Mediterranean. The apparent high attack rate among the crew suggests a low vaccine coverage in this group. Measles is highly contagious. Given the relatively long incubation period and the contagiousness prior to disease symptoms, it is likely that new cases will appear among the crew, and further transmission may take place.
From the 5-page document we get the following narrative.
EVENT BACKGROUND
On the evening of 27 February 2014, Italy reported that on board the Costa Pacifica – a cruise ship which had arrived from Palma de Mallorca, Spain, earlier that day and docked in the port of Civitavecchia, Italy – around forty crew members showed symptoms of exanthematous disease suspected to be measles. This was based on laboratory confirmation (PCR on urine samples) and the fact that the ship’s medical staff reported on 26 February 2014 that one crew member, a 27-year-old female, had a respiratory illness and a skin rash when she disembarked at Genoa on 22 February.
The medical staff at the Rome–Fiumicino Office of USMAF (Uffici di Sanità Marittima, Aerea e di Frontiera: Maritime, Air and Frontier Health Office under the Italian Ministry of Health), which is also responsible for Civitavecchia, and experts on infectious diseases from the National Institute of Infectious Diseases (INMI) in Rome performed a thorough examination of the medical situation on board upon the ship’s arrival.
On 28 February, Italy reported that nine persons were hospitalised at the National Institute of Infectious Diseases (INMI) in Rome, with symptoms suggestive of measles. Initial laboratory tests confirmed the diagnosis of measles in seven people (IgM antibodies). Two cases of probable measles infection in crew members were identified when the ship arrived in Savona on 1 March 2014. They and four close contacts were transferred to a resort in Orbetello, Italy, for isolation.
The ship arrived in Marseille on 2 March 2014 where no clinical cases of measles or fever were reported among the passengers and crew on board.
On 3 March, the Costa Pacifica docked in the port of Barcelona, Spain. After an inspection by the Port Health Officers, who had assessed the sanitary situation on board the vessel, the Ship Sanitation Certificate was ‘negative’, i.e. no cases were detected on board the vessel.
On 5 March 2014, the ship called at Palma de Mallorca, Spain; the ship’s authorities detected no new cases.
According to the information provided by the medical team on board and the medical log, no new suspected measles cases have been detected since 1 March 2014.The itinerary of the cruise ship involves the ports of Marseille, France; Barcelona, Spain; Palma de Mallorca, Spain; Civitavecchia, Italy; La Spenzia, Italy; and
Savona, Italy.
You’ll find proposed public health warnings, and mitigation and containment advice, in this risk assessment which can be read in full at the link below:
Rapid Risk Assessment: Measles on a cruise ship, Mediterranean Sea
