August 30, 2024
SINGAPORE – Vietnam’s most populous city, Ho Chi Minh City, this week announced its first measles outbreak as the number of known infections hit 353 on Aug 22, up from just one between 2021 and 2023.
Three fatalities were also reported.
Outbreaks of the highly contagious disease have also occurred in the United States and Europe in 2024.
Here are five things to know about measles:
1. What is measles?
Measles, also known as rubeola, is a disease caused by the highly contagious measles virus. It can affect anyone but is most common in children.
The potentially fatal disease affects the respiratory system, often resulting in a skin rash and other symptoms, including fever, a runny nose, coughing, as well as red and watery eyes.
Most deaths from measles are from complications related to the disease, which include blindness, encephalitis – an infection causing brain swelling and potentially brain damage – severe diarrhoea and related dehydration, ear infection as well as severe breathing problems such as pneumonia.
Unvaccinated young children and pregnant women are at highest risk of severe measles complications, according to the World Health Organisation (WHO).
2. How contagious is measles?
Measles is highly transmissible among people who have not been vaccinated.
The virus remains active and contagious in the air or on infected surfaces for up to two hours, according to the WHO.
One person infected by measles can infect nine out of 10 of his unvaccinated close contacts.
The virus has an incubation period of up to 14 days and is transmitted through respiratory droplets, direct contact with nasal or throat secretions, and – less commonly – by items that are freshly soiled with these secretions.
Before the introduction of the measles vaccine in 1963 and widespread vaccination, major epidemics occurred about every two to three years and caused an estimated 2.6 million deaths each year.
The WHO estimates that measles vaccination averted 57 million deaths between 2000 and 2022. However, despite a safe and cost-effective vaccine being available, there were an estimated 136,000 measles deaths globally in 2022, mostly among unvaccinated or under-vaccinated children below the age of five.
3. Why is measles making a comeback globally?
More than 50 countries experienced “large and disruptive” measles outbreaks in 2023, twice as many as in 2022.
An outbreak is defined as the occurrence of three or more confirmed measles cases, according to the WHO.
The WHO warned in May that cases were surging again in Europe for a second straight year. There were 56,634 cases and four deaths registered during the first three months of the year in 45 of the 53 countries that make up the WHO European region, which includes Central Asia.
That is just 5,000 cases fewer than for the whole of 2023, when 61,070 cases and 13 deaths were reported.
The WHO attributed the surge to an accumulation of children who missed routine vaccinations against measles during the Covid-19 pandemic, coupled with slow recovery in vaccination coverage in 2021 and 2022.
In the US, 13 outbreaks have been reported in 2024 so far, with 227 cases recorded as at Aug 22, according to the US Centres for Disease Control and Prevention. There were 58 cases tallied in all of 2023.
4. Is Singapore at risk?
Singapore’s population has a high level of immunity against measles.
In 2022, in response to a WHO warning of an imminent global threat presented by measles, the Ministry of Health (MOH) said the likelihood of a large outbreak here was low because of high vaccination coverage for the virus.
At least 95 per cent of a population has to receive two doses of measles vaccine to achieve herd immunity, according to the WHO.
In Singapore, the measles vaccination is mandatory by law for all children living here. The first vaccine dose coverage for the population was consistently above 95 per cent from 2011 to 2021, with second dose coverage hovering around 90 per cent, MOH said in 2022.
5. If you contract measles, what should you do?
Most patients recover completely from measles, states HealthHub, the national platform for digital health. There is no specific treatment for a measles infection. However, doctors can prescribe treatments to relieve symptoms such as fever, pain, cough or rash discomfort. The rash usually subsides on its own after five or six days. A person who has had measles develops lifelong immunity to the disease.