Correspondence Address:
Saurabh RamBihariLal Shrivastava
3^rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvanchery Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India

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Dear Editor,

Measles is a highly infectious and life-threatening disease associated with the deaths of numerous young children worldwide.[1] In the year 2015, nearly 0.13 million disease-associated deaths were reported that approximates to 15 deaths per hour.[1] Because an extremely safe and effective vaccine is available to prevent the infection, the disease-attributed death rates are just unacceptable and alarming.[1] Further, due to the incorporation of measles vaccine in the national immunization schedule of various nations, a four-fifth reduction in the incidence of cause-specific death rates have been observed in the period between 2000 and 2015.[1]

Globally, it has been decided to eliminate the disease from at least five regions of the World Health Organization (WHO) by 2020.[1] However, owing to the high secondary attack rate, there is always a potential risk for an emergence of an outbreak, whenever there is an aggregation of susceptible population or interruption in the routine immunization services.[1],[2],[3] This is clearly evidenced by the California outbreak in 2015 and the fear of the disease outbreak in West Africa following the Ebola outbreak due to the interruption of the routine welfare services and weakness in the public health care delivery system.[1],[2],[3] Further, the only way to stop such outbreaks is by sustaining high immunization coverage with two doses of measles vaccine.[1],[3]

In the European region, more than 550 cases of the disease have been observed in the month of January 2017 and even the incidence for the next month shows a rising trend.[4] Further, almost 85% of the identified cases have been isolated from the seven endemic nations in the region, and it has been anticipated that the current outbreak can ultimately present as a large outbreak in all those areas with immunization coverage less than the expected 95%.[4] Moreover, due to the rise in the incidence of international travel, it is a reality that no individual or nation lies beyond the reach of the infection.[3],[4] Consistent efforts have been taken to eliminate the disease from all the 53 nations in the region; nevertheless, the infection continues to remain endemic in 14 nations.[4] This indirectly suggests that an outbreak of the disease can precipitate in any area until each nation reaches the threshold levels of immunization.[5]

The worst affected nations are Romania and Italy in the European region, and an epidemiological and comprehensive laboratory assessment is required to ascertain the origin of the infection.[4] The regional office of the WHO has extended its support to the national health authorities, and strategies have been formulated to effectively respond to the outbreak.[1],[4] In addition, steps are being taken to strengthen the surveillance mechanism and immunize the susceptible individuals with the vaccine.[2],[3],[4] Furthermore, none of the planned measures can deliver desired outputs, unless local communities are involved in the response activities.[3],[4],[5] Thus, it is high time to take appropriate measures to stall the further rise in the incidence of cases; otherwise, it will negate the entire progress attained in the entire European region.[4]

To conclude, it is quite necessary to take prompt measures to interrupt the transmission of the infection within their borders and at the same time maintain high immunization coverage.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References