Measles cases rise globally, while the Americas Region regains measles elimination status – PAHO/WHO

November 14, 2024 | Geneva/Washington, DC (PAHO/WHO) – While global measles cases increased to approximately 10.3 million in 2023, a 20% increase from the previous year, the Americas region has successfully recovered its status as free of endemic measles, and Brazil recently reverified that the disease has been eliminated.

Globally, inadequate immunization coverage remains one of the main causes of the increase in measles cases. According to the World Health Organization (WHO) and the United States. Centers for Disease Control and Prevention (CDC)More than 22 million children did not receive their first dose of measles vaccine in 2023. Despite this global increase, countries in the Americas have kept measles at bay and no cases of endemic transmission have been reported.

Brazil was again verified as measles-free following a review by the Regional Commission for Monitoring and Reverification of the Elimination of Measles and Rubella (RVC), an independent group of experts convened by the Pan American Health Organization (PAHO). This new verification confirms the interruption of endemic measles transmission in Brazil, following an outbreak that began in 2018 and led to the reestablishment of endemic measles transmission in 2019. Through strong vaccination efforts, enhanced surveillance and response measures quickly, Brazil successfully interrupted transmission by June 2022.

In 2023, the Region confirmed the lowest number of measles cases in its history, with only 73 cases reported. For the first time since 2019, there was also an increase in vaccination coverage: the first dose of the measles, rubella and mumps vaccine (MMR1) reached 87%. However, there is still a significant gap, as 1.4 million children in the region did not receive any doses of the MMR vaccine that year.

In 2024, as of November 8, 389 confirmed cases of measles were reported in the region, all imported or related to importation. The countries’ rapid response prevented sustained transmission of the disease.

This achievement means that the Americas region is once again free of endemic measles, a milestone first achieved in 2016. In addition to Brazil, Venezuela was again verified as free of endemic measles in 2023, following the resolution of an outbreak that It started in 2018. and lasted more than 12 months.

Global increase in measles, but the Region of the Americas remains protected

The global increase in measles cases has mainly affected regions such as Africa, the Eastern Mediterranean, Europe, Southeast Asia and the Western Pacific, with large outbreaks reported in 57 countries. Almost half of all major outbreaks occurred in the African region. However, the Americas have managed to avoid such outbreaks thanks to robust immunization programs, strict surveillance, and rapid responses to imported cases.

It is estimated that in 2023, 107,500 deaths from measles will be recorded worldwide, with children under five years of age being the most vulnerable. Although this is an 8% decrease from the previous year, too many children are still dying from this preventable disease. Despite the increase in cases in other regions, the Americas have not reported any measles-related deaths and it is estimated that between 2000 and 2022, the measles vaccine alone prevented 6 million deaths in the region.

Ongoing efforts to strengthen immunization and surveillance in the Americas

PAHO continues to highlight the importance of strengthening immunization programs to prevent future outbreaks. Although measles transmission has been successfully interrupted in the region, achieving and maintaining 95% vaccination coverage is crucial to ensure herd immunity and protect populations.

Dr. Jarbas Barbosa, Director of PAHO, emphasized this week: “Recovering and sustaining measles elimination in the Americas is an incredible achievement, but the work is far from over. We must continue to prioritize vaccination, improve surveillance systems and strengthen our response capabilities to prevent future outbreaks and protect our children.”

In addition to measles, the Americas region also successfully eliminated rubella and congenital rubella syndrome in 2015, a situation that continues to this day.

General recommendations of the Regional Monitoring and Verification Commission

During the fourth annual meeting of the Regional Monitoring and Reverification Commission (CVR) for the Elimination of Measles and Rubella, held from November 4 to 6, 2024 in Lima, Peru, countries in the region were strongly recommended:

• Strengthen supervision and monitoring of immunization, surveillance and rapid response activities at the subnational and local levels.
• Adopt and adapt recent PAHO guidelines on active case finding as a strategy to improve the sensitivity of the surveillance system.
• Intensify efforts to close immunity gaps among migrant populations.

The full report with country-specific recommendations will be available soon.