While the aftermath of this year’s Ebola outbreak in West Africa is still evident in the nations of Guinea, Sierra Leone, and Liberia and still considered a threat, spread of the virus is now controlled and mostly contained. However, a greater and potentially more lethal epidemic could now threaten this region of Africa. A paper recently published in Science Magazine details this threat, citing a mass measles outbreak as a looming possibility for vulnerable West Africa. This vulnerability is mainly caused by the disruption of regular vaccination services and health efforts in the region, as all efforts recently have been funneled into the treatment and prevention of Ebola. Since the measles virus lives in the nose and throat mucus of its host, it can be easily transmitted. Additionally, it can live for up to two hours in the airspace where the infected person coughed or sneezed, making it highly contagious. The CDC reports that if one person has the virus, 90% of the people who are close to that person and not immune are likely to become infected.
Given the measles’ high rate of transmittance, “when there’s a disruption of medical services, measles is always one of the first ones in the door,” according to Justin Lessler, a co-author of the Science article. His study estimates that the disruption in measles vaccination services during the Ebola scare could lead to an additional 100,000 measles cases in the next 18 months, which could result in an additional 2,000 to 16,000 deaths. The researchers found these numbers by looking at the spatial distribution of unvaccinated children in West Africa, the measles susceptibility profile of individual countries, and estimating a 75% reduction in vaccination in recent months.
Image Source: PIUS UTOMI EKPEI
While the paper’s calculations are just projections, they do indicate the severity of another mass outbreak in West Africa. However, with dedicated public health initiatives, the susceptibility of individuals can be significantly decreased. As children are at the highest risk, it would be most effective to target those born during the Ebola epidemic, and then expand services to children six months to five years old. While this age range represents the most susceptible population, the measles vaccine is recommended for babies ages 12 months and over. However, any child younger than one year who gets the vaccine would need to receive two additional booster shots, which could be problematic given the already limited access to vaccines.
Lessler and his colleagues are urging for global health organizations to begin a vaccination campaign like this as soon as possible, before the incidence of measles begins to increase in Africa. The measles vaccine, of course, was not the only service disrupted, as there were similar reductions in the polio vaccination rate. Ideally, both the polio and measles vaccines would be administered together in a post-Ebola epidemic campaign. Lessler suggests that if initiatives like this were to be implemented effectively, they could actually make public health in West Africa better than it was before the Ebola epidemic. Hopefully in the coming months, preventative measures like the ones Lessler and his colleagues suggest will be implemented, and Africa can further recover from the trauma Ebola induced.
Feature Image Source: European Commission DG ECHO
