Measles, an ever-increasing disease in the world

Measles, which is strongly resurging worldwide, is a highly contagious viral disease, mostly affecting people who have not been or have been inadequately vaccinated.

More than 360,000 cases have been reported since January, the "highest" since 2006 and almost three times more than the same period last year, according to the World Health Organization (WHO). The Democratic Republic of Congo (DRC), Madagascar and Ukraine are the most affected countries.

The return of the disease led Thursday the international body to withdraw in the United Kingdom, Greece, the Czech Republic and Albania their status of "country that has eliminated measles."

This disease characterized by the eruption of red spots on the skin was, before the arrival of vaccines in the 1970s, a formidable killer of children (7 to 8 million estimated deaths per year in the world).

It is caused by a virus that is transmitted very easily through direct contact or through the air. This viral disease, which affects mostly children, but not only, is more contagious than Ebola or the flu.

After an incubation phase, the disease is characterized by a high fever, runny nose, cough, watery eyes … In a second time, appear red spots. The disease is contagious four days before and after this eruption.

Often benign, measles can lead to serious complications, respiratory (lung infections) and neurological (encephalitis), especially in fragile people.

There is no specific antiviral treatment and the care of the patient focuses on treating complications.

The global health authorities stress the importance of the vaccine, at the individual level, but also at the collective level: a high immunization coverage (95% of the population) protects people who can not themselves be vaccinated, in particular because their immune system is weakened (leukemia, antirejection treatment after a transplant …).

Worldwide, the number of deaths from measles had dropped sharply from the beginning of the 2000s until 2016, thanks to vaccination campaigns: the 2016 WHO assessment reported 90,000 deaths, compared with 550,000 in 2000. But it has risen to 110,000 deaths in 2017.

According to the United Nations Children's Fund (UNICEF), 98 countries reported more cases in 2018 than in 2017. 10, including Ukraine, Brazil and France, were responsible for three-quarters of the cases. the total increase.

In rich countries, this increase is largely attributed to mistrust of vaccines in general and MMR (measles / mumps / rubella) in particular.

According to a global survey published in June, France comes at the top of this skepticism, with one in three respondents who does not believe that vaccines are safe.

In this attitude of mistrust, the homeland of vaccination pioneer Louis Pasteur is followed by Gabon, Togo, Russia and Switzerland.

Many "anti-vax" rely on a 1998 publication linking the MMR vaccine and autism. However, it was established that its author, the British Andrew Wakefield, had falsified his results, and several studies have since shown that the vaccine does not increase the risk of autism.

The US President Donald Trump, before being elected, had himself linked autism and injection of several doses of simultaneous vaccines, a position he did not repeat recently. In April, he even deemed it "very important" that the population be vaccinated against measles.

Mistrust may also have religious motives, particularly in some conservative Jewish and Protestant communities.

In the United States, the state of New York, faced with a resurgence of measles in areas with a strong Orthodox Jewish population, voted in June to remove the religious exemptions that parents could invoke so far to circumvent the obligations of vaccination in schools.

At the global level, "the main reason" for inadequate immunization of children remains the failure of health systems in poor countries, which means that those "who need it most (do not) have access". , says the WHO.