The outbreaks in the United Kingdom and Romania lead to demands to improve Spanish vaccination rates: above 95% in the first dose, lower in the second, to avoid the virus
There is only one way to get rid of measles: the vaccine. “There is no other way to stop transmission,” says the spokesperson for the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc), María del Mar Tomás Carmona. While viruses from the paramyxovirus family, the cause of the infection, are doing their thing around the world, Spain enjoys an almost perfect shield thanks to high vaccine coverage rates, on average 95%.
The new measles alert is due to two major outbreaks. One in the United Kingdom, where between October 23, 2023 and January 15, 198 confirmed cases and 104 probable cases were recorded in the central county of the West Midlands. 80% of them were located in Birmingham.
This has sparked a massive call for vaccination against the virus across the country. The director of the United Kingdom Health Security Agency (UKHSA), Jenny Harries, has said that “action at a national level” is required to ensure that children and some adults born between 1998 and 2004 receive the vaccine.
The other took place in Romania, where three minors died, which led to the declaration of an epidemic situation. According to data published in Eurosurveillance, After two years without registering cases, from March to August more than 500 cases were registered. At the end of the year, according to his Ministry of Health, More than two thousand had already accumulated.
Measles an old KNOWN THREAT
Here the risk is perceived more like the fable of Peter and the wolf. International organizations and experts do not cease their alerts and insist again and again that vaccination is the only thing that stops the transmission of the virus. “Since 2018 we have been warning about the matter,” claims Tomás.
“Vaccine coverage below 95% leaves room for the pathogen to spread,” he emphasizes. At the end of 2023, the WHO and the ECDC were already alerted to the situation and focused on recovering vaccination rates that for one reason or another have decreased.
During the first two decades of the millennium, estimated global coverage grew from 72% to 86%, but Covid slowed the rise, dropping to 83% in 2020 and 81% in 2021. The following year it recovered to 83%. % and immunization increased in all regions except the American and European continents.
Tomás emphasizes that “the anti-vaccine movements, their resurgence during the pandemic and their persistence after it have caused holes in the system.” But they are not the only ones to blame. “The problems of access to the vaccine, too.” And he details that “there are structural obstacles such as wars and disasters caused by climate that prevent the elimination of this infectious disease.”
The latest WHO report estimates that 57 million lives were saved between 2000 and 2022 thanks to vaccination, compared to the absence of it. Among the 144 countries that reported discarded cases in 2022, half met the measles surveillance sensitivity indicator target of two or more discarded infections per 100,000 inhabitants.
A higher figure compared to the third of countries that did so in 2021, 2020 and 2019. In 2022, laboratories in the Global Measles and Rubella Laboratory Network received 273,080 samples for paramyxovirus testing compared to 139,319 in 2021 and 121,257 in 2020.
The risks of measles: high contagion
“We are talking about a very contagious disease,” emphasizes Tomás. Transmission is not only through skin secretions, “there are also studies that show that it is airborne.”
This possibility was already pointed out 40 years ago. It was JAMA magazine that reported the experience that occurred in a pediatrician’s office in Michigan: three children became infected in the waiting room, despite entering the room an hour or so later after a minor with measles passed through. . Later other studies in The Lancet would delve into the question.
The first signs of viral infection are confused with other processes. “It begins with respiratory symptoms, cough, mucus, conjunctivitis… And then it could be clinically differentiated from chickenpox because its rash begins on the face and neck and extends to the hands and palms of the feet,” details Tomás. In all that time, up to two weeks, there is a risk of contagion.
BUILD A SAFE SHIELD against the virus
The Seimc spokesperson points out that Spain has its homework done. “If there is an outbreak it would be limited, we have a good job done with vaccination coverage in minors.” The Spanish Association of Pediatrics (AEP) states that the average coverage exceeds 95%, but there is room for improvement.
“It must be taken into account that complete immunization is made up of two doses and that in both cases the 95% threshold must be exceeded,” Tomás clarifies. In the first dose, which is injected after 12 months, in Spain as a whole it reaches 97.2%.
There are 12 regions that exceed the 95% objective (in addition, three more are close to this figure); while four other communities are below or do not provide data (only Melilla below 90%, and Castilla-La Mancha only slightly above this figure).
However, the rates must be improved in the second dose, which corresponds between three and four years, because it only reaches 93.9%, below the objective. Andalusia, Aragon, Asturias, Cantabria, Valencian Community, Murcia and Navarra surpass it.
And they are below 90%, which means placing themselves in the high-risk area, Castilla-La Mancha, the Basque Country, La Rioja, Ceuta and Melilla; while the Canary Islands and Extremadura are only a few tenths above this figure. No data is provided to the AEP from the Balearic Islands.
The threats of imported cases
«We are a globalized society and we are exposed to migratory movements. “That makes us be alert before any outbreak,” Tomás emphasizes. At the moment, according to the latest Weekly Epidemiological Surveillance Report in Spain, from Renave, in 2024 one case has been recorded in Catalonia. In 2023 they exceeded ten.
From the WHO this week the emphasis was again placed on the European outbreaks. “If we take a quick snapshot of what is happening in the region, we see that around 42,000 cases of measles have occurred between January and November 2023, almost 45 times more than what we have seen in 2022,” warned Siddhartha Sankar Datta. , regional advisor on Vaccine Preventable Diseases and Immunization for WHO.
Which triggers a very worrying situation. “We must also be aware of the fact that there has been a 3% drop in measles coverage between 2019 and 2022 [atribuida a los años de pandemia]», concluded Sankar.
2024-01-22 00:57:03
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