Measles, WHO alert: “Cases are growing again. Retrieve missed vaccinations”
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On the eve of the approval of the new National Vaccine Prevention Plan, the warning launched by the European office of the World Health Organization also targeted Italy: “All States must develop a plan to recover the vaccinations not carried out in the last two years, starting with measles”, is the message released on the occasion of the publication of the first report of the year on vaccine-preventable diseases. A document entirely dedicated to measles and rubella. In other words, the two infections that our country’s institutions and health personnel would like to eliminate by 2025. But the road is all uphill. In fact, Italy is among those that recorded the highest number of cases in the Old Continent in 2022: with 18 cases out of a total of 834.
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Measles: in Italy vaccination coverage below 95 percent
This is why the message launched last Friday by Copenhagen – headquarters of the European office of the World Health Organization – has already bounced between the offices of the Ministry of Health and the studies of public health experts and pediatricians. Of the 904 cases reported between January and December, almost half were recorded in Tajikistan (451), which is also the country with the highest incidence (number of new cases out of the total population). Followed by Turkey (116), Russia (102), the United Kingdom (50), Poland (27), Kyrgyzstan (20) and France (19). Immediately after Italy, however, Belgium (17) and Germany (14). However, also reading the statistics relating to vaccination coverage recorded in 2021 along the Peninsula, one realizes that the 95 percent threshold set by the World Health Organization to protect the population and move towards the progressive eradication of the disease is still far away. Italy has in fact stopped at 93.85 per cent. But along the boot there are profound territorial differences. Within the country, however, there are profound territorial differences: the response rate in fact varies from just over 71 per cent in the Autonomous Province of Bolzano to almost 98 per cent in Lazio.
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In the last three years cases have been decreasing thanks to masks and distancing
The latest data on infections reported by the World Health Organization are much lower than those of 2019, when measles diagnoses were over 104 thousand. But the decline must not suggest a disease that is being eradicated. In fact, the collapse of cases concerned the entire three-year period of coexistence with Covid-19, of which it is a direct consequence. As mentioned, in 2022 “just” 18 measles diagnoses were recorded in Italy. A number that has decreased by almost a hundred times compared to 2019 (1,605). A sign that the use of masks and social distancing measures have also resulted in a protective effect against the measles virus: up to ten times more contagious than Sars-CoV-2 (with an R0 between 12 and 18). “But this does not mean that we have solved the measles problem: – comments a Health Rocky Russo, pediatrician of the mother-child operating unit of the ASL of Benevento and head of the vaccination technical table of the Italian Society of Pediatrics -. There are millions of susceptible subjects in society who, if not adequately vaccinated, could be involved in new outbreaks “. An increasingly concrete risk, if we take into account the cancellation of the containment measures adopted between 2020 and a good part of 2022.
Spotlight on Italy
That Covid-19 has shifted attention and hidden an already serious situation can also be seen by recovering some data relating to the period preceding the pandemic. According to data released by the European Center for Disease Prevention and Control (ECDC), in 2017 Italy was the fifth country in the world by number of infections (4,885): behind India (46,716 cases), Nigeria (8,414 ), Pakistan and China (5,469). Taking into account the lower population density in our country, the incidence in our country was actually higher than in the other states mentioned. And those affected by the infection were – in 2017 as in subsequent years, regardless of the total number of cases – above all people who were not vaccinated or vaccinated with a single dose.
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Measles prophylaxis is contained in the drug which also protects against mumps, rubella and chicken pox. The ideal scheme involves a first administration of the vaccine immediately after the first year of age (between the 12th and 15th month of life) and then a booster between the sixth and seventh year. This is why even the slight growth in adherence to vaccinations at 48 months observed in 2021 does not leave us calm. The average figure of 95.2 per cent, relating to those born in 2017, suggests that some families have arranged for the first dose of vaccine to be administered later than indicated in the vaccination calendar. But if you look at the rate of adherence to the second dose, you realize that the 86 percent threshold was not reached in 2020: in fact ten steps behind the goal set by the World Health Organization. This suggests that, over the years, the proportion of the population susceptible to infection is destined to grow stronger. And if the virus begins to circulate insistently, an increase in cases and possible more serious consequences is almost certain, to which infants, immunosuppressed people and pregnant women are exposed above all.
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Recovery of vaccines and identification of cases: the appeal of the Health Organization
With these data, one understands why the appeal launched by the World Health Organization also calls our country into question. “After a 2021 characterized by low circulation, measles cases have started to increase again since the beginning of 2022”, is the warning issued by the experts of the UN agency. An inevitable consequence of the immunity gap and the failure to administer vaccines during the pandemic. Circumstances that “have left many people, including a growing number of children, susceptible to the disease”. Hence the invitation to the national health authorities. “To prevent a resurgence of measles, we need to identify those who have not received the vaccination and develop strategies aimed at their recovery”. In the meantime, the World Health Organization recalls, it is also important to “strengthen surveillance against measles”, in order to discover all cases in a timely manner and thus reduce contacts with positives.
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