‘Fragile’ Africa prepares for high risk of coronavirus spread

By Juliette Jabkhiro and Kate Kelland

DAKAR/LONDON (Reuters) – An isolation ward stands ready at a hospital in Khartoum, Sudan. Laboratories in Senegal and Madagascar have the testing equipment they need. Passengers arriving at airports in Gambia, Cameroon and Guinea are being screened for fever and other viral symptoms.

Africa’s Centres for Disease Control and Prevention says it has activated its emergency operation centre in the face of what global health officials say is a high risk the coronavirus disease epidemic that began in China will spread to its borders.

On a poor continent where healthcare capacity is limited, early detection of any outbreak will be crucial.

The fear is great that a spreading epidemic of coronavirus infections will be hard to contain in countries where health systems are already overburdened with cases of Ebola, measles, malaria and other deadly infectious diseases.

“The key point is to limit transmission from affected countries and the second point is to ensure that we have the capacity to isolate and also to provide appropriate treatment to people that may be infected,” said Michel Yao, emergency operations program manager at the World Health Organization’s regional office for Africa in Brazzaville, Congo.

The Democratic Republic of Congo is barring its citizens from flying to China. Burkina Faso has asked Chinese citizens to delay travelling to Burkina, and is warning that they face quarantine if they do. Kenya, Tanzania and Rwanda have all suspended flights to China.

“What we are emphasising to all countries is that they should at least have early detection,” Yao said.

“We know how fragile the health system is on the African continent and these systems are already overwhelmed by many ongoing disease outbreaks, so for us it is critical to detect earlier to that we can prevent the spread.”

John Nkengasong, Africa’s CDC director, told a briefing in the Ethiopian capital Addis Ababa this week that the activation of the emergency operation centre would create a single incident system to manage the outbreak across the continent.

The Africa CDC will also hold a training workshop in Senegal for 15 African countries on laboratory diagnosis, he said.

The continent has more than doubled the number of laboratories now equipped to diagnose the viral infection, this week adding facilities in Ghana, Madagascar and Nigeria and to established testing labs in South Africa and Sierra Leone.

“By the end of the week we expect that an additional 24 countries (in Africa) will receive the reagents needed to conduct the tests and will have the test running,” a spokeswoman for the WHO’s Africa Region told Reuters.

(Additional reporting by Giulia Paravicini in Addis Ababa, Benoit Nyemba in Kinshasa, Thiam Ndiaga in Ouagadougou, Josiane Kouagheu in Douala, Pap Saine in Banjul and Saliou Samb in Conakry. Writing and reporting by Kate Kelland; Editing by Pravin Char)

WHO decries ‘collective failure’ as measles kills 140,000

By Kate Kelland

LONDON (Reuters) – Measles infected nearly 10 million people in 2018 and killed 140,000, mostly children, as devastating outbreaks of the viral disease hit every region of the world, the World Health Organization said on Thursday.

In figures described by its director general as “an outrage”, the WHO said most of last year’s measles deaths were in children under five years old who had not been vaccinated.

“The fact that any child dies from a vaccine-preventable disease like measles is frankly an outrage and a collective failure to protect the world’s most vulnerable children,” said the WHO’s director general Tedros Adhanom Ghebreysus.

The picture for 2019 is even worse, the WHO said, with provisional data up to November showing a three-fold increase in case numbers compared with the same period in 2018.

The United States has already reported its highest number of measles cases in 25 years in 2019, while four countries in Europe – Albania, the Czech Republic, Greece and Britain – lost their WHO “measles-free” status in 2018 after suffering large outbreaks.

An outbreak in the South Pacific nation of Samoa has infected more than 4,200 people and killed more than 60, mostly babies and children, in a battle complicated by a vocal anti-vaccination movement.

In 2018, measles hit hardest in Liberia, Ukraine, Democratic Republic of Congo, Madagascar and Somalia, the WHO said, with these five nations accounting for nearly half of all cases worldwide.

Globally, measles vaccination rates have stagnated for almost a decade. The WHO and the UNICEF children’s fund say that in 2018, around 86% of children got a first dose of measles vaccine through routine vaccination plans, and fewer than 70% got the second dose recommended to fully protect them.

STAGGERING

Heidi Larson, director of the Vaccine Confidence Project at Britain’s London School of Hygiene & Tropical Medicine, said the numbers were “staggering”.

“Some countries are scrambling to vaccinate in the face of serious outbreaks – far too late for many,” she said.

Measles is one of the most contagious known diseases, more so than Ebola, tuberculosis or flu. It can linger in the air or on surfaces for several hours after an infected person has been and gone, putting anyone not vaccinated at risk.

Among wealthier nations, vaccination rates have been hurt by some parents shunning them for what they say are religious or philosophical reasons. Mistrust of authority and debunked myths about links to autism also weaken vaccine confidence and lead some parents to delay protecting their children.

Research published in October showed that measles infection not only carries a risk of death or severe complications including pneumonia, brain damage, blindness and deafness, but can also damage the victim’s immune memory for months or years – leaving those who survive measles vulnerable to other dangerous diseases such as flu or severe diarrhea.

The WHO data showed there were an estimated 9,769,400 cases of measles and 142,300 related deaths globally in 2018. This compares to 7,585,900 cases and 124,000 deaths in 2017.

Charlie Weller, head of vaccines at the Wellcome Trust global health charity, said the numbers were a tragedy. “If we are to protect lives, we must understand and address the reasons why measles vaccine uptake is lower,” she said.

(Reporting by Kate Kelland, editing by Gareth Jones and Hugh Lawson)

U.S. retains measles-elimination status despite worst outbreak in 25 years: CDC

(Reuters) – The United States has narrowly retained its measles elimination status by World Health Organization standards, despite seeing more than 1,200 measles cases so far this year in the worst outbreak since 1992, federal health officials said on Friday.

The U.S. Centers for Disease Control have attributed the country’s worst outbreak over the past year, which began in New York on Oct. 1, 2018, in large part to parents who declined to vaccinate their children.

The disease was declared eliminated in the United States in 2000, meaning there was no continuous transmission for a year, and the outbreak in New York this year narrowly avoided meeting that threshold. The last rash onset associated with a measles case in New York was recorded on Aug. 19.

“Both jurisdictions have since passed two incubation periods for measles with no additional reported cases associated with these outbreaks as of October 1, 2019; however, continued vigilance is important to ensure that elimination is sustained,” the CDC said in a report released on Friday.

Federal health officials have attributed this year’s outbreak to U.S. parents who refuse to vaccinate their children. These parents believe, contrary to scientific evidence, that ingredients in the vaccine can cause autism.

(Reporting by Gabriella Borter in New York; Editing by Scott Malone and Bernadette Baum)

U.S. records no new measles cases for first week since outbreak began

An illustration provides a 3D graphical representation of a spherical-shaped, measles virus particle studded with glycoprotein tubercles in this handout image obtained by Reuters April 9, 2019. Centers for Disease Control and Prevention (CDC)/Handout via REUTERS

(Reuters) – Health officials recorded no new cases of measles in the United States last week, marking the first week without new cases of the disease since the start of an outbreak largely linked to parents who declined to vaccinate their children.

The U.S. Centers for Disease Control and Prevention said on Monday it had recorded 1,241 cases of the highly contagious and sometimes deadly disease in 31 states as of Sept. 12.

The current outbreak of measles is the worst to hit the country since 1992, when 2,126 cases were reported, and threatens to end the nation’s measles-free status.

The majority of U.S. measles cases this year have occurred in children who had not received the measles-mumps-rubella vaccine, which confers immunity to the disease.

Federal health officials have attributed the outbreak in large part to a vocal fringe of U.S. parents who refuse to vaccinate their children because they believe, contrary to scientific evidence, that ingredients in them can cause autism.

U.S. Health and Human Services Secretary Alex Azar in an April that the current outbreak is “completely avoidable” and the unfortunate result of some people’s choice to deny the proven safety of vaccines.

The weekly increase in the number of cases has tapered down over the last few months, dropping to 7 new cases last week. The report of zero new cases is the latest indication that the outbreak is petering out after dozens of cases were reported per week earlier this year.

The disease was declared eliminated in the United States in 2000, meaning there was no continuous transmission of the disease for a year. Still, cases of the virus occur and spread via travelers coming from countries where measles is common.

(Reporting by Gabriella Borter in New York and Tamara Mathias in Bengaluru; Editing by Shailesh Kuber and Nick Zieminski)

U.S. recorded 18 new cases of measles last week

FILE PHOTO: Materials are seen left at demonstration by people opposed to childhood vaccination after officials in Rockland County, a New York City suburb, banned children not vaccinated against measles from public spaces, in West Nyack, New York, U.S. March 28, 2019. REUTERS/Mike Segar/File Photo

(Reuters) – The United States recorded 18 new measles cases last week, taking the total for the year to 1,095 in the worst outbreak since 1992, federal health officials said on Monday.

The U.S. Centers for Disease Control and Prevention said it has recorded cases of the highly contagious and sometimes deadly disease in 28 states as of June 27, the majority of them in New York City and nearby Rockland County.

The running tally includes both active cases and those that have since resolved. No fatalities have been reported.

Health experts say the virus has spread among school-age children whose parents declined to give them the measles-mumps-rubella vaccine, which confers immunity to the disease. A vocal fringe of U.S. parents cite concerns that the vaccine may cause autism, despite scientific studies that have debunked such claims.

Measles was declared eliminated in the United States in 2000, meaning there was no continuous transmission of the disease for a year. Still, cases of the virus occur and spread via travelers coming from countries where measles is common.

CDC officials have warned that the country risks losing its measles elimination status if the ongoing outbreak, which began in October 2018 in New York, continues until October 2019.

(Reporting by Manas Mishra in Bengaluru; Editing by Arun Koyyur and Bill Berkrot)

U.S. records 33 new measles cases, raising year’s total to 1,077

FILE PHOTO: A vial of the measles, mumps, and rubella (MMR) vaccine at the International Community Health Services clinic in Seattle, Washington, U.S., March 20, 2019. REUTERS/Lindsey Wasson

(Reuters) – The United States recorded 33 new measles cases last week, bringing the number of confirmed cases this year to 1,077 in the worst outbreak of the virus since 1992, federal health officials said on Monday.

The U.S. Centers for Disease Control and Prevention said the cases of the highly contagious and sometimes deadly disease rose 3% in the week ended June 20 from the prior week. The 2019 outbreak, which has spread to 28 states, is the worst since 1992, when 2,126 cases were recorded.

Health experts say the virus has spread among school-age children whose parents declined to give them the measles-mumps-rubella vaccine, which confers immunity to the disease. A vocal fringe of U.S. parents, some in New York’s ultra-Orthodox Jewish communities, cite concerns that the vaccine may cause autism, despite scientific studies that have debunked such claims.

The disease has mostly affected children who have not received the vaccine.

Measles was declared eliminated in the United States in 2000, meaning there was no continuous transmission of the disease for a year. Still, cases of the virus occur and spread via travelers coming from countries where measles is common.

CDC officials have warned that the country risks losing its measles elimination status if the ongoing outbreak, which began in October 2018 in New York, continues until October 2019.

The outbreak has escalated since 82 people in 2018 and more than 40 people in 2019 brought measles to the United States from other countries, most frequently Ukraine, Israel and the Philippines, federal officials said.

(Reporting by Gabriella Borter in New York and Ankur Banerjee in Bengaluru; Editing by Shailesh Kuber and Susan Thomas)

Eroding trust in vaccines leaves populations vulnerable, global study finds

FILE PHOTO: A vial of measles, mumps and rubella vaccine and an information sheet is seen at Boston Children's Hospital in Boston, Massachusetts February 26, 2015. REUTERS/Brian Snyder/File Photo

By Kate Kelland

LONDON, June 19 (Reuters) – Trust in vaccines – one of the world’s most effective and widely-used medical products – is highest in poorer countries but weaker in wealthier ones where skepticism has allowed outbreaks of diseases such as measles to persist, a global study found on Wednesday.

France has the least confidence of any country in the world in the safety and effectiveness of vaccines, with a third believing that vaccines are unsafe, according to the study.

While most parents do choose to vaccinate their children, varying levels of confidence expose vulnerabilities in some countries to potential disease outbreaks, the study’s authors said, recommending that scientists need to ensure people have access to robust information from those they trust.

Public health experts and the World Health Organization (WHO) say vaccines save up to 3 million lives every year worldwide, and decades of research evidence consistently shows they are safe and effective.

But to achieve “herd immunity” to protect whole populations, immunization coverage rates must generally be above 90% or 95%, and vaccine mistrust can quickly reduce that protection.

“Over the last century, vaccines have made many devastating infectious diseases a distant memory,” said Charlie Weller, head of vaccines at the Wellcome Trust health charity, which co-led the Wellcome Global Monitor study.

“It is reassuring that almost all parents worldwide are vaccinating their children. However, there are pockets of lower confidence in vaccines across the world.”

The spread of measles, including in major outbreaks in the United States, the Philippines and Ukraine, is just one of the health risks linked to lower confidence in vaccines.

In Afghanistan and Pakistan, false rumors about polio vaccines being part of a Western plot have in recent years hampered global efforts to wipe out the crippling disease.

The study, led by Wellcome and polling company Gallup, covered 140,000 people from more than 140 countries.

It found 6% of parents worldwide – equivalent to 188 million – say their children are unvaccinated. “The highest totals were in China at 9%, Austria at 8% and Japan at 7%.”

Seth Berkley, chief executive of the not-for-profit GAVI vaccine alliance, said the report showed a “worrying number of people” questioning vaccine safety. But by focusing on the “vocal minority” who refused to vaccinate, it was easy to forget that the vast majority trusted vaccines and the science that underpinned them.

The study also found that three-quarters of the world’s people trust doctors and nurses more than anyone else for health advice and that in most parts of the world, more education and greater trust in health systems, governments and scientists is a also sign of higher vaccine confidence.

In some high-income regions, however, confidence is weaker. Only 72% of people in North America and 73% in Northern Europe agree that vaccines are safe. In Eastern Europe, it is just 50%.

Heidi Larson, director of the vaccine confidence project at the London School of Hygiene and Tropical Medicine, worked with researchers on this study. She said it “exposes the paradox of Europe” which, despite being a region with among the highest income and education levels, also has the world’s highest levels of vaccine skepticism.

In poorer regions, trust levels tend to be much higher, with 95% in South Asia and 92% in Eastern Africa feeling confident that vaccines are safe and effective.

(Reporting by Kate Kelland; editing by John Stonestreet)

U.S. measles outbreak spreads to Idaho and Virginia, hits 1,022 cases

FILE PHOTO: A vial of the measles, mumps, and rubella (MMR) vaccine at the International Community Health Services clinic in Seattle, Washington, U.S., March 20, 2019. REUTERS/Lindsey Wasson/File Photo

The United States’ worst measles outbreak in a quarter-century spread to Idaho and Virginia last week as public health authorities on Monday reported 41 new cases of the highly contagious and sometimes deadly disease.

The U.S. has recorded 1,022 cases of the diseases this year as of June 6, in an outbreak blamed on misinformation about vaccines, the U.S. Centers for Disease Control and Prevention said.

The 2019 outbreak, which has reached 28 states, is the worst since 1992, when 2,126 cases were recorded.

Federal health officials attribute this year’s outbreak to U.S. parents who refuse to vaccinate their children. These parents believe, contrary to scientific evidence, that ingredients in the vaccine can cause autism.

“We cannot say this enough: Vaccines are a safe and highly effective public health tool that can prevent this disease and end the current outbreak,” Health and Human Services Secretary Alex Azar said in a statement last week.

Measles was declared eliminated in the United States in 2000, meaning there was no continuous transmission of the disease for a year. Still, cases of the virus occur and spread via travelers coming from countries where measles is common.

CDC officials have warned that the country risks losing its measles elimination status if the ongoing outbreak, which began in October 2018 in New York, continues until October 2019.

(Reporting by Gabriella Borter in New York and Aakash Jagadeesh Babu in Bengaluru; Editing by Scott Malone and Susan Thomas)

Measles outbreak spreads to Oklahoma as U.S. reports 41 new cases

FILE PHOTO: FILE PHOTO: FILE PHOTO: A vial of the measles, mumps, and rubella virus (MMR) vaccine is pictured at the International Community Health Services clinic in Seattle, Washington, U.S., March 20, 2019. REUTERS/Lindsey Wasson/File Photo/File Photo/File Photo

(Reuters) – The worst measles outbreak in the United States in 25 years has spread to Oklahoma, federal health officials said on Monday as they reported 41 new cases nationwide, raising the total number sickened this year to 880 people.

The U.S. Centers for Disease Control and Prevention reported a 4.9% increase in the number of measles cases from May 10 to May 17 in an outbreak that has now reached 24 states. The agency has been providing weekly updates every Monday.

The CDC said there had been one confirmed case in Oklahoma.

Most of the new cases were in New York, CDC spokesman Jason McDonald said, with 21 cases recorded in New York City and nine in Rockland County.

Health experts say the virus has spread among school-age children whose parents declined to give them the vaccine, which confers immunity to the disease. A vocal fringe of U.S. parents, some in New York’s ultra-Orthodox Jewish communities, cite concerns that the vaccine may cause autism, despite scientific studies that have debunked such claims.

Although the virus was eliminated from the country in 2000, meaning the disease was no longer a constant presence, outbreaks still happen via travelers coming from countries where measles is still common, according to the CDC.

Experts warn that the outbreak is not over as the number of cases approaches the 1994 total of 958. That was the highest number since 1992, when the CDC recorded 2,126 cases.

More than 40 people in 2019 brought measles to the United States from other countries, most frequently Ukraine, Israel and the Philippines, federal officials said.

(Reporting by Gabriella Borter in New York, Ankur Banerjee in Bengaluru; Editing by Scott Malone and Bill Berkrot)

Maine Senate rejects ending religious exemptions for vaccinations

FILE PHOTO: An illustration provides a 3D graphical representation of a spherical-shaped, measles virus particle studded with glycoprotein tubercles in this handout image obtained by Reuters April 9, 2019. Centers for Disease Control and Prevention (CDC)/Handout via REUTERS/File Photo

An effort to end all non-medical exemptions for childhood vaccinations in Maine was in limbo on Thursday after the state Senate voted to amend it to allow parents to keep opting out on religious grounds.

The bill had passed the Democratic-controlled state House of Representatives last month, making Maine one of at least seven states considering ending non-medical exemptions amid the worst outbreak of measles in the United States in 25 years.

In a close vote, 18 lawmakers in the Democratic-led state Senate supported an amendment to the House bill to retain the religious exemption that exists in state law, while 17 voted against. The senators approved ending exemptions for children whose parents oppose vaccination for “philosophical reasons.”

Several senators who had trained and worked as doctors argued at length ahead of the vote to allow an exemption only if a healthcare provider deemed it medically necessary. Others noted no major U.S. religion opposes vaccinations.

Senator Linda Sanborn, a Democrat who has practiced family medicine, said the bill was to prevent “an impending disaster” in a state with one of the lowest vaccination rates in the country. Five percent of Maine’s kindergarten students have non-medical exemptions from vaccination, compared with a national average of 2 percent.

She said other fatal diseases could follow the fate of smallpox, which was globally eradicated through vaccination efforts, adding: “It takes a community caring about not just ourselves but our neighbors to make this happen.”

Senate Republicans, including Scott Cyrway, opposed the bill as government overreach into the private sphere.

“We’re forcing someone to do something when we don’t really have to,” Cyrway said.

In neighboring Vermont, lawmakers voted in 2015 to remove philosophical exemptions while leaving in place religious ones. As a result, more parents sought and received those exemptions – 3.9 percent in 2017, up from 0.9 percent in 2015, according to the state’s Department of Health.

In Maine, the amended bill will go back to the House, which can vote either to accept or reject the amendment. If both chambers cannot agree, the bill dies.

A spokeswoman for the House did not immediately respond to a request for comment.

There have been no measles cases in Maine since 2007, but officials have worried about recent outbreaks of whooping cough, another childhood disease for which there is a mandatory vaccination.

Only three states have outlawed any non-medical exemptions for vaccinations – California, Mississippi and West Virginia.

(Reporting by Jonathan Allen; Editing by Scott Malone and Peter Cooney)