2014 was a brutal year for measles in the Philippines as the country saw more than 58,000 cases and 110 fatalities. For the first nine months of last year, the archipelago reported in excess of 53,000 cases and 102 deaths.

Photographed early in 2014 in the Philippines capital city of Manila, this baby was in a hospital with measles (rubeola)/Jim Goodson, M.P.H.
Photographed early in 2014 in the Philippines capital city of Manila, this baby was in a hospital with measles (rubeola)/Jim Goodson, M.P.H.

What a difference a year makes.

For the first nine months of 2015, the Philippines has only seen 3,052 cases and three deaths. Dramatic.

Much of this can likely be attributed to mass measles vaccination campaigns in September and October of 2014.

In a follow-up to the measles outbreak in Mongolia, after reporting 20,010 cases during the first eight months of the year, September showed a dramatic slowdown of only 151 cases.

Mongolia was declared measles-free by the World Health Organization in 2014. In fact, prior to the outbreak that began in March this year, the rash onset of the last confirmed measles case in Mongolia was in the summer of 2010.

Measles is a highly contagious, serious disease caused by a virus. In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year.

Measles is caused by a virus in the paramyxovirus family and it is normally passed through direct contact and through the air. The virus infects the mucous membranes, then spreads throughout the body. Measles is a human disease and is not known to occur in animals.

According to WHO, the first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about 3 days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days).

Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of 5, or adults over the age of 20. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia.

Worldwide, measles kills 400 people a day—or about 16 deaths every hour, most of whom are children under the age of five. “Measles is the most highly infectious disease known, and it is easily prevented with just two doses of measles vaccine,” said Dr Sergey Diorditsa, Coordinator, Expanded Programme on Immunization for the WHO Western Pacific Region.

Robert Herriman is a microbiologist and the Editor-in-Chief of Outbreak News Today and the Executive Editor of The Global Dispatch

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