Four European countries officially lose measles-free status

Because of several measles outbreaks in the UK, Greece, Czech Republic and Albania, these Four European states are no longer considered "measles-free.” Measles is considered eliminated when there is no endemic disease transmission for 12 months or more in a specific geographic area.

Measles is highly contagious and common complications include diarrhea and vomiting, which can lead to dehydration, middle ear infection (otitis media), eye infection (conjunctivitis), inflammation of the voice box (laryngitis), infections of the airways and lungs and fits caused by a fever (febrile seizures). Measles is also potentially fatal. Other complications include blindness and, for pregnant women, miscarriage.

"Re-establishment of measles transmission is concerning. If high immunization coverage is not achieved and sustained in every community, both children and adults will suffer unnecessarily and some will tragically die," warned Gunter Pfaff, the head of the WHO's European Regional Verification Commission for Measles and Rubella Elimination.

Close to 365,000 cases have been reported worldwide this year, the WHO said, almost three times as many as in the first half of 2018. There were 89,994 cases of measles in 48 European countries in the first six months of 2019, more than double the number in the same period in 2018 when there were 44,175 cases, and already more than the 84,462 cases reported for all of 2018. The UK reported 953 cases in 2018 and 489 for the first six months of 2019. In the same periods Greece reported 2,193 and 28 cases, Albania 1,466 and 475, and the Czech Republic 217 and 569. Based on 2018 data, the disease is no longer considered eliminated in the UK, Greece, the Czech Republic and Albania.

"Each of these countries are examples that have extremely high national vaccination coverage. So these are not examples of countries that have particularly weak systems," said Kate O'Brien, director of the WHO's Immunization Department. "This is the alarm bell that is ringing around the world: being able to achieve high national coverage is not enough, it has to be achieved in every community, and every family for every child," she said.

While the disease is highly contagious, it can be entirely prevented through a two-dose vaccine, but the WHO has in recent months sounded the alarm over vaccination rates. According to the WHO, more than 20 million deaths have been prevented around the globe between 2000 and 2016 thanks to measles vaccination.

UK Prime Minister Boris Johnson has called on health leaders to address the issue. Current statistics show that current second round vaccinations for children in the UK is at only 87.2 percent. Mary Ramsay, of the government agency Public Health England, states, "Anyone who has not received two doses of MMR vaccine is always at risk."

Four countries were home to 78% of cases in the first six months of 2019: Ukraine, Kazakhstan, Georgia and Russia—60% of which were reported in Ukraine alone. Worldwide, the number of cases for January 1 to July 31 this year tripled to 364,808, compared with 129,239 during the same seven months last year. The highest numbers of measles cases were reported in the Democratic Republic of Congo, Madagascar, and Ukraine. The United States meanwhile registered its highest number of cases in 25 years. The numbers are especially worrying as nine in 10 cases are believed to go unrecorded worldwide, according to WHO.

The disease had been officially eliminated in many countries with advanced healthcare systems, with numbers steadily decreasing until 2016 when a resurgence began. Austria and Switzerland were confirmed to have elimination status in 2018. Measles has been eliminated in 35 of the 53 countries in the WHO's European region for 2018, from 37 in 2017. Early this year, Sri Lanka has been declared measles-free. Across the Atlantic, Americans have already suffered a record high measles outbreak in 2019. The Center for Disease Control and Prevention recently published a report showing that there were 1,172 cases so far with 124 hospitalizations and 64 reported serious health complications.

According to the WHO, the reasons for people not being vaccinated vary significantly between communities and countries, with a lack of access to quality healthcare or vaccination services hindering some from getting the jabs, while others may be misinformed about vaccines and the need to vaccinate. Some aren't following up on their shots because they believe that measles no longer poses any risk. In situations when a disease like measles is eradicated, people start to think the disease isn't around anymore.