Despite Advances, Measles Eradication Still Far Off

In what has been hailed as an historic victory for global health, directors of many of the world's largest health organizations announced Thursday that through an effort called the Measles Initiative, the death rate from measles declined by 60 percent between 1999 and 2005.

Now they have set a new goal -- to reduce measles deaths by 90 percent by 2010. And some have suggested that eliminating measles may be a possibility.

"We have an opportunity here to leave a lasting mark on the world through the eradication or elimination of diseases," said Kathy Bushkin, executive director of the United Nations Foundation in a press conference held Thursday. "We've already seen the eradication of smallpox, and we're close to eradicating polio."

But the total eradication of measles could be a different issue altogether. And some disease experts say such a goal may be difficult, or even impossible, to achieve.

One such expert is Dr. Samuel Katz, chairman emeritus of pediatrics at Duke University Medical Center. He said that through current means, the complete eradication of measles is "just not feasible."

"It is a little bit overly optimistic to talk about getting rid of measles entirely, and I think that we are whistling "Dixie" if we think we are going to get rid of measles in a few years," Katz said.

Dr. Pascal Imperato, chairman of the department of preventive medicine at the SUNY Downstate Medical Center, is no stranger to the measles battle; he immunized African children himself in the 1960s and 1970s.

And he said that though eliminating the disease is technically possible, it is a very difficult goal to achieve.

"Our hope at that time was to control it, not to eradicate it, because we knew that we could not hope to eradicate it," Imperato said.

"I think eradication is possible. But whether it is probable or not is another question."

High Immunization Rates

The good news is that it would technically be possible to completely eliminate measles using a tool that we already have.

This tool is the same measles vaccine that has existed for more than 40 years.

Now for the bad news -- measles is so contagious that to eradicate it, nearly every child would have to be immunized over an extended period of time.

"It is probably the most contagious of any of the viruses we deal with, and the transmission is very rapid," Katz said.

Worse, the disease is so infectious that sick children can infect others before they even exhibit any symptoms.

"It is a virus that is very, very likely to spread to other children who are unimmunized," Katz said. "All you need are a few children who are not immunized, and you have a problem."

"To get herd immunity we need to achieve at least 95 percent coverage," said Dr. Margaret Chan, director-general of the World Health Organization, at Thursday's press conference.

This means that 95 percent of children in affected countries would have to get measles shots for it to be possible to eliminate the disease.

The prospects of such an achievement face many challenges, most of which have to do with distributing the vaccine.

Many affected children may live in remote communities with little infrastructure and few amenities. Getting trained personnel to administer the shots is another consideration.

And regional conflicts in certain developing countries could threaten the effort, which would need to be sustained over many years to ensure complete effectiveness.

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