There is a measles outbreak in Cameroon, mostly in kids of fighters fleeing Boko Haram terrorist, causing the country to ramp up vaccination.  Approximately 100 vaccination teams have been deployed to try to vaccinate 67,000 at-risk kids. The government said that several dozen measles infections have been reported in the past 2 weeks, but most people do not visit conventional healthcare facilities, so the actual rate is likely higher. The last measles outbreak in Cameroon was in 2010-2011.

In 2020, there were 1,500 confirmed Measles cases in Cameroon, 74% of them were in the unvaccinated. Because of COVID, many parents did not bring their kids to hospitals or health centers to be vaccinated. In fact, around the globe, the COVID-19 pandemic has stalled child vaccinations for Measles, and other childhood vaccine-preventable illnesses, a trend that worries public health officials. It’s become so worrisome, that the American Academy of Pediatrics issued a warning in July. In Alabama from 2019-2021, the rate of vaccination for 16 childhood illnesses has decreased by 26%. In Louisiana, the rate of at least 1 dose of the MMR (Mealses, Mumps, Rubella) vaccine for 2 year olds in 2020 was 89%, which is below the US average of 2020 (93%). A virus as contagious as Measles can do tremendous damage in developing nations with low rates of vaccinations, little access to vaccines, poor nutrition and Vitamin A deficiency. Throughout the first half of 2021, the Democratic Republic of Congo (DRC) recorded 13,000 cases of Measles. This is after the country experienced one of the worst Measles outbreaks in history: between 2018-2020, more than 460,000 kids contracted Measles and 8,000 of them died, with three-quarters being under the age of 5. Madagascar also had a huge Measles outbreak from 2018-2020. 240,000 Measle cases were reported and 1,000 people, mostly kids, died. While some public health officials think fear over the new COVID vaccines may be fueling fear of all vaccines (definitely a concerning trend!) the low rates are likely due to the logistics of the pandemic and wanting to avoid hospitals and clinics out of fear of catching COVID.

The measles outbreak in Cameroon is concerning but not unexpected amongst an unvaccinated population. It’s a ridiculously contagious virus with a ridiculously high reproductive number of 12-18, which means that for every person who gets it, he/she will pass it on to 12-18 others. With those kinds of numbers, you get to exponential spread fast in a susceptible ( unvaccinated/unimmune) population. It spreads via coughing, oral secretions and sneezing. Kids who die from Measles do so from complications, including pneumonia or dehydration. Bad cases of Measles can result in long-term side effects, including vision difficulties or blidness, hearing loss and brain damage. Measles also creates something called “immune amnesia” for months to years after recovery. Immune amnesia means that a virus (like Measles) damages your pre-existing immune memory and cells, thereby making you more vulnerable to future infections. What’s also interesting to think about is how we’ve always had “long stuff” after a virus or infection. Everyone is discussing long COVID today, as if long-term consequences from an infectious disease is a new thing, but this has always been a thing. The 24/7 COVID coverage just put it in the spotlight. In addition to things like “immune amnesia” from Measles, some of you might remember that I did a podcast on PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep Infections) with  Dr. Steve Hyman, former head of the National Institute of Mental Health. It’s fascinating stuff and absolutely worth listening to, especially if you have kids- because they will get Strep infections. (You can listen to the podcast here.)

There is no treatment for Measles, only supportive care, but you can prevent it with the MMR vaccine. It’s given as 2 doses. The vaccine is a weakened virus that can’t cause disease but allows your immune system to respond to it and build up protection in case you are exposed to the actual virus in the future. Sadly, and even though the MMR vaccine has been around since the 1960s, due to money and access issues, kids in poor countries are lucky to get just 1 dose. Given how contagious Measles is ( its high reproductive number), it’s extremely difficult to prevent all outbreaks in these countries with just 1 dose, and therefore kids will die. Rich countries often forget how good we have it.

After reading Measles in Cameroon, also check out: 

Gonorrhea from a Hot Tub: An Unusual Case

COVID-19 in Deer: Spill Over from Humans & What this Means for the Pandemic