Ebola-hit countries more susceptible to measles epidemic

West African countries most affected by the 2014 Ebola outbreak could now be highly susceptible to a measles epidemic due to disruptions in routine health care such as vaccinations, US scientists have warned.
Researchers said that if a large measles outbreak occurs in the region, nearly twice as many people could be sickened by the disease and thousands more could die.
For every month of interruption in the health care system, researchers said, an additional 20,000 children between the ages of nine months and five years become susceptible to the measles.
"The secondary effects of Ebola - both in childhood infections and other health outcomes - are potentially as devastating in terms of loss of life as the disease itself," said study leader Justin Lessler, an assistant professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health.

"While the downstream effects of Ebola are many, we can actually do something about measles relatively cheaply and easily, saving many lives by restarting derailed vaccination campaigns," Lessler said.
The current Ebola outbreak began in March 2014 and since then there have been more than 14,200 confirmed cases in Guinea, Liberia and Sierra Leone, with more than 9,500 deaths blamed on the disease in those nations.

Many health-care facilities in the region have been closed; many citizens have stayed away from those that are open for fear of contracting the deadly disease. As a result, many have not received routine medical care.

In the study in the journal Science, Lessler and his colleagues used data-driven models of the region to estimate potential measles outbreak risk, attack rates and mortality rates resulting from a 75-per cent disruption in health care services in West Africa stemming from the Ebola outbreak.
The researchers estimated that prior to this Ebola outbreak there were about 778,000 children between nine months and five years old in the three nations who had not been vaccinated against measles, equating to roughly 4 per cent of the population.
After 18 months of Ebola-related disruptions to the health-care system, the researchers estimated, there will be up to 1,129,000 unvaccinated children between the ages of nine months and five years, a 45 per cent increase.

In the event of a large regional measles outbreak, the number of estimated cases was roughly 127,000 before Ebola and, after 18 months of interruption, an additional 100,000 cases would be estimated to occur.
The lion's share of these cases would likely be in young children who are at greater risk of complications. The researchers estimated that between 2,000 and 16,000 additional measles deaths could occur in such an outbreak.
Lessler said the Ebola epidemic has also slowed delivery of the oral polio vaccine, a tuberculosis vaccine and the pentavalent vaccine, which protects against Haemophilus influenzae type b, whooping cough, tetanus, hepatitis B and diphtheria.