29 May 2015 vol 348, issue 6238, pages 941-1052
Is measles next?
Before the polio virus is even in the grave, a small cadre of disease fighters is itching to set the next global eradication target: measles. The case is compelling. Measles killed 145,000 children last year in poor countries and left many more blind, deaf, or disabled. A cheap and effective vaccine has long been on the shelves; numerous expert panels have deemed measles eradication feasible, although daunting—it is the most contagious virus on Earth. But the biggest obstacle to measles eradication is polio, which hasn’t disappeared as it was supposed to do in 2000. Skeptics question whether a measles initiative would fall down the same rabbit hole as did the polio effort, which has spent billions of dollars and nearly 3 decades chasing the last few cases, only to see them disappear around the corner. Maybe it is time, they say, to settle for keeping measles cases really low but not trying to get to zero…
In Vietnam, an anatomy of a measles outbreak
Routine immunization is one of the great public health success stories in Vietnam, where rates of vaccine-preventable diseases have plummeted. But the measles outbreak last year was another story, with 60,000 reported cases and nearly 150 deaths in children under age 2. Experts trace the epidemic to the public’s loss of faith in the government-led vaccination program, following reports of adverse events associated in time with another vaccine. Many parents stopped vaccinating their children, leaving them susceptible to measles. When the virus swept in from the north and hit Hanoi, it exploded. Panicked parents rushed their children to the hospital, which was quickly overburdened. With poor infection control, the hospital became a hub of measles transmission, and children who weren’t already infected caught the virus there.