Measles nearly eradicated in U.S., health officials say

By CHARLES ORNSTEIN
Los Angeles Times

LOS ANGELES -- Measles, which afflicted most American children with red blotches just two generations ago, is nearing extinction in the United States, a feat that some health officials liken to the victories against smallpox and polio.

Federal health officials logged only 37 measles cases nationwide in 2002, down from 116 the year before.

"This has been a dramatic success story of the vaccination program," said Dr. Paul Offit, chief of infectious diseases at the Children's Hospital of Philadelphia and a member of the U.S. Advisory Committee on Immunization Practices.

The success seen in the United States, however, only accentuates the failures in the developing world. Globally, measles remains the leading cause of vaccine-preventable death among children under age 5. Roughly 30 million children worldwide contract the virus annually, and 745,000 died from it in 2001 -- half of them in Africa.

In 1990, the World Summit for Children set a goal of vaccinating 90 percent of children worldwide against measles by 2000. It didn't come close. The global immunization rate hovered around 70 percent throughout the decade, according to UNICEF. Coverage in sub-Saharan Africa dropped from 62 percent in 1990 to 50 percent in 1999.

Some say this performance is inexcusable given the effectiveness and low cost of the vaccine -- less than a dollar per child. But others note that measles has been eclipsed by other major public health concerns, such as eradicating polio and treating AIDS.

"It's unacceptable for children to die from measles when definitely they could be protected by immunization," said Mohammad Jalloh, a spokesman for UNICEF. "That's why we are moving now to make sure that we intensify the campaigns."

The progress in the Western hemisphere is, at least, a reminder of what is possible. Cases have declined from a high of about 250,000 in 1990 to an all-time low of 548 in 2001. (Because of outbreaks in Venezuela and Colombia, that number increased to 2,572 last year.)