The disruption of the Ebola virus may be wreaking havoc on
the measles vaccination programs in the three affected nations,
and such secondary effects are potentially "as devastating in
terms of loss of life as the disease itself," says Justin Lessler, PhD, leader of a study that models the knock-on impact.
The study, published today in Science, is a warning, says Dr.
Lessler - an assistant professor in epidemiology at the Johns
Hopkins Bloomberg School of Public Health - that: "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."
The study estimates that, before the Ebola outbreak, lack of
measles vaccination affected about 778,000 children in the
relevant age group in the three affected nations of Guinea,
Liberia and Sierra Leone - amounting to roughly 4% of the
population.
That estimate rises to 1,129,000 unvaccinated children between
the ages of 9 months and 5 years after a year-and-a-half of
"Ebola-related disruptions to the health care system" - or a 45% rise in lost vaccine coverage.
The researchers summarize the picture: for every month of
interruption in the health care system, "an additional 20,000 children" in this age group become susceptible to the measles.
To reach the estimates in the analysis, Dr. Lessler and his
colleagues used data-driven models of the region. The 18-
month forecasts are based on geospatial mapping and age-
related patterns of measles susceptibility.
They modeled the potential toll of measles, including for death
rates, resulting from 4 levels of disruption to health care
services in the region:
25% reduction in health care services due to Ebola outbreak
50% effect
75% health care reduction - where the researchers believe
the level of disruption has peaked
100% disruption.
The focus on Ebola's disruptive effects was in terms of measles
in the study, but Dr. Lessler believes the crisis has also slowed delivery of vaccines against other infectious diseases.
Dr. Lessler estimates that between 600,000 and 700,000
children in the region are not receiving these vaccines: the oral polio vaccine, tuberculosis vaccine, and the pentavalent
vaccine, which protects against meningitis, pneumonia and otitis caused by Haemophilus influenzae type b, whooping cough or pertussis, tetanus, hepatitis B and diphtheria.
Further, the provision of health care to people with malaria and HIV has also been disrupted.
Dr. Lessler has this warning about the bigger picture: The rise in measles cases in the US, alongside a fall in vaccine
uptake, as cited by the CDC (the Centers for Disease Control
and Prevention), is the subject of an MNT Spotlight feature.
The Ebola news topic is a hot one, and among the most recent
stories, a case study revealed last week that a needle stick-
injured Ebola doctor from the US was free of the virus after an experimental vaccination. And last month, scientists
determined that the Ebola virus can survive in victims' bodies for days.
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