SHARP RISE IN MEASLES CASES IN AFGHANISTAN

Measles is endemic in Afghanistan. Following periods of lower transmission in 2019 and 2020, measles cases have been increasing in all provinces since the end of July 2021, with the highest weekly toll observed so far occurring over the last four weeks. The number of cases and deaths increased by 18% in the week of January 24, and 40% in the week of January 31.

35 319 suspected cases of measles and 156 deaths have been reported in Afghanistan from 1 January 2021 to 29 January 2022. Of these, 3221 cases were laboratory confirmed. Ninety-one percent of these cases and 97% of these deaths were in children under five years-old.

Although the number of deaths is relatively low, the rapid rise in cases in January 2022 suggests that the number of deaths due to measles is likely to increase sharply in the coming weeks.

It is also important to note that measles-related deaths are not always reported or captured through surveillance systems.

The rise in measles cases is especially concerning because of the extremely high levels of malnutrition in Afghanistan. Malnutrition weakens immunity, making people more vulnerable to illness and death from diseases like measles – especially children. In addition, measles infection can cause immune system suppression and immunologic amnesia, which increases susceptibility to all pathogens, including those to which the individual was previously immune.

Measles is an extremely contagious viral disease. Unvaccinated young children are at highest risk. Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by other diseases. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, and severe respiratory infections such as pneumonia.

WHO response

In response to the recent rise in measles cases in Afghanistan, WHO and partners are strengthening measles surveillance capacities and providing technical support for lab testing, case management, risk communication, vitamin A distribution, and outbreak response immunization campaigns.

In December 2021, a measles outbreak response immunization campaign was carried out in some of the most affected provinces, reaching 1.5 million children. Providing children with vitamin A, especially in the context of widespread malnutrition, is also critical to help reduce sickness and death from measles. Vitamin A supplementation was provided to the 8.5 million children (aged 6-59 months) who were reached through a nationwide polio campaign in Afghanistan in November 2021.

WHO is now helping to plan for a larger measles outbreak response immunization campaign, which will start in May (or earlier, if possible), aiming to reach more than 3 million children. Support from WHO includes helping with the process needed to secure additional vaccines and devices, and operational funds and support for planning the campaign.

The best way to protect people – especially children – from measles is for countries to strengthen routine immunization to ensure that at least 95% of their population has received two doses of measles-containing vaccine.

About WHO

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing.