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Measles claims 140,000 lives as cases surge worldwide

Most deaths among children under five in 2018, show latest international data

Caroline White

Friday, 06 December 2019

Measles claimed more than 140,000 lives in 2018, show the latest estimates* from the World Health Organisation (WHO) and the US Centers for Diseases Control and Prevention (CDC). Most deaths were among children under the age of five.

Recent evidence shows that the measles virus can damage the immune system’s ‘memory’ for months or even years after infection, leaving survivors vulnerable to other potentially deadly diseases, like the flu.

The worst affected regions of the world were in sub-Saharan Africa, where many children have persistently missed out on vaccination.

In 2018, the countries with the highest number of new cases were Democratic Republic of the Congo (DRC), Liberia, Madagascar, Somalia and Ukraine. These five countries accounted for almost half of all measles cases worldwide.

This year’s modelling shows that there were 9,769,400 estimated measles cases and 142,300 related deaths globally in 2018, compared with 28,219,100 cases and 535,600 deaths in 2000. In 2017, there were 7,585,900 estimated cases and 124,000 estimated deaths.

By region in 2018, WHO estimates that in the African region, there were 1,759,000 total cases and 52,600 deaths; in the Region of the Americas, 83,500 cases; in the Eastern Mediterranean Region, 2,852,700 cases and 49,000 deaths; in the European region, 861,800 cases and 200 deaths; in Southeast Asia, 3,803,800 cases and 39,100 deaths; and in the Western Pacific, 408,400 cases and 1300 deaths.

A total of 353,236 cases were reported to WHO in 2018. In 2019, as of mid-November, there had already been over 413,000 cases reported globally, with an additional 250,000 cases in DRC. Taken together, this marks a three-fold increase compared with this same time last year.

“The fact that any child dies from a vaccine-preventable disease like measles is frankly an outrage and a collective failure to protect the world’s most vulnerable children,” said Dr Tedros Adhanom Ghebreysus, director-general of the WHO.

“To save lives, we must ensure everyone can benefit from vaccines - which means investing in immunisation and quality health care as a right for all.”

Vaccination rates globally have stagnated for almost a decade. WHO and UNICEF estimate that 86% of children globally received the first dose of measles vaccine through their country’s routine vaccination services in 2018, but fewer than 70% received the second recommended dose.

Worldwide, coverage with measles vaccine is not adequate to prevent outbreaks. WHO recommends that 95% vaccination coverage with two doses of measles vaccine is needed in each country and all communities to protect populations from the disease.

“We’ve had a safe and effective measles vaccine for over 50 years,” said Dr Robert Linkins, branch chief of Accelerated Disease Control and Vaccine Preventable Disease Surveillance at the CDC and chair of the Measles & Rubella Initiative.

“These estimates remind us that every child, everywhere needs – and deserves - this life-saving vaccine. We must turn this trend around and stop these preventable deaths by improving measles vaccine access and coverage.”

While the greatest impacts have been in the poorest countries, some wealthier countries have also been battling measles outbreaks, with significant ramifications for population health.

This year, the United States reported its highest number of cases in 25 years, while Albania, Czechia, Greece and the United Kingdom lost their measles elimination status in 2018 after protracted outbreaks of the disease. This happens if measles re-enters a country after it has been declared eliminated, and if transmission is sustained continuously in the country for more than a year.

“While hesitancy and complacency are challenges to overcome, the largest measles outbreaks have hit countries with weak routine immunisation and health systems. We must do better at reaching the most vulnerable, and that will be a fundamental focus of Gavi’s next five-year period,” commented Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance.

Over the past 18 years, measles vaccination alone is estimated to have saved more than 23 million lives.


*Measles and Rubella Surveillance Data. Figures prepared by WHO, 2019.

See also WHO factsheetCDC measles pages

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