A lot of attention has been directed at the recent measles outbreaks in North America and western Europe. Meanwhile, slightly away from the media spotlight, there’s a lesser-known outbreak of the virus that’s taken the lives of at least 922 people since October 2018.

The World Health Organization (WHO) told reporters on February 14 there were over 66,000 reported measles cases and at least 922 deaths in Madagascar between October 2018 to February 12, 2019. 

The overwhelming majority of these cases and deaths were children, they added. It’s also worth noting that fewer than 10 percent of actual measles cases are reported globally, so the real figure is likely to be much higher.

Dr Katrina Kretsinger, head of WHO’s expanded immunization program, also cited significant outbreaks of the disease in Ukraine, the Democratic Republic of Congo, Chad, and Sierra Leone. 

The measles virus is highly contagious and easily spread through coughing and sneezing. Once infected, people will experience a nasty fever, a distinctive rash, and a cough. It is also potentially deadly and can cause complications such as blindness and brain swelling.

However, the disease is easily preventable through two doses of a measles-containing vaccine.

All of this tragedy in Madagascar is inseparable from the African island nation's relatively low vaccination rate. In 2017, the estimated immunization rate was just 58 percent. For perspective, the rate in the WHO European Region was 94 percent in 2008. In light of this outbreak, the country is receiving an emergency outbreak response that’s already vaccinated 2.2 million of the 26 million population so far. 

The current situation serves as a clear demonstration of how under-vaccination rates can affect a community. If a relatively low percentage of people in a population are vaccinated, this allows the disease to spread significantly quicker and further. If an outbreak hits a population with widespread vaccination, the disease struggles to spread and the links to vulnerable people in the population are more likely to be cut off. To encourage such a scenario, the WHO recommends at least 95 percent immunization coverage with two doses of measles-containing vaccine.

Vaccination rates have been in steady decline in Europe and parts of North America for a number of years, namely thanks to mistrust of the vaccine's side-effects – concerns which have been categorically disproven and rejected by every major health organization in the world. As Madagascar shows, the dangers of under-vaccination in a community are very real and far-reaching. 

“Madagascar started with a few cases; now, we are almost close to 60,000 and the cases are still increasing,” said Richard Mihigo, coordinator for the World Health Organization’s immunization and vaccine development program at its regional office for Africa, according to The Washington Post. “I think societies like the US and western Europe should ring the bell and see… this is something that could also happen to them.”