2023-10-24 21:17:00
After the WHO Region of the Americas was declared measles-free in September 2016, a steady increase in measles cases imported from other WHO Regions and between countries in the Region of the Americas was observed between 2017 and 2019.
In 2019a total of 20,554 confirmed cases measles, including 19 deaths, have been reported in 14 countries and territories in the Region of the Americas: Argentina (107 cases), Bahamas (3 cases), Brazil (18,203 cases, including 15 deaths), Canada (113 cases), Chile (11 cases), Colombia (244 cases, including 1 death), Costa Rica (10 cases), Cuba (1 case), Curaçao (1 case), Mexico (20 cases), Peru (2 cases), United States America (1,282 cases), Uruguay (9 cases) and Bolivarian Republic of Venezuela (548 cases, including 3 deaths). Measles outbreaks reported in Brazil and the Bolivarian Republic of Venezuela contributed to 92% of reported cases during this period.
In 2020the number of confirmed cases measles decreased by 2.7 times compared to 2019, with outbreaks reported in Argentina and Mexico. This decrease in cases in 2020 can be explained by the social distancing measures imposed by the COVID-19 pandemic. Between 2020 and 2022, endemic circulation of the measles virus continued in Brazil.
In 2021, 730 confirmed cases Measles cases have been reported in the region, distributed as follows: Brazil (676), French Guiana (5) and the United States (49). The cases reported in French Guiana had a history of travel to Brazil.
In 2022, 167 cases have been confirmed, reported in Argentina (2), Brazil (49), Canada (3), Ecuador (1), Paraguay (1) and the United States (118). The genotypes identified between 2018 and 2022 were D8 and B3 among 100% of confirmed cases for which genetic sequencing was performed; between 2018 and 2020, the proportion of the D8 genotype was higher, with an average of 92.5%, compared to B3 (average of 7.5%). However, the proportion of the B3 genotype increased in 2021 (20.5%) and 2022 (50%) among samples for which genetic sequencing was carried out.
The year 2023 was characterized by the lowest number of reported measles cases. Notably, during epidemiological week (SE) 1 to SE 42, three countries in the WHO Region of the Americas have reported confirmed cases of measles : Canada with 8 cases, Chile with 1 case and the United States of America with 29 cases.
Au Canadabetween EW 1 and EW 39 of 2023, 8 confirmed cases measles imported or linked to an importation were reported by the provinces of Ontario (6 cases), Nova Scotia (1 case) and without information on the province (1 case). In 2023, genotyping carried out on samples from 7 cases made it possible to identify the D8 genotype (n=5) and the B3 genotype (n=2). Chilion August 12, 2023, the national IHR focal point of this country reported a confirmed case measles by serology and PCR. The patient is a 42-year-old Chilean citizen residing in the metropolitan area. He traveled to Armenia and Georgia (July 16 and 26), which corresponds to the incubation period. Symptoms began on August 7 with fever and then progressed to rash, conjunctivitis and arthralgia. UNITED STATESbetween January 1, 2023 and September 29, 2023, 29 confirmed cases measles have been reported in 16 jurisdictions. Vaccination status was as follows: 19 (66%) were not vaccinated, 5 (17%) were vaccinated and 5 (17%) had unknown vaccination status. Travel countries 16 cases directly imported were: South Africa (1), Armenia (1), Ethiopia (2), India (4), Kazakhstan (1), Romania (1), Russia (1), Russia/Turkey (1), Saudi Arabia /Turkey (1), Tanzania (1), Tanzania/Uganda (1), Yemen (1). The genotypes identified were B3 and D8.
PAHO/WHO recommends remaining vigilant in the face of the potential appearance of suspected and/or confirmed cases imported from other regions of the world and the appearance of new outbreaks of varying magnitude in the Region of the Americas. The following risk factors should be considered:
gaps in the performance of international indicators for integrated measles and rubella surveillance; the weak vaccination coverage first and second doses of measles, mumps and rubella vaccine (MMR1 and MMR2) in many countries and territories in the Region since 2020 (except Chile with a CV of 94% for the first dose of MMR, the other countries of the South American continent have CVs lower than 90%, or even lower than 70% for Paraguay (54%), Venezuela (68%) and Bolivia (69%); active circulation of the virus in other WHO Regions; migratory flows of vulnerable populations within the WHO Region of the Americas and from other WHO Regions; and the occurrence of mass gatherings in the Region, where people from various parts of the continent come together.
Source: Pan American Health Organization
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