Ebola Measles Outbreak

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Measles and Ebola. Getty

Well, in a way, yes.

Now that Ebola is receding, the countries most affected by Ebola – Guinea, Sierra Leone, and Liberia - may face more infectious diseases.

Ebola disrupts healthcare. It doesn’t just kill people, it kills hospitals. It stops the provision of emergency and preventative health care.

Ebola closes local health posts when nurses are infected. Parents don’t bring their children in for routine vaccinations.

Others don’t seek basic medical care, afraid of catching Ebola from health facilities.

Vaccination rates for multiple infectious diseases dropped as Ebola roared. UNICEF reports that vaccination for Diphtheria, Whooping Cough (Pertussis), Hib (Haemophilus Influenza), and Hepatitis B (all in one vaccine) were above the 90% age group targeted until August 2014 when Ebola surged and vaccination dropped. The only district where vaccination improved was the last district to see Ebola (which had no cases until October).

Measles returns

Even worse, in Sierra Leone, measles vaccination of targeted age groups dropped from 99% in January to 76% in July.  

By February 2015, measles was seen in Sierra Leone. This is the start of the “measles season”. Measles in West Africa usually appears in the dry season (January to July) in Sierra Leone and other parts of West Africa.

Measles has been a problem well before Ebola – and around the world.

UNICEF reports that Guinea, one of the 3 most Ebola-affected countries, had a measles outbreak in the early part of 2014 before Ebola had spread widely. In 2013, 59 infections were seen in Guinea; 215 in 2014. Likewise, Sierra Leone saw a rise from 2013 to 2014 from 13 to 39. Liberia had no cases in 2013, but 4 in 2014.

The reported cases were still small numbers but measles spreads. An outbreak can snowball.

There are also a lot of ways to stop measles from spreading. Catch-up vaccination and isolating infected patients can make a difference. Sierra Leone has successfully vaccinated in the past at the beginning of an outbreak.

There are also reasons why it's really important to make sure measles doesn’t spread. A case measles is a lot less deadly than Ebola, but it can be deadly and is also a lot more infectious. An Ebola patient may infect 2 other people. A measles patient may infect 15 or more. Measles spreads in the air and can be spread before there’s a rash. One case of measles can create an outbreak before anyone knows measles is spreading.

There may also be more chance for diseases to spread. Travel restrictions have been lifted in areas once affected by Ebola. During the height of the Ebola outbreak, roadblocks and lockdowns prevented movement. Curfews were in place. Schools were closed. Public gatherings were limited.

Many people were quarantined because someone they knew had Ebola. People simply did not travel very much as the region faced this epidemic.

Schools have begun reopening in February 2015 in Liberia and plan to reopen at the end of March in Sierra Leone. Life will hopefully go back to normal, as best as as it can. Hopefully it will be without any more disease outbreaks, and hopefully no more Ebola and no measles. We however always need to be mindful that when a disease overwhelms and affects health systems, other diseases can follow in its wake.

Diseases affect other diseases. Ebola has already taken close to 10,000 lives. It is important that it does not have any further repercussions on the health systems it has stormed through.

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