Worldwide Measles Epidemic

I read with interest the manuscript “On the Brink: Why the U.S. is in Danger if Losing Measles Elimination Status” by Mary Anne Jackson and Christopher Harrison in the July/August 2019 issue of Missouri Medicine.¹

The message delivered was compelling and concerning, but to my view left out an important statistic.

The largest measles outbreak in Europe in 2018 occurred in Ukraine, with more than 54,000 cases and 16 confirmed measles deaths.²

Figure 3, from their otherwise excellent manuscript¹ omitted this data. Of course, Ukraine, though located in Europe, is not a member of the European Union.

If Ukraine’s measles incidence had been displayed on Figure 3, the red dot would perhaps have been large enough to cover the entire nation of Ukraine.

Being a somewhat regular visitor to Poland, with Poland being located immediately west of Ukraine, being a member of the EU, and being currently impacted by cross-border measles importation, I may be more aware of Ukraine’s plight than most MSMA members.

Nonetheless, to omit Ukraine, to omit discussion of it’s largely in-immunized population, and to omit the magnitude of Ukraine’s current measles burden, I feel a large part of the measles story was inadvertently not communicated.