al-Razi examining a patient (miniature painting by Hossein Behzad, 1894–1968) by Wellcome ImagesWorld Health Organization
Measles is one of the most contagious diseases humans have ever faced. An ancient disease, it was described as early as the 9th century by Persian physician and scholar Abū Bakr Muhammad Zakariyyā Rāzī (also known by the Europeanized name Rhazes).
Francis Home (1719-1813) (1700-01-01/1700-12-13) by David AllanWorld Health Organization
It became more widespread as global exploration increased in the 16th century. In 1757, Scottish doctor Francis Home discovered that measles was caused by a pathogen: he transmitted the disease to healthy individuals using the blood of infected patients and demonstrated that it was caused by an infectious agent.
Lamentations for Keopuolani by the royal family, by William Richards (1825) Memoir of Keopuolani, late queen of the Sandwich Island (1823-09-01) by Barter. S., Wikimedia CommonsWorld Health Organization
Regions of the world without previous exposure to the measles virus were particularly vulnerable: outbreaks of the virus took devastating effect in isolated communities such as the Faroe Islands in 1846, Hawai`i in 1848, Fiji in 1875 and Rotuma in 1911.
A 3D graphic representation of a spherical-shaped, measles virus particle, that was studded with glycoprotein tubercles by Centers for Disease Control and PreventionWorld Health Organization
Before the advent of vaccination, measles had long been endemic around the world – and it remains a worldwide epidemic disease. In developed countries, advances in the health of communities – including better nutrition – meant mortality rates had dropped by the twentieth century.
Measles Awareness Poster (1939-02-14) by City of Minneapolis ArchivesWorld Health Organization
The availability of antibiotics, while powerless against the virus itself, could also help fight complications such as bacterial pneumonia. Yet common complications such as ear infections, croup, diarrhoea and pneumonia caused thousands of hospitalizations annually, and encephalitis, a more serious complication involving swelling of the brain, could result in brain damage, loss of hearing or vision, and death.
Semicircular ward, Measles pavilion, South Department, Boston City Hospital 1908 (1905-03-22) by Boston City HospitalWorld Health Organization
Globally, mortality rates remained high, with approximately 30 million cases and over 2 million deaths occurring each year.
At the North Lamma Island Clinic, the doctor decides a little girl's sore throat and rash signify a budding case of measles (1905-06-01) by WHO / Didier HenrioudWorld Health Organization
In 1954, a measles outbreak at a boarding school just outside Boston, Massachusetts provided an opportunity for doctors at Boston Children’s Hospital to try and isolate the measles virus, taking throat swabs and blood samples from infected students.
Preparing the measles serum (1946-02-06) by Nationaal ArchiefWorld Health Organization
The culture that Thomas Peebles, MD obtained from 11-year-old schoolboy David Edmonston successfully led to the virus’s cultivation and enabled doctors to create the first vaccine against measles.
Time Covers - The 60S (1961-11-17)LIFE Photo Collection
John Franklin Enders, Peebles’s boss, often called ‘the father of modern vaccines’, developed the measles vaccine from the ‘Edmonston-B’ strain, named after David and used as the basis for most live-attenuated vaccines to this day.
Measles is misery, protect your child now (1905-06-09) by Science Museum GroupWorld Health Organization
Enders and his team tested their measles vaccine on small groups of children from 1958 to 1960, before beginning trials on thousands of children in New York City and Nigeria. In 1961 it was hailed as 100% effective and the first measles vaccine was licensed for public use in 1963.
From 1968, this image depicts a number of West African boys standing in a line each awaiting his smallpox and measles vaccinations (1905-05-21) by CDC / W.L. DesPrezWorld Health Organization
Individual countries introduced mass vaccination programmes against measles at the national level from the 1960s on, and the first internationally focused measles immunization programmes took place in Africa from 1966.
Somali Refugees in Dolo Ado, Ethiopia (2012-06-11) by UNICEF EthiopiaWorld Health Organization
WHO worked with the governments of over 20 newly independent and decolonizing countries in western and central Africa, alongside the United States Agency for International Development (USAID) and Centres for Disease Control (CDC), to administer vaccinations with the joint aim of controlling measles and eradicating smallpox.
This historic photograph depicts what had been a spotted vaccine delivery vehicle, which displayed the message, “MEASLES MUST GO”, on its side by Centers for Disease Control and PreventionWorld Health Organization
Despite challenges such as the difficulty of maintaining the cold chain when transporting and storing the heat-sensitive vaccine, these campaigns provided evidence that vaccination was effective against measles, and by May 1967 The Gambia became the first country in the world in which transmission of the virus was interrupted.
Maurice Hilleman (1919–2005) (1905-05-11) by Walter Reed Army Medical CenterWorld Health Organization
An improved version of the measles vaccine was created in 1968 when Dr Maurice Hilleman, a pioneer in vaccine development, passed the virus through chick embryo cells 40 times to weaken it, producing a vaccine that did not cause such severe side effects.
By Henry GroskinskyLIFE Photo Collection
This weaker version, known as the Edmonston-Enders strain, was developed into some of the strains still used in measles vaccines today.
Vials of measles and rubella vaccine (2009-01-09) by WHO / Igor SergienkoWorld Health Organization
In 1971 Hilleman combined the recently developed vaccines against measles, mumps and rubella into the MMR vaccine, administered as a single shot, with one booster dose following – and in 2005, the varicella vaccine was added, to make the combined MMRV vaccine.
An EPI worker, Majra bibi prepares measles vaccine for Mawah Roohullah (9 months old) in basic health unit Akora II (2018-03-01) by WHO / Asad ZaidiWorld Health Organization
Standalone measles vaccines remain available in many countries.
By Lynn PelhamLIFE Photo Collection
In 1974, measles was among the first diseases targeted by the World Health Organization (WHO) when it established the Expanded Programme on Immunization (EPI, now the Essential Programme on Immunization) to develop and expand immunization programmes throughout the world.
Adanech and her daughter Elizabeth and Health Extension Worker Guenet-SNNPR (2008-12-04) by UNICEF EthiopiaWorld Health Organization
Widespread childhood vaccination against measles has drastically reduced disease rates worldwide. WHO now recommends vaccination at 9 months for babies in areas where measles is common, and at 12–15 months for those in other areas.
Emergency vaccination to save lives (2008-03-05) by Julien HarneisWorld Health Organization
A second dose is recommended for all children, essential to protect the approximately 15% of children who don’t develop protective immunity after their first dose.
From warehouse to remote indigenous communities (2017-03-24) by Pan American Health Organization (PAHO)World Health Organization
Measles elimination efforts in the Americas Region started in 1991 and all those 9-15 years of age in the region were vaccinated with an additional dose of measles vaccine. The strategies for elimination in use today were first developed and implemented in the Region of the Americas.
The Lancet 1998 article by The LancetWorld Health Organization
A minor setback for the success of the measles vaccination programme occurred in 1998, when a fraudulent research paper was published in ‘The Lancet’, asserting a link between the MMR vaccine and autism without any robust scientific evidence.
Measles outbreak, Parents warned (2007-04-07) by Martin DeutschWorld Health Organization
The influence of this paper, along with systemic misinformation by anti-vaccination groups in high-income countries, resulted in a drop in vaccination rates, below the level required for community protection, which caused a resurgence in measles cases in England and Wales, as well as parts of the USA and Canada.
In 2010 the British General Medical Council ruled that the study’s lead author engaged in misconduct. The paper was formally retracted by ‘The Lancet’, and its author was banned from practising medicine.
A woman waits in line for a routine vaccination at an immunization site, in Ghaziabad (2011-07-09) by WHO / Andrew Caballero ReynoldsWorld Health Organization
Because measles has such a high infectivity rate, the threshold for community protection is also very high, requiring at least 95% immunity among the population to prevent epidemics. The failure to maintain very high rates of immunization can result in outbreaks when the disease is reintroduced.
Parents and Children line up in during the massive measles vaccination campaign in Conakry, Guinea (2014-02-08) by UNICEF GuineaWorld Health Organization
In addition to the suffering caused by measles, containing outbreaks is costly and detracts from other health care services. Measles deaths continue to occur in many countries, especially those with gaps in their immunization programmes.
Vaccination campaign at Kibati II camp (2008-11-14) by WHO / Christopher BlackWorld Health Organization
For example, in the Democratic Republic of the Congo 2299 people died during the Ebola epidemic of 2018–2020, compared with 7,800 deaths from measles during an outbreak in the same time period.
Created in 1981, this poster reminded viewers to have children vaccinated against the measles, or rubeola virus, of the genus, Morbillivirus, in order to prevent the spread of this disease (1905-06-03) by CDC / Meredith HicksonWorld Health Organization
The region of the Americas was declared free of endemic measles in 2016 by an independent body of experts, becoming the first WHO region to achieve this distinction of having eliminated measles.
This 2019 image depicted Centers for Disease Control and Prevention (CDC) measles health alert messages displayed in English and Spanish at a US-Mexico land border crossing (1905-07-11) by Centers for Disease Control and PreventionWorld Health Organization
But this status was lost two years later due to a measles outbreak, initiated by a social and political crisis in one country where there were gaps in vaccination coverage and delays in implementing a rapid response. The virus spread to neighboring countries where it was successfully controlled.
Vaccination for measles prevention in a riverside population in northern Brazil (2021-09-17) by Karina Zambrana - OPAS/OMSWorld Health Organization
To address these issues, the Pan American Health Organization (PAHO, the WHO Regional Office for the Americas), has trained countries in rapid response to avoid measles and rubella virus spreading, improved surveillance, and launched renewed high-quality follow up vaccination campaigns.
1.7 million Somali children to be reached with life-saving vaccines (2019-11-18/2019-11-24) by WHO / Ismail TaxtaWorld Health Organization
Between 2000 and 2020, measles vaccination prevented an estimated 31.7 million deaths worldwide.
Number of Reported Measles Cases, 2019 (1905-07-11) by IVB Department, WHO HQWorld Health Organization
But even though a safe and cost-effective vaccine is available, global measles deaths continued to climb prior to the COVID-19 pandemic. In 2019 there were over 207 000 measles deaths globally, and the highest number of reported cases in 23 years.