Measles is a major source of unnecessary suffering, premature mortality, and expense. Except in isolated populations, measles is nearly universal, most persons being infected before reaching the age of 15. Babies and adults who catch measles are often much sicker and are more likely to suffer longer or die than elementary school children and teenagers with measles.
[Developing countries] Therapy for measles and its complications is a major drain on medical care resources in most parts of Africa, Asia, and Latin America. In 1989 not only did it kill an estimated 1.5 million children annually, but it also contributed to malnutrition and aggravated other diseases, thus indirectly contributing to an even higher number of deaths and morbidity. In the Inter-American Investigation of Mortality in Childhood it was found that measles is either the main cause of death or the second most frequent cause in children aged 1-4 years in several cities in Latin America. Measles outbreaks in Africa and Asia have case-fatality rates of 5-20% among children, especially malnourished ones. Measles complications may also result in developmental retardation, lifelong handicaps, and both direct and indirect economic loss. Furthermore, in children in the developing world, measles interacts with diarrhoeal disease and malnutrition to increase the morbidity and mortality from these conditions. Statistics from the WHO and UNICEF programme in the 1980s suggest that the number of Third World children immunized against measles has risen from three in 10 to more than seven in 10, and that the annual death rate has dropped from a high of 3 million to 1 million in 1993.
[Industrialized countries] The Centre for Disease Control and Prevention in the USA reported only 175 cases of measles in 1993. There was a measles epidemic in the USA between 1989 and 1991, when more than 56,000 people contracted the disease and at least 132 died. Most of the cases were among unvaccinated pre-school children. The measles vaccination rate has grown since the vaccine was introduced in 1963. In 1965 only about 33.2% of children between ages one and four had been vaccinated for measles. By 1991 the vaccination rate had risen to 77.6. Britain and other industrialized countries could also see the eradication of the disease by the end of the century. Between 1980 and 1991 the number of measles cases in the UK fell from 147,000 to 12,000.