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In Ebola-stricken countries, measles is now a risk

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Here's what happens when your healthcare system collapses

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Ebola itself was bad enough in Sierra Leone, Guinea, and Liberia. But the outbreak also led to turmoil in those countries' health care systems — and now a measles outbreak is a risk. Should a measles outbreak occur, almost twice as many people will be sickened, compared with before the outbreak. Thousands could die, according to a study appearing in the journal Science today.

"Measles in particular is known to show up during or after humanitarian crises because it’s so infectious," says Justin Lessler, a study lead author and an assistant professor at the Johns Hopkins Bloomberg School of Public Health, in a call with reporters.

"Measles in particular is known to show up during or after humanitarian crises."The Ebola crisis kept people away from clinics, for fear of contracting the disease. That means that many children didn't receive vaccines. The researchers created models of vaccination rates in the area. Their main model was that vaccinations had been decreased by 75 percent in West Africa, which was closest to the reports the scientists received as they were working, though they also looked at 25, 50 and 100 percent disruptions. Then they made an 18-month forecast.

Before the epidemic, about 778,000 children nine months old to five years old hadn't been vaccinated — about 4 percent of the population. After the epidemic, there will be about 1.1 million children of the same age who are susceptible to measles. If a large outbreak occurs, that means an additional 100,000 cases of measles for a total of 227,000 cases; the extra illnesses are most likely to occur among the youngest children — who are more likely to develop severe complications. An additional 2,000 to 16,000 deaths from measles may occur, the study found.

An additional 2,000 to 16,000 deaths from measles may occur Though countries had been engaging in vaccination campaigns or considering them, the Ebola outbreak halted them, says Lessler. Because vaccination campaigns are complex, they require coordination from a lot of health authorities. Those authorities have been preoccupied by Ebola, he says. Though there have been some measles cases reported, no major outbreaks have occurred yet.

The paper looked only at the potential for a measles outbreak, but other vaccines — like those against polio, tuberculosis, whooping cough, and tetanus — have also been difficult to deliver during the Ebola outbreak. The researchers focused on measles because they're so contagious that it's one of the first diseases where herd immunity no longer will protect the population, Lessler says.