title: Reduced vaccination and the risk of measles and other childhood infections post-Ebola.
abstract: The Ebola epidemic in West Africa has caused substantial morbidity and mortality. The outbreak has also disrupted health care services, including childhood vaccinations, creating a second public health crisis. We project that after 6 to 18 months of disruptions, a large connected cluster of children unvaccinated for measles will accumulate across Guinea, Liberia, and Sierra Leone. This pool of susceptibility increases the expected size of a regional measles outbreak from 127,000 to 227,000 cases after 18 months, resulting in 2000 to 16,000 additional deaths (comparable to the numbers of Ebola deaths reported thus far). There is a clear path to avoiding outbreaks of childhood vaccine-preventable diseases once the threat of Ebola begins to recede: an aggressive regional vaccination campaign aimed at age groups left unprotected because of health care disruptions.
authors.affiliation: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA.
authors.forename: Saki
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA. Woodrow Wilson School, Princeton University, Princeton, NJ 08544, USA.
authors.forename: C Jessica E
authors.initials: CJ
authors.lastname: Metcalf
authors.affiliation: Centre for Infectious Disease Dynamics, Pennsylvania State University, State College, PA 16801, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Ferrari
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Moss
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Truelove
authors.affiliation: Department of Geography and Environment, University of Southampton, Southampton SO17 1BJ, UK. Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA. Flowminder Foundation, 17177 Stockholm, Sweden.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Tatem
authors.affiliation: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA. Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Grenfell
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. justin@jhu.edu.
authors.forename: Justin
authors.initials: J
authors.lastname: Lessler
mesh_terms: D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D004198:Disease Susceptibility; D016701:Guinea / Q000453:epidemiology; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D007988:Liberia / Q000453:epidemiology; D008457:Measles / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D008458:Measles Vaccine; D012807:Sierra Leone / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D008458:Measles Vaccine