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Measles deaths worldwide swelled to their highest level in 23 years last year, according to a report released Thursday, a stunning rise for a vaccine-preventable disease and one that public health experts fear could grow as the coronavirus pandemic continues to disrupt immunization and detection efforts.

The global death tally for 2019 — 207,500 — was 50% higher than just three years earlier, according to the analysis, released jointly by the World Health Organization and the Centers for Disease Control and Prevention. No measles deaths were reported in the United States, but measles cases in the country hit a record annual high of 1,282 across 31 states, the most since 1992, according to figures updated earlier this month. As recently as 2012, the U.S. case number was 55.

Public health experts said the soaring numbers are the consequence of years of insufficient vaccination coverage. They worry that the pandemic will exacerbate the spread of measles, a disease that is even more contagious than COVID-19.

Measles outbreaks have already occurred this year in at least half of the 26 countries that had to suspend vaccination campaigns because of the pandemic. As of this month, 94 million people are at risk for missing measles vaccines, according to the WHO.

Details of the international measles outbreaks were reported by the Measles and Rubella Initiative, an international consortium that includes the WHO and CDC as well as the American Red Cross, UNICEF and the United Nations Foundation. The group highlighted the grim numbers to reinforce its message: that vaccination efforts should persist, especially during the pandemic, when health care resources are being exhausted.

Of 184 countries reporting, nine accounted for 73% of the cases in 2019: Central African Republic, the Democratic Republic of Congo, Georgia, Kazakhstan, Madagascar, North Macedonia, Samoa, Tonga and Ukraine.

To prevent a measles outbreak, 95% of a population must receive two measles vaccines. But since 2010, rates for the first vaccine, ideally given when a child is about a year old, have been stuck at a worldwide average of about 85%; while comprehensive coverage for the second shot, typically given between ages 4 and 6, has increased, it is now only at 71%.

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