Next week I'll be hopping on a plane for an 11-hour ride to Europe with a strong-willed, 1 1/2-year-old toddler.
A big concern is how to deal with the inevitable meltdowns. But my top priority before boarding is about my little girl's health: Is she protected from the measles?
The virus — which kills almost 400 kids each day worldwide — is hitting Europe hard this year.
Romania is fighting a large outbreak with more than 3,400 cases, including 17 deaths. And Italy is seeing a big surge in cases, with at least 400 already in 2017, the World Health Organization reported last week
The outbreak is only going to get worse.
"Preliminary information for February indicates that the number of new infections is sharply rising," WHO wrote.
And the problem isn't just in Europe. Guinea is battling a widespread outbreak, with nearly 3,500 confirmed cases, Doctors Without Borders reports. Nigeria is having an emergency campaign to vaccinate 4 million kids after an outbreak flared up in a region crippled by violence. And Mongolia — which was declared measles-free in 2014 — is still reeling from a massive outbreak nearly 20,000 cases.
In other words, 2017 is shaping to be bad year for the measles worldwide, says Dr. Seth Berkley, who leads the nonprofit Gavi, The Vaccine Alliance, devoted to vaccinating children worldwide.
There's one big reason why: Vaccine rates around the world have stalled, Berkley says.
Since the 1980s, the world has seen a massive plunge in measles cases, dropping from more than 4 million cases each year to fewer than 500,000.
But that improvement has plateaued.
"Over the past five years, measles vaccine coverage around the world has stagnated at around 78 percent," Berkley says. "That in combination with the European outbreak is worrisome."
For the measles, it's not enough to have 78 percent of a population vaccinated. You need about 90 to 95 percent to stop outbreaks, Berkeley says.
Because measles is one of the most contagious diseases on Earth. One sick person spreads it to 18 others, on average. The virus literally floats around in clouds through the air, seeking out the unvaccinated.
"You don't even need to be in the same room with a sick person to catch measles," Berkley says. "If you were to leave a doctor's office and someone came an hour later, that person could catch measles just from the virus left in the air."
"So in places where vaccine coverage has dropped, we're seeing a lot more cases," he says.
That includes includes poor countries, like Guinea, Mongolia and Nigeria, where families just don't have access to vaccines. But also rich countries, like Romania, Italy and France, where false perceptions about vaccine's risks have kept parents from immunizing some kids. For example, the French have the lowest confidence in vaccines in the world, researchers reported last year. Nearly 40 percent say they don't think vaccines are safe.
"The problem is measles is a disease that people don't remember because the vaccine has been quite successful," Berkley says. "But 1 out of 4 people who catch the measles will be hospitalized. One out of 1,000 will end up with brain swelling, which could lead to brain damage. And 1 or 2 out of 1,000 can die, even with the best care."