Resurgence of Vaccine-Preventable Diseases in Venezuela as a Regional Public Health Threat in the Americas

Abstract

Venezuela's tumbling economy and authoritarian rule have precipitated an unprecedented humanitarian crisis. Hyperinflation rates now exceed 45,000%, and Venezuela's health system is in free fall. The country is experiencing a massive exodus of biomedical scientists and qualified healthcare professionals. Reemergence of arthropod-borne and vaccine-preventable diseases has sparked serious epidemics that also affect neighboring countries. In this article, we discuss the ongoing epidemics of measles and diphtheria in Venezuela and their disproportionate impact on indigenous populations. We also discuss the potential for reemergence of poliomyelitis and conclude that action to halt the spread of vaccine-preventable diseases within Venezuela is a matter of urgency for the country and the region. We further provide specific recommendations for addressing this crisis.

Keywords: Americas; Venezuela; diphtheria; immunization; measles; outbreak; polio; vaccination; vaccine-preventable diseases; vaccines; vector-borne infections; viruses.

Figure 1

Clinical features observed in children infected with vaccine-preventable diseases, Venezuela, 2017–2018. A, B) Classic morbilliform measles rash in a Creole infant from Caracas. Note the pronounced erythematous confluent macules and patches on face and subsequently a cephalocaudal spread onto the trunk and extremities. C) Thick, gray membrane covering the pharynx and posterior aspects of tonsils in a case of diphtheria. D) A Pemón Amerindian child with a classical varicella rash exhibiting various lesion stages. E) Swelling of the parotid glands in a girl with mumps from the state of Lara in central-western Venezuela.

Figure 2

States affected by (A) measles and (B) diphtheria (blue), Venezuela, 2017–2018. Circles indicate neighboring countries reporting imported and autochthonous cases of these 2 diseases. Reclamation zone is a territory under dispute between Guyana and Venezuela.