China is often viewed as a political, economic or military threat to the United States. It may be that a looming medical crisis in that nation will pose a medical threat. The Chinese are reporting staggering numbers of measles cases and the outbreak will only grow larger, according to a story in the July 7 South China Morning Post.
The Chinese conducted a successful immunization campaign in 2010 that saw nearly 100 million children under age 14 receive the measles vaccine. In 2012 the nation reported about 6,000 measles cases which was a record low. The Morning Post states that the China's total for 2013 was 27,646 with 24 measles-related deaths. The World Health Organization in a June 10 release notes that China has already reported 25,514 confirmed cases of measles and 51,099 suspected cases since the beginning of 2014.
The problem? The Morning Post points to 245 million migrant workers who have flocked to China's cities for jobs. They represent 18 percent of China's population but, as a survey done in Beijing discovered, their immunization rate is very low. In the local survey cited by the Morning Post, just 55 percent of these workers were immunized as opposed to 92 percent of the children of permanent residents.
The Harvard International Review looked at the health status of migrant workers in China in Jan. 2014. The piece notes the legal status of migrant workers in China's cities is questionable.
A key institutional barrier that has prevented migrant workers’ equal access to healthcare benefits is the Hukou, or household registration system. Hukous are categorized into urban ones and rural ones, which give the holder different entitlements. When a person moves from a rural area to a city, his/her Hukou retains its rural status – the government has made it all but impossible to switch easily to an urban one, in fear of opening a floodgate for rural migrants.
In effect, if migrant workers need health care, they must pay for it. Many just "hold on", buy over-the-counter medications or seek treatment at unlicensed clinics.
The measles outbreak in China is small by the 1.36 billion population of the country. Measles is among the most contagious illnesses known. The large numbers of migrant workers without immunity to measles in China mean that an explosion in the number of cases is possible. Measles is also contagious several days before any symptoms appear, allowing a patient opportunity to travel across a country or an ocean.
A report from the Migration Policy Institute produced in Jan. 2012 notes that the Chinese were the "second-largest immigrant group in the country" in 2010. The large increase in illegal immigrants in the last month appears to include Chinese who could be bringing measles with them. Albert Spratte, a Border Patrol officer in Texas, told the National Review that “[Traffic of Chinese-born persons] seemed to have dried up for awhile, but then maybe within the last month or so it seemed to have increased.”