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Measles Outbreaks in Europe

02 May 2017

On the 28 April 2017 the European Centre for Disease Prevention and Control (ECDC) published an epidemiological updateLink on European measles outbreaks.

Austria: Since the beginning of 2017 and 12 April, Austria has reported 71 measles cases.

Belgium: Between 20 December 2016 and 16 April 2017, Wallonia has reported 288 measles cases of which 163 confirmed, 81 probable, and 44 are clinical. The outbreak affects all provinces of Wallonia, with the exception of the province of Luxembourg.

Bulgaria: Between mid-March 2017 and 24 April, the media in Bulgaria has reported 65 measles cases, of which 37 are confirmed. On 9 April 2017, Bulgaria reported one death of a 10 month old unvaccinated infant.

Czech Republic: As of 10 April 2017, 38 cases of measles have been reported in the Moravian-Silesian region of the Czech Republic. Of these 20 cases are in children below the age of vaccination and 18 are adults.

France: Since 1 January and 31 March 2017, France has reported 134 measles cases. The cases are predominantly linked to an outbreak in Lorraine (60 cases).

Germany: Since the beginning of 2017 and the 9 April 2017, Germany has reported 462 measles cases.

Hungary: Between 21 February and 22 March 2017, Hungary has reported 54 measles cases.

Iceland: On 31 March, Iceland reported 2 measles cases in 10 month old twin siblings. The infants were unvaccinated.

Italy: Since the beginning of 2017 and 23 April, Italy has reported 1739 measles cases. Cases have been reported from 18 of the 21 regions in Italy. Most cases are over 15 years old and 88% of the cases unvaccinated, 33% reported one or more complications, 39% were hospitalised.

Portugal: Since the beginning of 2017 and 26 April 2017, Portugal has reported 25 confirmed measles cases, of which 16 were over 18 years old, 15 were unvaccinated, and 12 were hospitalised. One death has been reported.

Romania: Between 1 January 2016 and 21 April 2017, Romania has reported 4881 measles cases, including 22 deaths. Cases are either laboratory confirmed or have an epidemiological link to a laboratory confirmed case. Currently 38 of the country’s 42 distracts have reported measles cases with Caras Severin (West part of the country, at the border with Serbia) being the most affected district with 943 cases. Vaccination campaigns are ongoing in order to protect communities with suboptimal vaccination coverage. On 25 April, the media reported an additional death, this brings the total number of deaths to 23.

Spain: An outbreak started in the first week of January in Barcelona metropolitan area, linked to an imported measles case from China. As of 27 March, 44 cases have been confirmed. Most cases are unvaccinated or incompletely vaccinated adults, only 4 of the cases are children, and 10 cases were hospitalised.

Sweden: Since the beginning of 2017 and 21 March 2017, Sweden reported 15 measles cases, including 3 imported cases.

Advice for Healthcare Professionals

Travel may increase an individual’s risk of exposure to measles virus, and facilitate the spread of disease to unvaccinated and susceptible populations. The travel consultation provides healthcare practitioners with a valuable opportunity to ensure individuals are protected against the measles virus. Consider vaccinating:

  • All travellers who have not previously had two doses of a measles containing vaccine or prior measles infection.
  • Particularly children and those who will be living or working closely with the local population at their destination, in countries with high endemnicity or recent outbreaks.
  • To help decide whether your traveller may be at risk of measles based on year of birth and vaccination history please read the table for measles recommendations

Charging for Measles Containing Vaccine:

  • In Scotland, GP practices may charge for the administration of MMR vaccine if the traveller does not fall into one of the groups that can receive free vaccine and it is solely being given for the purposes of travel, but have discretion not to charge.
  • In England, GPs will be reimbursed for administering one or two doses of MMR vaccine as required to all unvaccinated patients aged 16 and over who present to the GP surgery requesting vaccination.
  • Further explanantion on charging arrangements can be found here Vaccine Charges FAQ

Advice for Travellers

It should be confirmed that children have received their recommended doses of MMR at 12-13 months of age and again pre-school around 3 years 4 months. Consider vaccinating all unimmunised adults who have not had the disease themselves, particularly if they are going to be at higher risk. Two doses of MMR vaccine, at least one month apart, are required to give adequate protection.