Measles Outbreaks in Europe (Update 13)

On 18 May 2018, the European Centre for Disease Prevention and Control (ECDC) reported that transmission of measles continues across Europe.

Within the European Union:

Austria has reported 43 cases from 01 January to 04 May 2018. This is an increase of 14 cases since 13 April.

Bulgaria has reported 4 cases of measles in 2018, up to 13 May.

The Czech Republic has reported 103 cases of measles between 01 January and 30 March 2018. The majority of cases were reported in Prague and more than half of the cases were not vaccinated.

France reported 2 173 cases from 1 January 2018 to 13 May, with an increase of 568 cases since 8 April 2018. Nearly half of the case total has been reported from the Nouvelle Aquitaine region. Highest incidence is in the very young and most are unvaccinated.

Finland has reported three cases of measles in 2018, up to 17 May. Two of these cases were imported.

Germany has reported 176 cases of measles in 2018 from 01 January to 21 April 2018. This is an increase of 99 cases since 13 April 2018.

Greece has reported 1 948 cases (including 2 deaths) from 01 January to 17 May 2018 as of 17 May, including two deaths. This is an increase of 416 cases and 1 death since 13 April 2018. Most cases are in southern Greece among Roma children and young Greek adults. An increase in measles in northern Greece has also been observed.

Hungary reported 16 cases of measles in 2018, as of 6 May. This is an increase of two cases since previous CDTR on 13 April.

Ireland has reported 72 cases from 01 January to 12 May 2018. This is an increase of 12 cases since 13 April.

Italy has reported 805 cases of measles (including 2 deaths) between 1 January and 31 March 2018. This is an increase of 394 case and 2 deaths since 13 April 2018. Among the cases there were 38 healthcare professionals. More than 87% of cases were from Sicily, Lazio, Campania, Calabria and Lombardy. Most cases were unvaccinated (92%) or had received only one of vaccine (2%).

Poland has reported 44 cases from 01 January to 30 April 2018, an increase of 13 cases since 13 April.

Portugal has reported 111 cases of measles from 01 January to 8 April 2018, nearly all in the north of the country. This is an increase of six cases since 13 April. Additionally 24 cases are pending test results. All but 1 of the cases are adults and 79 of them are healthcare professionals.

Romania has reported 2 712 measles cases (including 15 deaths) from 01 January to 11 May 2018. This is an increase of 1 003 cases (including 6 deaths) 13 April 2018. The Romanian outbreak began in October 2016 there have been 12 991 confirmed cases (including 52 deaths) from that time until 6 April 2018.

The United Kingdom has reported 440 cases from 1 January and 9 May, 2018. Among other areas, cases have been reported from London (164), the South East (86), West Midlands (78), South West (42) and West Yorkshire (37). Fifty-four percent of cases are aged over 15 years. The most common strain is B3, currently also circulating in Romania.

Neighbouring countries outside the European Union

Albania has reported over 600 cases in 2018, according to media reports on 25 April. This is an increase of 248 cases since 13 April. Most cases are children and unvaccinated people.

Belarus has reported 67 cases from 01 January to 25 March 2018.

Georgia has reported 517 from 01 January to 19 April 2018, an increase of 70 cases since 13 April.

Russia has reported 843 cases from 01 January to 31 March 2018, an increase of 272 cases since 13 April.

Serbia has reported 5 167 cases (including 15 deaths) from October 2017 to 10 May 2018. This is an increase of 629 cases (including 3 deaths) since 13 April.

Turkey has reported 44 cases in 2018, according to media on 30 March.

Ukraine has reported 15 261 cases (including eight deaths) from 01 January to 15 May 2018. This is an increase of 6 170 cases (including 1 death) since 13 April. Sixty percent of cases are adults. The majority cases have been reported in Chenivetsk, Ivano-Frakivsk, Zakarpatie, Lviv and Odessa regions.

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.

For further information see Measles