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Measles Outbreaks in Europe

22 May 2017

On 19 May 2017 the European Centre for Disease Prevention and Control (ECDC) published an epidemiological updateLink on European measles outbreaks. All national public health administrations emphasize the importance of vaccination to prevent further spread of infection.

Countries affected

Austria: From 1 January 2017 to 12 May, Austria has reported 76 cases. This exceeds the total number of cases reported in 2016.

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: From 1 January 2017 to 3 May, media in Bulgaria have reported 71 cases. Thirty-seven cases are confirmed, mostly in the city of Plovdiv.

Czech Republic: From 1 January 2017 to 16 May 2017, the Moravian-Silesian region has reported 104 measles cases, of which 95 have been confirmed. Of the confirmed cases, 14 are healthcare workers.

France: from 1 January 2017 to 31 March, France has reported 134 cases, three times more than over the same period in 2016. Most cases are linked to an outbreak in Lorraine (60 cases).

Germany: From 1 January 2017 to 16 April, Germany has reported 504 cases. In the same period in 2016, Germany reported 33 cases.

Hungary: From 21 February to 22 March 2017, Hungary has reported 54 cases. Health authorities have lifted quarantine from a hospital in Mako, Southeast Hungary, with no new cases being detected in two weeks.

Iceland: On 31 March 2017, Iceland reported two cases in 10-month-old unvaccinated twin siblings. The first was diagnosed 10 days before the second case. This is the first occasion in a quarter of a century that measles has been reported in Iceland.

Italy: From 1 January 2017 to 14 May, Italy has reported 2 395 cases in 18 of 21 regions. Of these cases, 197 were healthcare workers. Most of the cases (73%) were older than 15 years. Eighty-nine percent of cases were unvaccinated and 7% received only one dose of vaccine.

Portugal: From 1 January 2017 to 16 May, Portugal reported 29 confirmed measles cases cases. Nineteen (66%) of these were older than 18 years of age, 17 (59%) were unvaccinated, 13 (45%) are health professionals. One death has been reported.

Romania: From 1 January 2017 to 12 May 2017, Romania has reported 5 728 cases, including 25 deaths. Infants and young children are most affected. Thirty-nine out of 42 districts have reported cases, Timis (near the border with Serbia) is most affected with 1 051 cases. Vaccination efforts are ongoing in communities with suboptimal vaccination coverage. Media reported another death on 16 May bringing the total number of deaths to 26.

Spain: An outbreak began in the first week of January 2017 in the Barcelona area, following importation of a case from China. As of 7 April, 46 cases have been confirmed. Most cases are unvaccinated or incompletely-vaccinated adults. Four cases are children.

Sweden: From 1 January 2017 to 21 March, Sweden has reported 15 cases in Stockholm area, including three imported cases. On 30 April, a further 5 five cases were reported in southern Sweden.

Two countries have reported only imported infections

Denmark: On 15 March 2017, Denmark reported an imported case in an unvaccinated adult infected while travelling in Asia.

Slovakia: On 24 April 2017, Slovakia reported an imported case in a 25-year-old unvaccinated Italian student.

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.