Measles Outbreaks in Europe (Update 3)

On 28 July 2017 the European Centre for Disease Prevention and Control reported measles transmission continues in Europe with 1 death in the past week.

Affected countries with updates since 21 July 2017.

Bulgaria: From 1 January to 16 July 2017 there were 166 cases, with 3 cases since 21 July.

France: On 27 July 2017 the death of a 16-year-old unvaccinated girl was reported. She became unwell in Nice and died on 27 June 2017 in Marseille.

Germany: From 1 January to 26 July 2017 there have been 801 cases in Germany with 4 cases since 21 July 2017. This compares to 187 cases in the equivalent period of 2016.

Italy: There have been 3 842 cases, including three deaths from 1 January to 25 July 2017. There 170 cases between 21 July and 25 2017. Of the total, 271 are healthcare workers. 89% of cases were unvaccinated and 6% had only one dose of vaccine.

Romania: There have been 229 cases, including 1 death, since 21 July 2017. From 1 January 2016 to 21 July 2017, there were 8 246 cases, including 32 deaths. Infants and young children are the most affected groups. Timis, in western Romania is the most affected district (1 215 cases).

Spain: There have been seven cases since 14 July 2017, bringing the total from 1 January to 25 July 2017 to 145 cases.

United Kingdom: Since 21 July 2017 Public Health Wales has reported 2 cases related to an outbreak in Newport and Torfaen, bringing the Welsh total to 10 cases. There have been 76 cases since 21 July 2017. From 1 January to 23 July 2017, Public Health England and Public Health Wales reported 922 cases. In the same time period in 2016, they reported 946 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.

For further information see Measles