Measles Outbreaks in Europe (Update 10)

On 10 November 2017 the European Centre for Disease Prevention and Control (ECDC) reported measles continues to be transmitted in Europe, with the potential for further spread. Lack of vaccination, or incomplete vaccination remains an obstacle to controlling the outbreaks.

Austria has reported 1 case since 13 October 2017 bringing the total for the current year to 85 cases as of 25 October.

Germany has reported 7 cases since 13 October 2017. As of 15 October, Germany has reported 898 cases in 2017.

Greece has reported 153 cases (including 1 death, an unvaccinated infant) since 13 October 2017. There have been 368 cases in Greece from 17 May to 29 October 2017.

Ireland has reported 7 cases since 8 September 2017, bringing the total for this year to 16 cases as of 28 October.

Italy has reported 158 cases since 13 October 2017. As of 31 October the total for 2017 is 4 775 cases (including 4 deaths).

Romania has reported 189 cases (including 1 death) since 13 October 2017. From 1 January 2016 to 3 November 2017, Romania reported 9 728 cases, including 35 deaths. Of these, 1 969 cases were in 2016 and 7 759 were in 2017.

Spain has reported 159 cases from 1 January to 27 October 2017.

The United Kingdom has reported an outbreak in Gloucestershire, South West England, involving over 30 cases. More than 20 cases are children in one school.

Countries outside the European Union /European Economic Area.

Switzerland has reported 26 cases since 15 September 2017. This brings the total number of cases to 102 as of 31 October 2017.

The former Yugoslav Republic of Macedonia reported 8 cases since 13 October 2017. As of 27 October, 19 cases, all in the area of Skopje have been reported in 2017.

Kosovo has reported 94 cases up to 12 October 2017.

Serbia has reported 65 cases as of 8 November 2017.

Ukraine reported 1 627 cases up to 26 September 2017. Cases are reported from Ivano-Frankivsk (747), Odesa (589, including 2 deaths) and Ternopil (70). On 9 October 2017, media reported a further 38 cases in Chernivtsi oblast, including 24 in Putyla district.

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