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Measles in Madagascar (Update 4)

18 March 2019

The World Health Organisation reports that in the week ending 24 Feb 2019, there were 6 607 cases of measles (including 41 deaths) in Madagascar. From 3 September 2018 to 24 February 2019, 86 985 cases (including 1 141 deaths) have been reported. About 70% of reported cases are aged 1 to 14 years old.

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