A new report today describing the large scale of measles outbreaks in European countries underscores their serious public health and economic implications. The World Health Organization European Region’s report emphasizes the urgent actions European countries should take to prevent measles outbreaks in 2012 and beyond, particularly with the approaching high season for measles transmission.The WHO’s newest measles summary in the Weekly Epidemiological Record reports more than 26,000 cases of measles in 36 European countries from January-October 2011, with more than 14,000 of those in France. Despite strong health systems, Western European countries have reported 83% of these cases. These outbreaks have caused nine deaths, including six in France, and 7288 hospitalizations.
“The increase in measles in European countries reveals a serious challenge to achieving the regional measles elimination goal by 2015,” said Mrs Zsuzsanna Jakab, WHO Regional Director for Europe. “Every country in the European Region must take the opportunity now to raise coverage amongst susceptible populations, improve surveillance and severely reduce measles virus circulation before the approaching measles high season. ”
Dr Marc Sprenger, Director of the European Centre for Disease Control, added that “a substantial commitment is needed and should involve all stakeholders, especially health professionals who have a decisive role to play in helping parents make informative decisions regarding vaccination.”
The peak months for measles outbreaks in Europe are typically February through May.
The outbreak in Western Europe is amongst the largest in the world in 2011, together with the Democratic Republic of the Congo (>100 000 cases), Nigeria and Somalia (both with >15 000 recorded cases). Measles from Europe has been linked to outbreaks in several other countries including Brazil, Canada, and Australia and is responsible for the majority of the outbreaks, along with the South-East Asia Region, in the United States, which this year is suffering the highest number of measles cases since 1996.
The majority of European cases (90%) were amongst adolescents and adults who had not been vaccinated or for whom vaccination history was not reported.
In response to the report, the Measles Initiative underscored the collective responsibility of all countries to control and eliminate measles. The Initiative is spearheading efforts to reduce measles deaths by 95% globally as compared to 2000, in support of a resolution by the 193 member World Health Assembly.
“Measles elimination requires focused attention on every country with measles and support to the developing countries which still carry the highest burden of measles cases and deaths,” said Dr. Stephen Cochi, Senior Advisor for immunization at the U.S. Centers for Disease Control and Prevention, on behalf of the Measles Initiative.
France has taken a strong step forward in responding to the outbreak. This includes the launch of a nationwide communications campaign in October to raise awareness about the need for measles vaccination.
The communication campaign targets those age groups most affected by the outbreak to verify their vaccination status. Other specific actions include a recommendation for everyone born since 1980 to have two doses of the measles-containing vaccine (MMR) as most people infected (70%) are more than ten years of age. It also recommends that children in daycare settings be immunized at 9 months (rather than the usual 12 months) followed by a second dose before age two years.
“France can simply not afford to have deaths, painful and costly hospitalizations, disruptions to work and school from a completely vaccine-preventable disease,” said Mr. Jean-Yves Grall, the Director-General for Health in France. “France is now actively encouraging two doses of measles vaccine for everyone born since 1980. High vaccination coverage in France and every European country is essential to stop this measles outbreak for good.”
Measles outbreaks are extremely costly to control. A well-documented 2008 outbreak in Arizona of seven measles cases, traced to a traveler from Switzerland, affected two hospitals, caused significant disruption, and cost $800,000 to respond to and contain. That same amount of money could purchase about 2,5 million doses of measles vaccine for developing countries.
Efforts spearheaded by the Measles Initiative reduced global measles deaths by 78% between 2000 and 2008. However measles is now resurging worldwide and kills an estimated 164,000 kids every year, or about 450 each day. The current funding gap to ensure measles control in countries requiring support in 2012 is estimated at US $43 million.
The World Health Organization underscores that two doses of measles containing vaccine will protect more than 99% of persons vaccinated and that vaccination coverage in the population of 95% or higher can lead to complete elimination of the disease.
The Measles Initiative – a global health partnership led by the American Red Cross, United Nations Foundation, UNICEF, U.S. Centers for Disease Control and Prevention and the World Health Organization – has mobilized and invested US $875 million in measles control activities, supporting the vaccination of more than 1 billion children in more than 80 countries. These efforts have helped to save an estimated 4.3 million lives, and contribute significantly to reduction in child mortality as per Millennium Development Goal 4. The Measles Initiative aims to reduce measles mortality by 95% by 2015 and eventually eliminate measles and rubella.
For updates on measles in the WHO European Region please see: https://www.euro.who.int/en/what-we-do/health-topics/disease-prevention/vaccines-and-immunization/facts-and-figures/monthly-data-summary-tables-for-vaccine-preventable-diseases