In the first three months of 2018, 18 329 measles cases have been reported in 36 countries of the WHO European Region, including 23 measles-related deaths in 7 countries.
Measles is a highly contagious viral disease. It remains one of the leading causes of morbidity and mortality among young children globally, despite the availability of a safe and effective vaccine.
Transmission from person-to-person is airborne, as well as by direct or indirect contact of secretions (nasal, throat) of an infected person. The virus can cause widespread outbreaks in the presence of large numbers of susceptible persons.
Given the current increased measles circulation in the European Region as a result of suboptimal vaccination coverage and population immunity gaps in some countries (including Ireland) , the risk of continued disease transmission and further potential spread to other countries remains. Measles has also been reported among health workers and nosocomial transmission has contributed to some outbreaks (including Ireland).
Initial symptoms of measles, which usually appear 10-12 days after infection, include high fever, runny nose, red eyes, cough, and tiny white spots on the inside of the mouth. A few days later, a rash develops, starting on the face and upper neck and gradually spreading downwards. A patient is usually infectious 4 days before the start of the rash to 4 days after the appearance of the rash.
There is no specific antiviral treatment for measles. Vaccination is the only way to prevent the disease. High vaccination coverage of at least 95% with two doses of measles vaccines in all population groups and age cohorts at national level and in all districts is crucial to elimination.
Countries need to identify susceptible individuals and population groups and consider undertaking catch-up immunization or supplementary immunization activities to close immunity gaps. Tailored strategies to reach older populations and marginalized groups may be required.
Every opportunity should be used to vaccinate susceptible children, adolescents and adults. Measles-containing vaccines should also be recommended for susceptible persons intending to travel to countries where measles is endemic and where outbreaks are ongoing.
To protect health workers, prevent nosocomial infections and limit transmission of these diseases, health workers should be vaccinated. Those with an uncertain vaccination status or unknown history of disease should have their immunity status checked and be vaccinated accordingly.
Elimination of measles is a priority goal that all European countries have firmly committed to. In adopting the European Vaccine Action Plan 2015–2020, all 53 Member States of the Region committed to eliminating measles and rubella as one of the Region's priority immunization goals. The cornerstones for eliminating measles remain high population immunity to stop disease transmission and high-quality surveillance to monitor disease occurrence for public health action but also to adequately ascertain its absence in the elimination process.
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WHO Epidata, April 2017 – March 2018. In press: (Landing webpage: http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/surveillance-and-data/who-epidata )
European Centre for Disease Prevention and Control. Risk of measles transmission in the EU/EEA,21 March 2018. Stockholm, ECDC. 2018
European Centre for Disease Prevention and Control. Health topics Measles [internet]. 2017 [cited 2018 May 10]. Available from: http://ecdc.europa.eu/en/healthtopics/measles/Pages/index.aspx .
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