400% increase in measles cases in Europe

Dr Harish Madhava

Editorial Board

February 21st, 2018

Dr Harish Madhava
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‘Measles is back: WHO records 21,000 cases and 35 deaths in 2017’

Measles has rebounded in the WHO’s 53-nation European Region, threatening efforts to eliminate the disease. Following a record low of 5,273 cases in 2016, a total of 21,315 cases were recorded in 2017. This included 35 deaths.

With the measles virus spreading in several European countries, particularly where vaccination rates are too low, it puts people at risk if they are too young or too sick to have the vaccine themselves. Measles is highly contagious but if 95% of people in a given community are vaccinated it can provide protection for everyone.

“Every new person affected by measles in Europe reminds us that unvaccinated children and adults, regardless of where they live, remain at risk of catching the disease and spreading it to others who may not be able to get vaccinated. Over 20 000 cases of measles, and 35 lives lost in 2017 alone, are a tragedy we simply cannot accept,” says Dr Zsuzsanna Jakab, WHO Regional Director for Europe.

Health ministers from the WHO European region met in Montenegro in late February to discuss how they can get measles elimination efforts back on track. The Americas have been measles-free for more than a decade – meaning that only imported cases have been recorded in countries including the US, Colombia, Cuba and Peru.

‘Elimination of both measles and rubella is a priority goal that all European countries have firmly committed to, and a cornerstone for achieving the health-related Sustainable Development Goals,’ Dr Jakab said. ‘This short-term setback cannot deter us from our commitment to be the generation that frees our children from these diseases once and for all.’

1 in 4 European countries suffer large outbreaks

The surge in measles cases in 2017 included large outbreaks (100 or more cases) in 15 of the 53 countries in the Region. The highest numbers of affected people were reported in Romania (5,562), Italy (5,006) and Ukraine (4,767).

The WHO Regional Office for Europe says these countries have experienced a range of challenges in recent years, such as declines in overall routine immunisation coverage, consistently low coverage among some marginalized groups, interruptions in vaccine supply or underperforming disease surveillance systems.

Greece (967), Germany (927), Serbia (702), Tajikistan (649), France (520), the Russian Federation (408), Belgium (369), the United Kingdom (282), Bulgaria (167), Spain (152), Czechia (146) and Switzerland (105) also experienced large outbreaks, many of which were in decline by the close of 2017.

The WHO is calling for a range of actions to combat measles including raising public awareness, immunising health-care professionals and other adults at particular risk, and addressing challenges in access, and improving supply planning and logistics.

The process of verifying measles and rubella elimination by country, introduced in 2012, has moved the Region closer to its measles and rubella elimination goal. Each year, the independent Regional Verification Commission (RVC) reviews country data and immunisation activities and recommends actions to resolve the specific challenges faced by countries.

As of the end of 2016, 42 of the 53 countries in the Region had interrupted endemic measles transmission. However, outbreaks will continue to occur until every susceptible child and adult is protected, the WHO said in a statement.

A Region-wide midterm European Vaccine Action Plan (EVAP) progress report will be presented at the 68th session of the WHO Regional Committee for Europe in September 2018.