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Epidemiological update on measles in EU/EEA

31 Mar 2011

Measles is a potentially severe disease that can be prevented by an effective and safe vaccine. When given in two doses, at least 98% of those receiving the vaccine are protected against the disease. All countries of the European Region of the World Health Organization, including the EU/EEA countries, are committed to eliminate measles by 2015.

Current situation in France

Source: Institut de Veille Sanitaire, France.
Rougeole, situation épidémiologique actuelle. Point au 23 mars 2011. 

Since the end of 2008, France is facing increased continuous indigenous circulation of measles across the country (more than 10,000 reported cases including five deaths) with a recent explosion of cases reported in the first months of 2011 (Figure 1). In January and February 2011, there were 3,749 cases notified in the country compared with 5,021 cases in 2010 and 1,544 cases in 2009 (provisional data for 2010 and 2011).

Figure 1. Number of measles cases notified in France, January 2008 – February 2011

From October 2010 through February 2011, the most affected French Regions were Rhône-Alpes (incidence rate: 44 cases per 100,000 inhabitants), Franche-Comté (22/100,000), Languedoc-Roussillon (19/100,000), Provence-Alpes-Côte d'azur (13/100,000) and Auvergne (11/100,000). 

Figure 2. Number of cases and incidence rate per region, France, 2010


In 2010, 89% of the cases were in persons under 30 years of age. The highest incidence was observed in infants (under one year of age) who according to the national childhood vaccination programme were, in the vast majority, not eligible for vaccination. This was followed by children between one and two years of age. The incidence rates among the cases in both these age categories were above 50 and 45 cases per 100,000 respectively. Compared with 2009, the number of cases in 2010 more than tripled in infants under one year of age, and increased fivefold in adults 20-29 years old. Despite the fact that measles is a notifiable disease in France, the health authorities estimate that the incidence rates for cases seeking care are under-estimated by probably half.

Of the notified cases in 2010, almost 30% were hospitalised. A higher severity of the disease was observed in infants under one year of age and adults above 20 years, with respective proportions of hospitalised cases of 38% and 46%. In 2011, more than 300 people were hospitalised with acute encephalitis for eight of them. One measles-related death was reported. 

Within the current wave of measles transmission in France, more cases are expected in the coming months. Efforts are undertaken by the health authorities to increase measles vaccination coverage both in the general population and around cases, targeting especially infants of one year of age (nine months if attending day-care centre) and not fully vaccinated adults under 30 years old. For individuals at risk of severe measles, post-exposure prophylaxis has been enhanced.  

Situation in the EU/EEA countries

Source: EUVAC.Net, Surveillance data of measles

Despite efforts to achieve the 2015 measles elimination goal, 2010 was the year with the highest number of measles cases reported in Europe in more than ten years. 

Preliminary reports for 2010 show that there were more than 30,000 cases of measles in EU/EEA countries, five times more that the annual average for the preceding five years. The highest number of cases was reported from Bulgaria (22,005 cases, including 24 deaths) followed by France (5,021, including two deaths), Italy (861) and Germany (787). Only eight out of the 29 EU/EEA countries for which the information is available, reported zero measles cases in 2010. The outbreak in Bulgaria, which started in March 2009 following importation of measles from Germany, was the main cause for the high increase noted in 2010.

Measles continues to spread in 2011 with more than 4000 cases reported in the EU/EEA for the first two months of the year. ECDC is committed to closely monitor the measles situation in Europe, and collaborates closely with the Member States and the World Health Organisation towards the elimination goal in 2015.

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