Epidemiological update: Measles among asylum seekers in Germany, 10 August 2016

Epidemiological update

​​​On 8 August 2016, the Robert Koch Institute in Berlin published an overview of measles cases reported from asylum seeker centres in Germany over the period January to July 2016.

  • from the beginning of 2016 until mid-May 2016, three cases of measles were reported from asylum seeker centres
  • from mid-May to 20 July 2016, 53 measles cases were reported from asylum seeker centres.

This increase seems to be concomitant with the arrival in Germany of groups of asylum seekers from Chechnya.

These 53 cases of measles were reported from 11 different asylum seeker centres across eight Federal states. All cases were in children aged 0–13 years, with the exception of two adults aged 21 and 22 years. Cases had travelled from Chechnya to Germany using different routes crossing Poland, Russia or Belarus. The initial case among Chechen asylum seekers was reported on 10 May 2016, a few days after arrival at a centre, suggesting infection was acquired while travelling. Similarly, symptoms appeared within a few days of arrival at the asylum seeker centres for several other cases, suggesting that the infection was likely to have been acquired while travelling to Germany. Typing pointed towards a strain that has been circulating in the Caucasus.

Secondary cases were reported among residents and staff at the centres.
 
This update highlights two important issues:

  • The potential for measles outbreaks in structures hosting migrants and asylum seekers: ECDC has highlighted some of the public health concerns that may affect these population groups in a Scientific Opinion on the public health needs of irregular migrants, refugees or asylum seekers. The concerns addressed include measles and options for public health action are advised. Measles vaccination with an MMR vaccine should be considered and prioritised upon arrival for children up to 15 years of age with no or undocumented vaccination history.
  • The need for staff working in migrant reception centres to be vaccinated against measles: Measles vaccination should be recommended to staff working in migrant reception centres who are not immunised, only partially immunised or do not know their immunisation status and for whom there are no contra-indications. The infection in Germany spread to staff who may then have transmitted it further and suffered from complications. A measles outbreak in a refugee settlement in Calais, France, in January 2016 was another example of an event where cases also occurred among staff working within refuge centres.

Although efforts are underway to eliminate measles in Europe, outbreaks continue to occur because of low vaccination coverage in some countries and pockets of susceptible people who are either not immunised or only partially immunised.