Epidemiological update: Measles - monitoring European outbreaks, 4 August 2017

Update of the week

Updates were received from the following EU/EEA countries (see also below): Belgium, the Czech Republic, Finland, Germany, Italy, Romania and the United Kingdom. Several other countries have also reported outbreaks. According to national public health authorities, measles have caused 40 deaths in several EU countries in 2016 and 2017 due to current outbreaks. In 2016, deaths occurred in Romania (12) and the UK (1). In 2017, deaths were reported from Romania (20), Italy (3), Bulgaria (1), Germany (1), Portugal (1) and France (1). 

Epidemiological summary

EU/EEA countries with updates since last week:

Belgium: From late June until 26 July 2017: outbreak in a Ghent prison with 19 cases (14 prisoners and five staff members).

Czech Republic: Three additional cases since the report on 23 June 2017. Since the beginning of 2017 and as of 30 July, the Czech Republic reported 133 measles cases. During the same time period in 2016, the Czech Republic reported four cases. 

Finland: On 3 August 2017, Finland reported a cluster of four measles cases among Finnish travellers returning from Italy. All cases had been vaccinated twice against measles and had mild rash and fever symptoms. Since the beginning of the year and as of 3 August 2017, and adding the cluster above, eight cases of measles have been reported in Finland, compared with one for the same time period in 2016. 

Germany: An increase of 13 cases since the last report on 28 July 2017 was reported. Since the beginning of 2017 and as of 2 August, Germany reported 814 measles cases. During the same time period in 2016, Germany reported 196 cases. 

Italy: An increase of 159 cases since the last report on 28 July 2017 was reported. Since the beginning of 2017 and as of 1 August, Italy reported 4 001 cases, including three deaths. Among the cases, 275 are healthcare workers. The median age is 27 years, 89% of the cases were not vaccinated, and 6% received only one dose of vaccine. During the same time period in 2016, Italy reported 522 cases. 

Romania: An increase of 101 cases since the last report on 28 July 2017 was reported. Since 1 January 2016 and as of 28 July 2017, Romania reported 8 347 cases, including 32 deaths. Of these, 1 969 cases were reported during 2016, and 6 378 cases were reported between January 2017 and 28 July. 

United Kingdom: Public Health Wales reported two additional cases related to the outbreak in Newport and Torfaen, bringing the number of cases related to this outbreak to 12. Since the last report on 28 July 2017, England and Wales report an increase by 40 cases. Since the beginning of 2017 and as of 30 July 2017, England and Wales report 962 cases. In the same time period in 2016, they reported 996 cases. 

ECDC assessment

Measles outbreaks continue to occur in EU/EEA countries. There is a risk of spread and sustained transmission in areas with susceptible populations. Vaccination with two doses remains the most effective measure.

Actions

All EU/EEA countries report measles cases on a monthly basis to ECDC, and these data are published every month. Since 10 March 2017, ECDC has been reporting on measles outbreaks in Europe on a weekly basis. ECDC also monitors worldwide outbreaks on a monthly basis through epidemic intelligence activities. ECDC published a rapid risk assessment on 6 March 2017