Measles in the EU/EEA: current outbreaks, latest data and trends – January 2018

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Measles outbreaks continue to occur in a number of EU/EEA countries, and there is a risk of spread and sustained transmission in areas with susceptible populations. Since the beginning of 2016, 49 deaths due to measles have been reported in the EU.

New data published today by ECDC in the Communicable Disease Threat Report (CDTR) show that the highest number of measles cases since 1 January 2017 were reported in Romania (8 274), Italy (4 885) and Germany (919). Greece is currently experiencing a measles outbreaks with 968 cases including two deaths reported since May 2017 and significant emerging outbreaks have been reported in France (77 cases), Sweden (26 cases) and the UK (62 cases). Most cases were unvaccinated or incompletely vaccinated.

ECDC’s Director, Dr Andrea Ammon said: “It is tragic and unacceptable that 49 children and adults in EU countries have died from complications of measles infection in the past 2 years, while safe and effective vaccines are readily available”. She continued, “Vaccination with at least two doses of MMR vaccine remains the most effective measure to prevent the further spread of measles. ECDC is committed to further work with Member States in support of their efforts to eliminate measles, particularly through its core functions of surveillance, scientific advice, preparedness and response, and communication.”

The monthly measles and rubella surveillance monitoring report is also published today and provides more in-depth analysis of the situation.

The spread of measles across Europe is due to suboptimal vaccination coverage in many EU/EEA countries: of all measles cases reported during the one-year period 1 December 2016 to 30 November 2017 with known vaccination status, 87% were not vaccinated. Measles increasingly affects all age groups across Europe and in 2017, 44% of measles cases with known age were aged 15 years or older. Romania, Italy, Germany and Greece were the countries most affected by measles during 2016 and 2017 and each shows different trends: Romania saw a sharp increase in cases from October 2016, and the trend has continued throughout 2017; in Italy, the increasing trend started in January 2017, while in Germany it began in February 2017; Greece has seen a measles outbreak starting in the second half of 2017, with 250 cases, including one death, reported in November 2017. This was an increase from 167 cases, including one death, in October and 127 cases in September. This data is based on analysis of the cases notified to ECDC and included in the monthly and annual monitoring reports.

The latest available figures on vaccination coverage collected by WHO (2016) show that the vaccination coverage for the second dose of measles was below 95% in 20 of 27 EU/EEA countries reporting second dose coverage data.

In order to achieve the measles elimination goal, the vaccination coverage rates for children targeted by routine vaccination programmes should increase in a number of countries, as the vaccination coverage of the second dose must be at least 95% to interrupt measles circulation and achieve herd immunity. This is particularly important to protect children below one year of age, who are particularly vulnerable to complications of measles but are too young to have received the first dose of vaccine.