Europe, 14 November 2011
Measles is back!

A major outbreak of measles - one of the most contagious infectious diseases - has hit many European countries  and the U.S.  this year.
Expectantly serious in babies and in immunosuppressed individuals, measles is not only a childhood illness as it affects people of all ages.

Measles is commonly marked by fever, cough, coryza, conjunctivitis, and pathognomonic enanthem followed by an erythematous maculopapular rash on the third to seventh day, but serious complications require hospitalisation and include pneumonia, seizures and encephalitis. Close and domestic contact, coughing and sneezing are the main infection transport agents.

As far as infection confers life-long immunity, international authorities like the World Health Organisation and the ECDC blame a lack of vaccinations in children which has brought the infection to spread. Following the introduction of an effective measles vaccine in 1963, the incidence of measles significantly decreased, instead countries where immunisation rates are still under the immunity level are today suffering from a resurgence of measles.

The standing failure in vaccination is due to several different reasons. Fear of  alleged adverse events following MMR vaccination, lack of reminders to parents, difficult access to health care, all lead to neglect the seriousness of the disease and to underestimate the need for vaccination. In Europe, notwithstanding the vast majority of children are vaccinated with MMR, the increasing number of vaccine sceptics overcome the threshold of not immunised people and increase the risk of outbreaks (5% susceptible population being sufficient to sustain periodic epidemics).

According to both European and U.S. recommendation, a second vaccine dose of MMR vaccine is needed in order to induce immunity to whom do not respond to the first dose and so to keep the immunised level under the epidemic threshold.

The WHO European Region is committed to eliminate measles and rubella by 2015. Strong commitment of all relevant partners (doctors, public health managers, policy makers, parents associations, etc.) is needed in order to meet such an important appointment.

References:

European Centre for Disease Prevention and Control (ECDC). European Monthly Measles Monitoring Report, September 2011.
CDC Health Advisory. June 22, 2011.