In the first two months of 2019, 34 300 measles cases have been reported in 42 countries of the World Health Organisation European Region, including 13 measles-related deaths in three countries, Albania, Romania and Ukraine, WHO said on May 6.
The majority of cases are reported in Ukraine, with more than 25 000 cases, WHO said.
As of March 28 2019, the WHO European Region reported a total of 83 540 measles cases and 74 related deaths for 2018.
This is compared to 25 869 cases and 42 deaths in 2017, and 5 273 cases and 13 deaths in 2016.
In 2018, eight countries reported over 2000 cases each including Ukraine (53 218), Serbia (5076), Israel (3140), France (2913), Italy, (2686), Russia (2256), Georgia (2203) and Greece (2193).
Although the European Region achieved its highest ever estimated coverage for the second dose of measles vaccination in 2017 (90 per cent), countries with measles outbreaks have experienced a range of challenges in recent years including a decline or stagnation in overall routine immunisation coverage in some cases, low coverage at sub-national level or among some marginalised groups and immunity gaps in older populations, WHO said.
“Most cases are occurring in unvaccinated or under-vaccinated individuals.”
Ten countries including Belgium, Bosnia and Herzegovina, France, Georgia, Germany, Italy, Romania, Russian Federation, Serbia and Ukraine remain endemic for measles.
Measles is transmitted via droplets from the nose, mouth or throat of infected persons. Initial symptoms, which usually appear 10–12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.
Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, and severe respiratory infections such as pneumonia.
Routine measles vaccination for children, combined with mass immunisation campaigns in countries with low routine coverage, are key public health strategies to reduce global measles deaths, WHO said.
While global measles deaths have decreased by 84 per cent worldwide in recent years — from 550 100 deaths in 2000 to 89 780 in 2016 — measles is still common in many developing countries, particularly in parts of Africa and Asia.
An estimated seven million people were affected by measles in 2016. The overwhelming majority (more than 95 per cent) of measles deaths occur in countries with low per capita incomes and weak health infrastructures.
The measles vaccine has been in use since the 1960s.
“It is safe, effective and inexpensive,” WHO said.
WHO recommends immunisation for all susceptible children and adults for whom measles vaccination is not contraindicated.
Reaching all children with two doses of measles vaccine, either alone, or in a measles-rubella (MR), measles-mumps-rubella (MMR), or measles-mumps-rubella-varicella (MMRV) combination, should be the standard for all national immunisation programmes, WHO said.