Measles cases have soared across Europe over the last year, with large outbreaks affecting one in four countries, according to the World Health Organisation (WHO) which is concerned by low rates of immunisation against the disease.
WHO Europe says there has been a four-fold increase during 2017, with more than 21,000 cases and 35 deaths. That will be a major disappointment following the record low in 2016, when there were just 5,273 cases in Europe.
“Every new person affected by measles in Europe reminds us that unvaccinated children and adults, regardless of where they live, remain at risk of catching the disease and spreading it to others who may not be able to get vaccinated,” said Dr Zsuzsanna Jakab, WHO regional director for Europe. “Over 20,000 cases of measles, and 35 lives lost in 2017 alone, are a tragedy we simply cannot accept.”
Measles can kill or cause long-term damage. One in every thousand children affected develops encephalitis, which is swelling of the brain and can lead to deafness or learning difficulties.
Measles is targeted for elimination around the world, because of the efficacy of the vaccine, but it has been bedevilled by regular outbreaks. WHO said there were large outbreaks last year in 15 of the 53 countries in the European region. Romania was worst affected with 5,562 cases, followed by Italy with 5,006 and Ukraine with 4,767.
Immunisation in those countries has hit a number of problems in recent years. There have been declines in overall routine immunisation coverage, consistently low coverage among some marginalised groups, interruptions in vaccine supply or underperforming disease surveillance systems.
Greece (967), Germany (927), Serbia (702), Tajikistan (649), France (520), the Russian Federation (408), Belgium (369), the United Kingdom (282), Bulgaria (167), Spain (152), Czechia (146) and Switzerland (105) also experienced large outbreaks, many of which were in decline by the close of 2017.
Confidence in the MMR – measles, mumps and rubella – vaccine and in immunisation generally has been an issue in Europe and in the United States following the discredited claims of the researcher Andrew Wakefield, who linked the MMR to the development of autism.
WHO released the data ahead of a ministerial meeting on immunisation in Montenegro on 20 February 2018, saying that the drive to eliminate the disease continues. “Elimination of both measles and rubella is a priority goal that all European countries have firmly committed to, and a cornerstone for achieving the health-related Sustainable Development Goals,” said Jakab. “This short-term setback cannot deter us from our commitment to be the generation that frees our children from these diseases once and for all.”
Europe has been moving closer to the goal, with one country after another reviewed each year by an independent commission, which recommends what should be done to overcome specific challenges such as problems with the supply of vaccines. By the end of 2016, 42 of the 53 countries in the WHO region had interrupted endemic measles transmission. But cases will continue to cross borders and spark outbreaks until all of them - and their neighbours - are measles-free.
Last month, Public Health England (PHE) warned that there were measles cases in several regions of England: Sussex, West Midlands, Surrey, Greater Manchester, Merseyside and West Yorkshire. Parents were urged to get their children vaccinated if they had not done so. PHE said anyone who had visited Romania, Germany or Italy might be particularly at risk.
The first dose of MMR vaccine is given to babies when they are a year old. The second, which is more often missed, is given just before children start school.