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Friday 26th April 2019

Measles makes comeback in Europe

21st June 2011

Measles is still a leading cause of preventable death in children under five in spite of the availability of effective vaccines.


The vaccine has been around for four decades, and yet the disease is still endemic in many parts of Europe.

Before the vaccine was developed, measles was responsible for more than six million deaths annually around the world.

The number of global measles deaths dropped by 78% from 2000 to 2008, to around 164,000.

And yet, there have been outbreaks in Spain, the UK, the Netherlands, Italy, Ireland, France, Germany and Austria over the past two years.

Europe saw a total of 27,795 cases of measles in 2010 alone, with 25 deaths in Bulgaria linked to measles.

The US saw a sharp increase in measles cases, with nearly 18,000 cases reported during the course of 1989, after a fall in incidence of the disease earlier in the decade.

The failure to administer a second dose of measles, mumps, and rubella (MMR) vaccine was blamed for the surge in cases among the school-age population.

After the authorities introduced a second round of vaccines, cases began to fall, with transmission of endemic measles declared eradicated by the end of 2000.

But a further 118 cases were reported this year, from January 1 to May 20, with 46% of those imported from Europe.

Immunity against measles was usually acquired through infection or by antibodies travelling from mother to baby during pregnancy.

In order to get measles, a person has to both be susceptible to it, and to have contact with the infectious secretions of a person who has the disease.

Measles incidence will rise if a number of susceptible individuals enters the population, so the more people are vaccinated, the fewer cases will be reported.

The more susceptible individuals accumulate in between epidemics, the more serious the epidemic will be at its next peak. The more susceptible people there are, the sooner the peak will arrive.

In a well-vaccinated population, the peaks can be spaced 10 years apart, but without vaccination, they recur every 3-4 years.

Measles has resurged during a decline in the uptake of immunisation in the past decade.

Measles is hard to eradicate entirely because a person is infectious before they show symptoms.

The virus' spread should be halted if 95% of children in any given population are given two doses of MMR vaccine, however.

Access to services, public scepticism and religious beliefs may contribute to a failure to achieve this coverage, as well as a lack of organisation, meaning that some children only get one dose.

Progress towards elimination in Europe is flagging, with only 30 European countries reaching the target of less than one case per million of population.

The remaining 23 European states need to put more effort and resources into improving vaccine coverage.

Better public education could improve vaccine uptake by parents, and catch-up campaigns are needed to target those who missed immunisation the first time around.

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