Measles and rubella monitoring, January 2015
Measles and rubella are targeted for elimination in Europe by 2015. ECDC closely monitors progress towards interruption of endemic transmission of both diseases through enhanced surveillance and epidemic intelligence. Measles and rubella vaccinations are routinely delivered as trivalent measles-mumps-rubella (MMR) vaccine in Europe, and the first of the two recommended doses is normally given during the second year of life.
On 25 February 2015, the World Health Organisation Regional Office for Europe urgently called on policy makers, health care workers and parents to immediately step up vaccination against measles across age groups at risk.
In the last five years Europe has experienced a dramatic resurgence of measles and rubella, and several countries reported outbreaks with case numbers in the thousands. Notably, Germany has reported more than 600 cases already for 2015, as part of an ongoing outbreak in Berlin.
In the last 10 years, on average 40% of measles cases in the EU were over 14 years old. Moreover, high notification rates have been reported in infants below one year of age (6.2% of cases in 2014), an age group too young to be vaccinated and who most benefit from herd immunity.
In 2014 , 30 EU/EEA countries reported 3 616 measles cases; among those with known vaccination status, 83.0% were completely unvaccinated.
There are a number of barriers to reaching the 95% vaccination coverage target with two doses required to eliminate measles effectively, which apply to differing degrees in each European country, notably:
- perceptions by the general population and HCW that measles is a mild disease;
- a decline in public confidence in vaccines in general;
- the existence of pockets of under-vaccinated populations;
- increasing resource constraints of public health budgets.
ECDC endorses the WHO Europe call on boosting vaccination coverage against measles. There are a number of actions that public health authorities can take to increase vaccination coverage:
- Increase access for individuals and families to healthcare services, for some countries this particularly extends to addressing hard-to-reach communities.
- Commit more financial and human resources for MMR immunisation programmes.
- Ensure healthcare workers (HCW) have the required knowledge and skills to appropriately support vaccination take up as they have a critical role to play in parents’ decision making
- Enhance surveillance quality towards detection and investigation of all suspected cases;
- Respond to outbreaks promptly and actively.
The double failure of not responding adequately to the ongoing measles epidemic and not achieving measles and rubella elimination in the Europe would result in a significant health risk for European citizens and threaten to undermine regional and global disease control efforts.
We need to safeguard decades of progress and ultimately achieve the goal of measles elimination.