Global Alert and Response (GAR)

Measles outbreaks in Europe

As of 18 April 2011, 33 countries in Europe have reported more than 6 500 measles cases. Epidemiological investigations and genotyping have confirmed transmission of measles virus among several countries in the Region and to the Americas.

Belgium* has reported 100 cases to date, compared to 40 cases in all of 2010.
Bulgaria* has reported 131 cases this year, compared to 24 000 cases in 2009-10.
France* reported 4 937 cases from January to March 2011, compared to 5 090 cases reported in all of 2010.
In Serbia**, nearly 300 cases have been reported from Leskovac in the southeastern part of the country.

Spain* has reported two ongoing measles outbreaks since October 2010, with more than 600 cases reported in Andalusia. In the first outbreak, the most affected areas are Sevilla and surrounding municipalities, where more than 350 measles cases have been reported since January 2011. Cases of measles are reported among healthcare workers as well. The second outbreak was reported in the province of Granada, where about 250 cases have been reported since October 2010.

Since the beginning of a measles outbreak in September 2010, the former Yugoslav Republic of Macedonia** has reported 636 cases as of the first week of April 2011, with more than 400 cases diagnosed in 2011. The national capital, Skopje, has been most affected by the outbreak.

Turkey* reported an outbreak in Istanbul with more than 80 cases in January 2011.

In all the outbreaks except for the second outbreak in Spain and the outbreak in Turkey, the D4 genotype of measles virus has been confirmed. The B3 genotype of measles virus was isolated from cases in the second measles outbreak in Spain, while the D9 genotype, originating from and common in south-east Asia (e.g. Malaysia and Indonesia) was confirmed to have caused the outbreak in Istanbul, Turkey in January 2011.

In addition, this year, there have been outbreaks and an increase in the number of cases reported in Germany*, the Netherlands*, Norway*, Romania*, Russian Federation**, Switzerland* and the United Kingdom*.

Travel increases the risk for exposure to measles virus and its further spread into susceptible populations if not vaccinated. To prevent further spread, WHO encourages health authorities to advocate for immunization before travel and to provide immunizations through health systems’ immunization services according to existing national immunization schedules.

WHO recommends two doses of measles vaccine for all children and at least one dose prior to international travel for adolescents and adults who are unsure about their immunity status.

* Source: EUVACNET (http://www.euvac.net/graphics/euvac/index.html) ** Source: CISID (http://data.euro.who.int/cisid/)

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