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Published Date: 2011-05-31 00:41:43
Subject: PRO/EDR> Measles update 2011 (16)
Archive Number: 20110531.1660

MEASLES UPDATE 2011 (16)
************************

A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:

Europe
[1] UK (vaccination appeal)
[2] UK (London)
[3] UK (Yorkshire)
[4] Spain (Aragon)
[5] Spain (Ceuta)
[6] Spain (Seville)
[7] Spain (national)
[8] Switzerland (east)

The Americas
[9] Guatemala (alert)
[10] Peru (Tacna)
[11] USA (Massachusetts}
[12] USA (New Mexico]
[13] USA (New York)
[14] USA (Virginia)

******
Europe
---------
[1] UK (vaccination appeal)
Date: Fri 27 May 220111
Source: BBC News [edited]
http://www.bbc.co.uk/news/health-13561766

Parents in England and Wales are being urged to have their children
vaccinated after a 10-fold rise in measles cases in the 1st 4 months
of the year. The Health Protection Agency [HPA] reported 334 cases
compared with 33 in the similar period last year [2010].

The outbreak is thought to be linked to an epidemic in France, where
7000 cases have been reported since January 2011, more than in the
whole of 2010. The HPA says it is "crucial" that those at risk are
fully immunised. It says the latest cases are mainly among
unvaccinated people under 25 years old and are centred on "small
clusters in universities, schools or families or associated with
travel abroad."

Worst-hit are London and the South East, with 104 and 102 confirmed
cases respectively in the 1st quarter of this year [2011]. Recently,
the Health Protection Agency sent out letters to some primary schools
and further education colleges in London warning of the risks of
taking children who are not fully immunised to mainland Europe.

Measles cases in Europe, January-April 2011:
France - 7321*
Spain - 657
Switzerland - 390
UK - 345
Germany - 276*
(*January-March figure / Source: EUvac)

Dr Mary Ramsay, head of immunisation at the Health Protection Agency,
warned parents and young adults of the importance of immunisation.
"Although MMR coverage has improved over the last few years, we cannot
stress enough that measles is serious, and in some cases, it can be
fatal. Measles is a highly infectious and potentially dangerous
illness which spreads very easily. Whether you stay here in the UK or
travel abroad, it is crucial that individuals who may be at risk are
fully immunised."

In the UK, 2 doses of the MMR vaccine are usually given, the 1st at
around 12 months and the 2nd around the time of starting school. The
HPA advises parents to contact their GP as soon as possible if their
child is over a year old and has never had the MMR jab. Two doses of
the MMR vaccine are required to provide the greatest protection
against measles. HPA figures show that the number of toddlers getting
the MMR vaccination is climbing steadily but is still far from the 95
percent uptake rate needed to stop the spread of the disease in the
community. In December 2010, 89.4 percent of 2-year-old children in
the UK had received their 1st dose of the MMR vaccine. For
5-year-olds, the uptake rate had risen to 92.8 percent.

[Byline: Philippa Roxby]

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******
[2] UK (London)
Date: Mon 30 May 2011
Source: The Times [edited]
http://www.times-series.co.uk/news/topstories/9051728.Measles_cases_rocket_in_borough/

8 cases of measles were discovered in Barnet [Outer London] between
January and April this year [2011], prompting calls for parents to get
their children vaccinated. Last year [2010], only one case of the
disease, which can be fatal, was diagnosed in the borough.

Now the Health Protection Agency [HPA] is urging parents to give
their children the MMR vaccine in a bid to stop the alarming spread
across the whole of the capital. Dr Brian McCloskey, head of the HPA
in London, said: "The cases of measles we are seeing in London are
mainly associated with either recent travel abroad or small clusters
in unvaccinated or partially vaccinated children and young adults.
Some cases have also been seen in adults over 25 years of age. Measles
is a nasty illness which spreads easily in nurseries, schools and
colleges and in rare cases can be fatal. There is no age limit for
having the MMR vaccine, which protects against 3 illnesses, so it's
never too late to be immunised."

[Byline: Alex Hayes]

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[Barnet is a London borough in North London and forms part of Outer
London. It has a population of 340 000 approximately and borders
Hertfordshire to the north and 5 other London boroughs: Harrow and
Brent to the west, Camden and Haringey to the south-east and Enfield
to the east. It can be located in the map of the London boroughs at
http://www.milesfaster.co.uk/information/london-boroughs.htm. -
Mod.CP]

******
[3] UK (Yorkshire)
Date: Fri 27 May 2011
Source: Yorkshire Post [abridged, edited]
http://www.yorkshirepost.co.uk/news/at-a-glance/main-section/warning_as_measles_cases_rise_in_yorkshire_1_3422691

More than 330 cases of measles have been reported [in the UK] in the
1st 3 months of 2011 -- similar to the whole of last year [2010] --
with Yorkshire seeing one of the highest numbers. Data from the Health
Protection Agency (HPA) revealed 334 confirmed cases of measles to the
end of April 2011 in England and Wales, compared with 374 in all of
2010. Small outbreaks have been noted in universities, schools and
within individual families, while some people caught the disease
abroad as Europe faced a surge in measles cases.

In England and Wales, the under-25s were most affected in the 1st 3
months of the year [2011]. The vast majority had not had the vaccine
against the disease. Most cases occurred in London and the South East,
followed by Yorkshire.

The most recent UK figures for uptake of the measles, mumps and
rubella (MMR) jab, covering September to December 2010, showed 89.4
percent of children had received their 1st dose by the age of 2. By
age 5, 84.8 percent of children had received their 2nd dose. Both are
slightly up on previous figures.

--
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[The location of Yorkshire can be found on the map of English
Counties at:
http://www.picturesofengland.com/mapofengland/counties-map.html. -
Mod.CP]

*****
[4] Spain [Aragon]
Date: Sun 29 May 2011
Source: El Periodico de Aragon [in Spanish, machine trans., abridged,
edited]
http://www.elperiodicodearagon.com/noticias/noticia.asp?pkid=675693

The measles outbreak that has been declared in several European
countries has now come to Aragon. Since mid-March 2011, 20 cases have
been confirmed, whereas in recent years there were one or none, except
for 2006 when there were 4. The Directorate General of Public Health
of the Government of Aragon stated that although one cannot anticipate
how the outbreak will develop, the situation is unlike that in
Andalusia, where they have already declared almost 1000 cases. And in
Spain, the situation is less serious than in some other countries such
as France, where there have been more than 7000 cases this year
[2011].

What is known is that in Aragon, there have been 20 cases in 2.5
months, all in the city of Zaragoza and nearby towns, and that there
are 2 distinct strains [genotypes?] of the virus. It is unknown where
they came from, but likely they were introduced by visitors from other
countries (such as Italy), where vaccination has not been
comprehensive. For instance, in Italy about 10 000 cases are reported
annually.

According to Luis Gascon, technical DGA Public Health, in Aragon the
percentage of coverage of young children is 99 percent, which exceeds
the 95 percent coverage level recommended by WHO. Although this age
group is the most vulnerable, unlike in other communities, in Aragon
there have been few cases that require hospitaliation. In neighboring
Catalonia, for example, 1/3rd of the 115 cases requiring
hospitalization for respiratory complications came from this age
group.

--
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[The location of Aragon can be found in the map of the regions of
Spain at:
http://www.idealspain.com/pages/information/geographyheading.htm. -
Mod.CP]

******
[5] Spain (Ceuta)
Date: Sat 28 May 2011
Source: El Faro [in Spanish, machine trans. edited]
http://www.elfarodigital.es/ceuta/sanidad/50998-el-brote-de-sarampion-llega-a-15-infecciones-en-ceuta.html

The measles outbreak currently affecting Spain and Europe is now
fully established in Ceuta [Spanish territory on the north coast of
Africa]. According to data from a report compiled by Public Health and
Epidemiological Surveillance of the Ministry of Health, the number of
cases has reached 15 in the city, with the most recent case recorded
on 19 May 2011.

In Ceuta, there have been no more than 2 cases per year during the
past 5 years, a figure close to the estimate by the World Health
Organisation in 1991 of the level necessary to reduce the annual
incidence of confirmed cases in Europe to less than one per 100 000
inhabitants. Thus, the 2011 data in the entire European Union,
including Ceuta, makes this estimate invalid now.

Nonetheless, Margarita Medina, a member of the Committee of Public
Health and Epidemiological Surveillance, says it is likely that cases
of measles infection have peaked now, given that in the temperate
zone, the disease occurs mainly in late winter and early spring. "The
most appropriate response is vaccination. In the Autonomous City of
Ceuta, MMR (measles, rubella and mumps) is administered at 15 months.
A 2nd dose, needed to develop an effective resistance to the virus, is
given at 6 years of age," said Medina.

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[Ceuta is a 18.5 square km (7.1 sq mi) autonomous city of Spain and
an exclave located on the north coast of North Africa surrounded by
Morocco. Separated from the Iberian peninsula by the Strait of
Gibraltar, Ceuta lies on the border of the Mediterranean Sea and the
Atlantic Ocean. - Mod.CP]

****
[6] Spain (Seville)
Date: Sat 28 May 2011
Source: Capital [in Spanish, trans. Corr.SB, edited]
http://noticias.lainformacion.com/salud/enfermedades/un-brote-de-sarampion-con-origen-en-sevilla-acumula-ya-65-casos_jKgfHTd1bBTtcXFeZoJVh/

Measles has returned to Extremadura [Province]. The different Health
districts have received reports of a total of 65 cases of which 54 are
already confirmed, according to the latest official report of the SES,
which was updated on Monday [23 May 2011]. The outbreak is localised.
Those affected are children between 5 and 9 years of age, and only 3
had been vaccinated against the disease.

--
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[Seville is located in the province of Andalucia and can be found in
the map of the regions of Spain at:
http://www.idealspain.com/pages/information/geographyheading.htm. -
Mod.CP]

******
[7] Spain (national)
Date: Fri 27 May 2011
Source: ABC Sevilla [in Spanish, machine trans. abridged, edited]
http://www.abcdesevilla.es/20110527/sevilla/sevp-casos-sarampion-superan-millar-20110527.html

The Andalusian capital is the most affected, with 323 infections,
followed by Alcala and Dos Hermanas. Measles infection continues to
spread through the province of Seville and now exceeds 1000 since an
outbreak began in January [2011], with initial focus in the town of
San Juan de Aznalfarache.

Despite the measures implemented to stop the spread of the disease,
case numbers have increased again to 689 in recent weeks, according to
the latest figures provided by the Department of Public Health.

As of 24 May 2011, according to figures provided by the Department of
Health, Seville has experienced the greatest increase, with 323 people
affected, representing 77 new cases since the latest figures published
on 26 Apr 2011. Of the total, 164 have occurred in the slums of South
Range, 50 in The Litany, 41 in La Candelaria, 32 in Torreblanca and 36
in La Plata.

Seville is followed by the town of Alcala de Guadaira, where there
have been 130 cases, almost 50 more than those recorded a month ago.
In contrast with 108 cases, the municipality of San Juan de
Aznalfarache, the epicenter of the outbreak, has recorded no more
cases. Not so in towns like Dos Hermanas, which experienced a
considerable increase in passing from 25 to 54 cases, and Coria del
Rio, which almost doubled the number of cases, from 23 to 44. To close
the list, Mairena del Aljarafe with 19 cases has recorded 3 new
infections.

--
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[The HealthMap/ProMED-mail interactive map of Spain an be accessed
at: http://healthmap.org/r/00dK. - Mod.CP]

*****
[8] Switzerland (east)
Date: Mon 30 May 2011
Source: genevalunch.com [edited]
http://genevalunch.com/blog/2011/05/30/measles-outbreak-shifts-from-western-to-eastern-switzerland/

The 2011 measles epidemic that spiked in Basel, Geneva and Lausanne
in the 1st 4 months of the year is moving on to eastern Switzerland,
according to figures published Monday [30 May 2011] by the Federal
Public Health Office, with 515 cases throughout the country from 1 Jan
to 24 May 2011.

The 2011 epidemic appears to have reached its peak in western
Switzerland, but numbers are now dropping. By mid-May 2011, Geneva
(110 cases) and Vaud (93) had felt the impact of a major epidemic in
France, while Basel, with 57 cases, was affected mainly by a group
that is reluctant to vaccinate its children.

Cantons Aargau, Saint Gall, Thurgau, Zurich, and also Neuchatel and
Ticino are now seeing a rapid increase in cases.

Outbreaks in 2009 and 2010 prompted large vaccination programmes in
the Swiss Army and at EPFL in Lausanne [Ecole polytechnique federale
de Lausanne], after cases of the highly contagious disease developed.
Geneva schools sent letters in April 2011 alerting parents to the need
to vaccinate and follow up with a 2nd vaccination as the disease
spread.

Public health authorities are again urging people to make sure they
have had a follow-up vaccination if they had only one, and to be
vaccinated if they were not. The disease, also called rubeola, is a
respiratory tract infection that requires being quarantined.
Complications can be more severe in adults: 41 percent of the Swiss
cases since December 2010 have been adults over the age of 20. In 88
percent of the cases, the patients were not vaccinated at all, and in
7 percent, they were not sufficiently covered.

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******
The Americas
------------
[9] Guatemala (alert)
Date: Wed 25 May 2011
Source: Prensa Libre [in Spanish, machine trans. edited]
http://www.prensalibre.com/noticias/comunitario/Alerta-Chiquimula-brote-sarampion-paises_0_487151512.html

Health authorities in Chiquimula in cooperation with the governments
of El Salvador and Honduras will maintain a sanitary cordon on both
borders in response to the outbreak of measles in several European
countries and Panama.

Doctor Luis Antonio Velarde, director of Chiquimula Health, said that
consultations are taking place with neighboring countries to take
necessary action. Velarde added that information is being collected to
establish what proportion of children and adults have been vaccinated
in order to develop a strategy to prevent the epidemic from
spreading.

[Byline: Edwin Paxtor]

--
Communicated by:
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[Chiquimula is a city in Guatemala. It serves both as the capital of
the department of Chiquimula and as the municipal seat for the
surrounding municipality of the same name. The HealthMap/ProMED-mail
interactive map of Guatemala can be accessed at:
http://healthmap.org/r/009P. - Mod.CP]

******
[10] Peru (Tacna)
Date: Sun 29 May 2011
Source: Correo [in Spanish, machine trans. edited]
http://diariocorreo.pe/nota/11377/se-incrementa-alerta-de-contagio-de-sarampion-en-tacna/

The regional health director of Tacna, Renan Zegarra Neira, noted
that the 1st cases of measles had been notified in the Chilean city of
Arica one week ago. Tacna, by virtue of its location close to the
Chilean border, is at increasing risk.

He recalled participating in the original measles vaccination
campaign when the goal was to vaccinate 23 000 people from 5 to 23
years of age by 31 Jun [year?] when the season ended, adding that 61
percent of the target had been achieved and that the goal has been
advanced 61 percent.

Neira dismissed the concerns of some parents who believed that the
vaccine has side effects, emphasizing that the quality and
effectiveness of the vaccine was endorsed by the World Health
Organization (WHO). "For 10 years there have been no cases of measles
in Peru; do not put this situation at risk," he added.

--
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[San Pedro de Tacna, or simply Tacna, is a city in southern Peru and
the regional capital of the Tacna Region. It is located on the border
with Chile, inland from the Pacific Ocean and in the valley of the
Caplina. - Mod.CP]

******
[11] USA (Massachusetts)
Date: Wed 25 May 2011
Source: 7Newswhdh.com [edited]
http://www1.whdh.com/news/articles/local/boston/12004405765725/2-more-cases-of-measles-confirmed-in-boston/#ixzz1NldPn2XK

2 more cases of measles have been confirmed in Massachusetts. On a
Boston playground, word of the latest measles case in a young child
hits close to home. "I'm petrified," said the father of twins. "It's
the 1st time I've heard that actually."

According to Boston's Public Health Commission, the 23-month-old boy
who lives in the city and received the measles-mumps-rubella vaccine
as directed still got the disease but did not have to be
hospitalized.

For parents who've carefully weighed the decision to vaccinate, the
idea that the shot didn't prevent the measles is worrisome. "You
expect your child to be safe. The vaccine is given for a reason," said
a parent.

It's one of 2 cases reported this week and comes on the heels of 2
elementary students at the Driscoll School in Brookline being
diagnosed last week. Earlier this month [May 2011], 5 cases were
reported in Boston, including a worker at South Station. And back in
February 2011, the French consulate in the Back Bay was the center of
the scare.

The highly contagious and potentially deadly disease causes a large
[extensive] rash and flu-like symptoms. Children are advised to get
the 1st dose of the vaccine between the ages of one year and 15 months
with a booster before kindergarten.

Health experts say a recent outbreak in Europe is playing a role in
the increase.

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*****
[12] USA (New Mexico)
Date: Sun 29 Mau 2011
Source: Alamogordo Daily News [edited]
http://www.alamogordonews.com/ci_18159115

The New Mexico Department of Health is investigating a case of
measles in Otero County. The department's scientific laboratory
division says it has confirmed a case in a 14-month-old boy who
recently traveled in Europe. The boy is reportedly recovering at
home.

This is the 2nd measles case in New Mexico in 2011. The 1st case was
found in a 27-year-old woman from Santa Fe County. Health officials
said measles is highly contagious and can be transmitted through the
air. Early symptoms of measles include red eyes, fever, runny nose and
cough. Within a few days following the cough and runny nose, a rash
will typically begin on the head and spread down the body. Measles is
diagnosed by a combination of symptoms and laboratory testing.

"Our staff is working closely with the family and the Centers for
Disease Control and Prevention to identify other people who may have
been exposed to the disease so we can prevent more cases," said Dr.
Catherine Torres, the Department of Health's cabinet secretary.
"Patients with measles serve as a reminder to all of us to keep
immunizations current."

The Department of Health recommends that people traveling outside of
the country check that they are current on all immunizations,
including the measles vaccination. Vaccines are free for any child in
New Mexico, regardless of insurance status, under the Vaccines for
Children program. Children who have no insurance coverage can get the
vaccine at their local public health department.

--
Communicated by:
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[A map showing the locations of the counties of the state of New
Mexico can be accessed at:
http://geology.com/county-map/new-mexico.shtml. Otero is in the
south of the state. - Mod.CP]

******
[13] USA (New York)
Date: Fri 27 May 2011
Source: CBS New York, Associated Press report [edited]
http://www.newstimes.com/default/article/Va-reports-measles-outbreak-1397750.php

The Nassau County Department of Health Friday [27 May 2011] announced
that a case of measles had been confirmed in an adult who resides in
Nassau County.

Residents may have been exposed to this individual with measles if
they visited the following location(s) on the dates and times listed
below:

- Crest Hollow Country Club, 8325 Jericho Turnpike, Woodbury, NY
11797. Exposure: Sun 22 May 2011 from 6:30 p.m. to 12:00 a.m.
- Factory/Office Building, 99 2nd Avenue, Garden City Park, NY 11040.
Exposure: Mon 23 May 2011 from 8:30 a.m. to 9:00 p.m.
- Factory/Office Building, 55 Denton Avenue, New Hyde Park, NY 11040.
Exposure: Tue 24 May 2011 from 8:30 a.m. to 1:30 p.m.
- Office/Medical Building, 520 Franklin Avenue, Garden City, NY
11530. Exposure: Tue 24 May 2011 from 2:00 p.m. to 6:00 p.m.
- Office/Medical Building, 999 Franklin Avenue, Garden City, NY
11530. Exposure: Wed 25 May 2011 from 9:00 a.m. to 1:00 p.m.

The Health Department will be providing immune globulin prevention
injections to individuals at high risk. High risk individuals are:
un-immunized against measles, with weakened immune system, infants
under the age of one year who may have been exposed at the above
mentioned locations.

If you have received the recommended childhood vaccinations, which
include the measles vaccine, you should be adequately protected from
contracting measles. The Nassau County Department of Health is
advising individuals who may have been exposed and who have symptoms
consistent with measles to call their health care providers or
emergency rooms before going for care so that others are not exposed
to the illness.

Measles is a highly contagious respiratory disease caused by a virus
and is spread by direct contact with nasal or throat secretions of
infected people. Measles symptoms generally appear in 2 stages. In the
1st stage, which lasts 2 to 4 days, the individual may have a runny
nose, cough and a slight fever. The eyes may become reddened and
sensitive to light while the fever gradually rises each day. The 2nd
stage begins on the 3rd to 7th day and consists of a red blotchy rash
lasting 5 to 6 days. The rash usually begins on the face and then
spreads downward and outward, reaching the hands and feet. The rash
fades in the same order that it appeared, from head to extremities.
Symptoms of measles usually appear in 10 to 12 days but can occur as
late as 18 days after exposure. Although measles is usually considered
a childhood disease, it can be contracted at any age.

The Health Department has notified all emergency rooms, the Nassau
County Medical Society and the Nassau County Pediatric Society that an
individual with measles has been diagnosed in Nassau County. For
additional information about measles, visit the Health Department
website at http://www.nassaucountyny.gov/agencies/Health/index.html
or call at (516) 227-9697.

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******
[14] USA (Virginia)
Date: Thu 26 May 2011
Source: Newstimes.com [edited]
http://www.newstimes.com/default/article/Va-reports-measles-outbreak-1397750.php

The Charlottesville-Albemarle Health Department is dealing with a
measles outbreak. Media outlets reported Thursday [26 May 2011] that
the agency is warning people they may have been exposed after
confirming that a woman who contracted the disease in India has passed
it along to 2 others. Thomas Jefferson Health District director Dr.
Lilian Peake says it's possible more people will get sick.

Measles is rare in Virginia. Peake says there were 3 cases in
Virginia last year [2010] and one each in 2009, 2008 and 2001. The
last time measles was confirmed in the Charlottesville area was 1990.

The Virginia Health Department warns that anyone who develops a
fever, runny nose, watery red eyes and a cough should stay home and
contact their doctor.

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[The HealthMap/ProMEDmail interactive map of the USA can be accessed
at: <http://healthmap.org/r/01bQ. - Mod.CP]

See Also