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Published Date: 2012-01-23 10:03:14
Subject: PRO/EDR> Measles update 2012 (04)
Archive Number: 20120123.1018565

MEASLES UPDATE 2012 (04)
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In this update

Europe
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[1] ECDC report
[2] Isle of Man
[3] Span

The Americas
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[4] Ecuador (CHI)
[5] USA (Kansas)
[6] USA (Pennsylvania 2009)

Asia
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[7] India (AP)

Oceania
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[8] Australia (ACT)

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Europe
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[1] ECDC report
Date: Mon 16 Jan 2012
Source: ECDC European monthly measles monitoring report
http://ecdc.europa.eu/en/press/news/Lists/News/ECDC_DispForm.aspx?List=32e43ee8-e230-4424-a783-85742124029a&ID=546&RootFolder=%2Fen%2Fpress%2Fnews%2FLists%2FNews

EMMC report
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The latest European Monthly Measles Monitoring (EMMC) report states that, during the period January to November 2011, more than 28 800 cases of measles were reported to the European Surveillance System by the 29 contributing EU [European Union] and EEA [European Economic Area] countries.
- 8 measles-related deaths and 26 cases of acute measles encephalitis were recorded. The highest incidence was among infants under one year (39.1 cases per 100 000 population);
- 3 out of the 29 reporting countries remained measles-free until the end of November 2011, namely Cyprus, Hungary, and Iceland;
- the peak measles transmission period is approaching and the number of new measles cases is expected to start increasing towards the end of January [2012].

Measles, a highly infectious vaccine-preventable disease, is re-emerging in Europe. Countries within the European Region of the World Health Organization, which include EU and EEA/EFTA countries, have committed to eliminate measles by 2015. Elimination of measles requires sustained vaccination coverage above 95 per cent with 2 doses of a measles-containing vaccine (MCV).

ECDC is monitoring measles transmission in these countries and produces epidemiological updates. The EMMC aims to provide timely public updates on the measles situation in Europe for effective disease control measures, and in support of the common 2015 measles elimination target.

Read the European monthly measles monitoring report (EMMC), December 2011
See measles maps: (http://ecdc.europa.eu/en/activities/surveillance/euvac/data/Pages/measles_maps.aspx) and surveillance tables (http://ecdc.europa.eu/en/activities/surveillance/euvac/data/Pages/data_bymonth.aspx)

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[2] Isle of Man
Date: Thu 19 Jan 2011
Source: isleofman.com [abbreviated & edited]
http://www.isleofman.com/News/article.aspx?article=42840

Suspected measles case in the Isle of Man
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The Department of Health has confirmed that a teenager from the Isle of Man is a suspected case of measles. It says it is likely that the teenager acquired the viral infection abroad as there have been several outbreaks of measles in many European countries. People in close contact with the teenager have been identified, contacted directly and advised of the individual action that they need to take.

Measles is a viral infection which is highly infectious to someone who is not protected against it. It can cause serious complications such as pneumonia, encephalitis (infection of the ear), and middle ear infections.

The Public Health directorate of the Department of Health has issued the following advice to members of the public:
- all individuals aged under the age of 40 need to check their immunisation history which can be done by calling your GP practice. If you have not received the measles vaccine make an appointment with your practice nurse to receive 2 doses of MMR;
- there have been major outbreaks of measles in many European countries. Recent arrivals from European countries to the Isle of Man need to ensure that they are registered with a local GP to obtain health care and ensure that all members of their family are fully immunised;
- all parents need to ensure that their children are fully immunised as recommended by their GP;
- if you or any member of your family develop symptoms of measles (fever, coughing, skin rash), please seek advice from your GP or Manx Emergency Doctors (MEDs) by telephone. Do not attend A & E, your GP surgery or MEDs unless instructed to do so.

The last time measles was confimed in the Island was in September last year [2011].

(byline: Tessa Hawley)

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[The Isle of Man is a self-governing British Crown Dependency, located in the Irish Sea between the islands of Great Britain and Ireland, within the British Isles. The island is not part of the United Kingdom. - Mod.CP]

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[3] Spain
Date: Thu 19 Jan 2012
Source: EuroWeekly online [edited]
http://www.euroweeklynews.com/news/costa-blanca/costa-blanca-south/90899-measles-cases-rising-in-spain

Measles cases rising in Spain
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Vaccination levels have fallen to 85 per cent. Spanish paediatricians have advised bringing forward measles vaccinations due to the rise of the number of cases.

Almost 2000 cases of measles were detected in Spain last year [2011], compared with 173 in 2010. Therefore the Vaccination Advice Committee of the Spanish Paediatric Association has suggested bringing the MMR vaccine [campaign] forward and giving the first dose to children at 12 months instead of 15 months.

This is because cases are being detected in children between 12 and 15 months when children have an insufficient amount of antibodies to fight it. The second dose is recommended at age 2 years, instead of waiting to between 3 and 4 or sometimes 6 years old.

In Europe, 30 000 cases of measles were detected in 2011, killing 8 people. In Spain, 2000 were registered, but the true figure is believed to be closer to 3000, with 2000 in Sevilla alone, mainly due to the fact that there are a lot of gypsy families whose children are not vaccinated.

Most of the other cases were also in Andalucia, and in Madrid and Barcelona. Measles is one of the most contagious diseases known, infecting more than 10 million children per year and killing 120 000 people. Experts claim the rise in the number of cases is due to the fact that vaccination levels have fallen to 85 per cent, when the ideal to prevent a disease from spreading is 95 per cent. This, they say, is because parents have relaxed and stop taking their children to the doctor after the age of 2, because many haven’t had measles and forget that it can be a killer.

Other causes are a campaign in the UK which related the measles vaccine to autism [now discounted] and the fact that many parents don’t want to vaccinate their children because they believe illness is natural.

(byline: Jennifer Leighfield)

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The Americas
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[4] Ecuador (Chimborazo)
Date: Thu 19 Jan 2012
Source: Diario Los Andes, Ecuador [In Spansh, trans. by JT/JG, edited by Mod.CP]
http://www.diariolosandes.com.ec/index.php?option=com_content&view=article&id=1017:salud-confirmo-tres-casos-de-sarampion-&catid=59:portada&Itemid=157

Measles in Chimborazo
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In the province there have been 109 cases, of whom 106 were negative and 3 positive. The head of the Epidemiology Dept. of the Bureau of Health of Chimborazo stated that the results of other 7 tests are pending.

To date 89 per cent of children 6 months to 1 year old and 84 per cent in children 1 to 4 years have received MMR [measles, mumps, rubella] vaccination. Meanwhile, vaccination of children between 5 and 15 years is in progress. The confirmed cases are a child of 5 years, a 3 year old girl, and a boy of 14. These 3 juveniles had not received MMR vaccine due to parental opposition to vaccination. These parents have been requested to take their children to a vaccination centre to prevent further spread of the infection.

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[A map of Cimborazo province of Ecuador can be accessed at http://www.exploringecuador.com/maps/mapas_provincias/grandes/chimborazo/chimborazo_map.htm. - Mod.CP]

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[5] USA (Kansas)
Date: Thu 19 Jan 2012
Source: KSN.com [edited]
http://www.ksn.com/news/local/story/More-measles-cases-confirmed-in-Finney-County/lpLcq31z2kKPd7PGLJPwSw.cspx

More measles cases confirmed in Finney County
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Garden City: The Finney County Health Department has confirmed 2 more cases of measles. That brings the number of cases in Finney County to 4. Health officials are investigating and are contacting those at risk for the disease.

Because of the widespread use of the MMR vaccine, cases in the US are rare, but measles still kills 200 000 people worldwide each year. Measles is spread through the air by breathing, coughing, or sneezing. It is so contagious that any person who is exposed to it and is not immune will probably get the disease. Measles can be spread to others from 4 days before to 4 days after the rash appears.

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[6] USA Pennsylvania (2009)
Date: Thu 19 Jan 2012
Source: about.com, Pediatrics [edited]
http://pediatrics.about.com/b/2012/01/19/pennsylvania-measles-outbreak.htm

Pennsylvania: CDC report on 2009 hospital-associated measles outbreak
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Of five cases, there were:
- a 10 year old who had recently moved to Pennsylvania from India (unknown vaccination status) and was seen in the ER [emergency room] for evaluation of fever and rash (the source patient);
- an 11 month old (too young to routinely be vaccinated against measles) who had been in the ER at the same time as the source patient and subsequently developed symptoms of measles;
- a 23 month old and 4 year old, both intentionally unvaccinated, and their partially vaccinated father, all of whom developed symptoms of measles after being exposed to the source patient in the ER; and
- the vaccinated ER physician who evaluated and treated the source patient.

Although the report stated that "health-care-associated measles outbreaks are costly," it didn't give a dollar amount like we have seen in some other reports, like the $130 000 Utah outbreak or $800 000 Arizona outbreak.

It did show how easy it is for people to get exposed to someone with measles, including the people on the flight from India, a time when the patient was contagious, a hotel, and at a doctor's office, in addition to the exposures in the hospital ER.

(byline: Vincent Iannelli, MD)

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Asia
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[7] India (AP)
Date: Thu 19 Jan 2012
Source: IBN Live.in.com India [edited]
http://ibnlive.in.com/generalnewsfeed/news/measles-outbreak-reported-from-arunachal-district/952659.html

Measles outbreak reported from Arunachal district
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With the detection of at least 30 cases, a measles outbreak has been reported in the remote villages of East Kameng district of Arunachal Pradesh. The worst affected villages in the district are Namchar Bagang and Soshi Bagang, around 17 kilometres from Chayangtajo, the circle headquarter, official sources said here today. To remain isolated from other infected people, villagers have been forced to take shelter in makeshift accommodation in the deep forest, they said. A voluntary health camp was held at Chayangtajo on Sunday [15 Jan 2012] and a team of doctors also went to various villages and gave medications to infected children. The team would visit every household to reach out to all the villagers, sources informed. Suspicious cases of malaria and viral cough were also detected, said Dr B Gara of General Hospital, Naharlagun.

Sources say the anti-measles vaccination campaign team is yet to reach the headquarters, and in the interior areas it is worse as children are not vaccinated against the dreaded viral disease. Even the Measles Catch-Up Campaign 2011, which was launched across the state last 28 November, is yet to begin in the district, officials added.

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[Arunachal Pradesh is located in the far north east corner of India. It borders the states of Assam and Nagaland to the south, and shares international borders with Burma, Bhutan, and China. A map of East Kameng district can be accessed at http://www.mapsofindia.com/maps/arunachalpradesh/districts/eastkameng.htm. - Mod.CP]

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Oceania
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[8] Australia (ACT)
Date: Mon 16 Jan 2012
Source: The Canberra Times [edited]
http://www.canberratimes.com.au/news/local/news/health/measles-outbreak-a-warning/2420441.aspx

Measles outbreak "a warning"
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A recent outbreak of measles at a Canberra school should serve as a warning for parents to get their children vaccinated before they start school, health officials say. ACT (Australian Capital Territory) Medicare Local reminded parents of the recent health scare at Orana Steiner School, where one case of measles infected a dozen other people and resulted in 3 people being admitted to hospital. A number of parents at the school had chosen not to vaccinate their children and doctors say this almost certainly increased the rate of spread for the highly infectious disease.

ACT Medicare Local chair Rashmi Sharma said all children should be vaccinated against diseases like mumps, measles, chicken pox, whooping cough, diphtheria, tetanus, polio, influenza, hepatitis B, and rubella. The warning was particularly relevant for 4 year olds, who would be due for booster shots after having their initial vaccines when they were younger.

"Some people choose not to vaccinate their children because of possible side effects but it is very rare for any person to get side effects and if they do, they are usually quite mild," Dr Sharma said. "However, the side effects from contracting some of these diseases can be really catastrophic and that is what people have to weigh up.

"We don't see cases of illnesses such as diphtheria in Australian society because the majority of people are vaccinated. If people choose not to vaccinate their child, it's not only their child they are putting at risk but the rest of society as well."

Dr Sharma said all vaccinations listed above were provided free by the Commonwealth Government and could be administered by a nurse at most general practice clinics and all vaccination clinics. Doctors had also created "catch-up schedules" for children who had missed their first vaccinations as an infant.

(byline: Breanna Tucker)

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[An interactive map of Australia shunt the locate of the ACT can be accessed at http://www.street-directory.com.au/sd_new/home.cgi?StateID=7. - Mod.CP]

See Also