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Published Date: 2012-03-24 17:51:57
Subject: PRO/EDR> Measles update 2012 (13)
Archive Number: 20120324.1079789

MEASLES UPDATE 2012 (13)
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In this update:

Europe
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[1] UK (Merseyside)
[2] UK (Wirral)
[3] UK (North Wales)
[4] Ukraine (update)

Asia
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[5] India (Jammu & Kashmir)

The Americas
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[6] Canada (Edmonton)
[7] USA (EURO-2012 travel alert)
[8]] USA (Olympics travel alert)
[9] USA (Washington)
[10] Ecuador (Cotopaxi)

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Europe
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[1] UK (Merseyside)
Date: Mon 21 Mar 2012
Source: VaccineNewsDaily.com [edited]
http://vaccinenewsdaily.com/news/318287-british-measles-outbreak-grows/

British measles outbreak grows
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The U.K. Health Protection Agency recently announced that more cases of the measles have been identified in the county of Merseyside. The HPA declared the existence of an outbreak last month following the hospitalization of six people from the illness. There are now 85 confirmed measles cases and another 44 probable cases being investigated, according to the BBC.

The majority of cases involve children who had not been administered the MMR vaccine, or infants too young to receive it. The agency said that non-vaccinated teenagers and young adults are considered to be at risk of infection. Parents have been warned to ensure that their children’s vaccinations are up-to-date.

"Measles is highly infectious and unvaccinated children are at risk when it gets into a community, as it has done here on Merseyside," Dr. Roberto Vivancos of the HPA’s Cheshire and Merseyside Health Protection Unit said, the BBC reports. “Furthermore, when unvaccinated older children pick up an infection they can pass it on to vulnerable infants who are too young to be vaccinated. That would appear to be what’s happened in this outbreak.”

Measles in an extremely infectious viral illness that can be spread through the air from coughs and sneezes. In the first six weeks of 2011, there was only one confirmed case of the measles in Merseyside.

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[2] UK (Merseyside)
Date: Tue 20 Mar 2012
Source: The Wirral Globe [edited]
http://www.wirralglobe.co.uk/news/9600677.Merseyside_measles_outbreak_continues___medics_urge_parents_to_get_children_immunised/

Merseyside measles outbreak continues
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A measles outbreak is continuing on Merseyside. There are now 85 laboratory confirmed cases and a further 44 probable cases are under investigation. A team of staff from the Health Protection Agency [HPA} and local NHS services has worked seven-days-a-week, identifying and following up the contacts of 441 suspected measles cases since the outbreak started. The majority of cases are in children under the age of five who were not vaccinated at the optimum age of 13 months; babies and toddlers who are too young to be vaccinated; and teenagers and young adults who were not vaccinated as children. The best form of protection against measles is vaccination with MMR, says the HPA.

NHS services on Merseyside identified and wrote to the parents of 7300 children under the age of five who were not fully immunised. The letters advised parents to arrange vaccination through their family doctors. MMR uptake rates on Merseyside are now very good with 95% of children under the age of two having had their first MMR injection. The feeling in the team is that the outbreak is a legacy of earlier years when uptake rates were not as good. Dr Roberto Vivancos from the HPA's Cheshire and Merseyside Health Protection Unit said: "Measles is highly infectious and unvaccinated children are at risk when it gets into a community, as it has done here on Merseyside. "Furthermore, when unvaccinated older children pick up an infection they can pass it on to vulnerable infants who are too young to be vaccinated. That would appear to be what's happened in this outbreak."

The HPA's advice to children and adults with measles is to:
- Avoid contact with others, particularly pregnant women and infants as they are more vulnerable to infection and measles is highly infectious.
- Stay away from schools, nurseries and work places until at least four days after the onset of the rash.
- Telephone family GP for advice before attending surgeries, NHS walk-incentres or hospital Accident and Emergency units so arrangements can be made in advance for minimising the patient's contact with others who may be more vulnerable to infection.

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[Merseyside is a metropolitan county in North West England, with a population of approx. 1 365 900. It encompasses the metropolitan area centred on both banks of the lower reaches of the Mersey Estuary, an comprises five metropolitan boroughs: Knowsley, St Helens, Sefton, Wirral, and the city of Liverpool. Merseyside takes its name from the River Mersey. Its location can be seen in the map at: http://en.wikipedia.org/wiki/Merseyside. - Mod.CP]

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[3] UK (North Wales)
Date: Mon 19 Mar 2012
Source: WalesOnlione .com [edited]
http://www.walesonline.co.uk/news/wales-news/2012/03/19/measles-outbreak-spreads-taking-total-tally-to-42-cases-91466-30564653/

North Wales measles outbreak spreads
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A healthcare worker in North Wales is among a further six people clinically diagnosed with measles following a recent outbreak, taking the total tally of cases to 42. The health professional, based at Bronmeirion Surgery, Penrhyndeudraeth, Gwynedd, is one of six new cases of measles confirmed by Public Health Wales (PHW) on Monday. The unidentified member of staff worked for two days while contagious. Sufferers can be infectious for four days before any rash appears. Health officials are now contacting 61 people who may have come in contact withe the health worker and will be advising theme of the situation and, where necessary offering immediate MMR vaccination. But the authorities said that others who had attended the surgery in the past week were not under any increased risk of developing measles. Of the 42 cases so far, 30 have been associated with an outbreak at Ysgol Eifionydd School, Porthmadog, Gwynedd. The other 12 cases live in the same geographical area but have no direct links to the outbreak associated with the school.

The majority of cases have either had no MMR vaccination or only one dose. Dr Judy Hart, consultant in communicable disease control for PHW, said: "Most people who were born before 1970 are immune to measles, having been exposed to the infection in childhood. "People younger than this may not have been exposed to measles and so they may be at risk unless they have received two doses of the MMR vaccine. "MMR is a safe and effective vaccine that protects children from the most severe and unpleasant viral-rash illness of childhood."

GPs in North Wales are offering vaccinations to children in the area who have not had both doses of the MMR vaccine. The first inoculation is due when a child is between 12 and 13 months old, with a second required at three years and four months of age. PHW and Betsi Cadwaladr University Health Board are urging parents in North Wales whose children have missed one or both of these doses to get their children vaccinated with MMR.

Officials said ensuring children were vaccinated was of "particular importance" as large groups of children are due to congregate for the Eisteddfod in coming weeks.

Measles is a serious and highly infectious viral disease that can cause complications including pneumonia, meningitis and encephalitis, particularly in children under five years of age, those with weakened immune systems and children with a poor diet. It can be fatal in rare cases. Symptoms include fever, a cough, red eyes, a blocked nose and feeling unwell. Sufferers will then develop a blotchy rash a few days later which begins on the face and spreads down the body over several days.

Dr Hart added: "If you or your child is unwell and you suspect it is measles, you should contact your GP. Your child should not attend school or nursery and you should not attend work for five days after the rash starts. "The only way to prevent outbreaks of measles is to ensure that at least 95% of children in Wales have received two doses of the MMR vaccine. "Although more children are having the vaccine now, we still have some way to go before we can guarantee the safety of children in Wales from measles."

(By Madeleine Brindley)

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[The National Eisteddfod is Wales’ leading festival held annually during the first week of August. The Eisteddfod Festival is the pinnacle of the Welsh cultural calendar, it travels from place to place, alternating between north and south Wales giving communities across the country a chance to welcome up to 160 000 visitors over an eight day period. - Mod.CP]

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[4] Ukraine (update)
Date: Mon 5 Mar 2012
Source: ukranews.com, 05 March 2012 [ In Russian, abbrev. & trans. by Mod NR, edited]
http://ukranews.com/ru/news/ukraine/2012/03/05/65581

Measles epidemics in Ukraine - update
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The Sanitary epidemiological surveillance Centre has registered 4447 cases of measles in Ukraine during the period of 1 Jan to 3 Mar 2012. The largest number of cases were registered in the western regions of Ukraine. Quarantine restrictions are in place. By comparison only 1513 cases were registered in Ukraine in the previous year year. One of the causes of the outbreak has been the importation of infection from sources outside of Ukraine

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Asiai
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[5] India (Jammu & Kasmir)
Date: Sat 23 Mar 22012
Source: Greater Kashmir [edited]
http://www.greaterkashmir.com/news/2012/Mar/23/mysterious-disease-outbreak-in-poonch-village-69.asp

Mysterious disease outbreak in Poonch village
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SURANKOTE (Poonch): At least six children have reportedly died due to an outbreak of a mysterious disease in a remote village of this border district. Reports said that the epidemic has spread in the Phaglla village of Surankote infecting more than two dozen children in last three days. Though officials confirmed the death of only four children, the locals claimed that six of them have lost their lives so far, while condition of some others is critical.

The village is situated 16 kms from Poonch and [without] road connectivity. The district administration has dispatched a team of doctors and para-medics to the village to take stock of the situation but there was no confirmation about the nature of the disease. "At least six children have died so far due to the mysterious disease in the last 48 hours", Wiladat Hussain, Saparanch of the area told Greater Kashmir over the phone.

He claimed that a local resident lost his two children -- a 2 year old and a 5 year old. Similarly, two children of another local resident died ass a result if this epidenic. He identified another two victims in another local family.

The Sarpanch claimed that over 100 children in the village and its adjoining areas have been infected and are suffering from severe fever and skin irritation. Block Medical Officer of the area, who was camping in the village, confirmed death of four children. He said that a team of doctors has been constituted by the department and all the pediatricians serving in various hospitals of the district have been directed to report to Surankote hospital.

When contacted, DDC Poonch Ajeet Kumar Sahu also confirmed death of four children saying the disease has been preliminary identified as measles. "Due to the outbreak of measles in some areas of Surankote, 4 children have lost their lives, while 14 others were badly affected", the DDC said, adding that: "a high alert has been declared in the area to control the spread of the diseases". He said that a team of doctors has been sent to the area and all health institutions have been directed to ensure Measles vaccination for all the children of the area. "All this is being done on war footing", the DDC said.

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[Surankote is a tehsil (administrative division) in the Poonch district of the Indian state of Jammu and Kashmir. It occupies the Surankote valley, located between the Pir Panjal and Rattan Panjal ranges within the Himalayas. The valley comprises 43 villages. A map of Jammy and Kashmir can be accessed at: http://www.mapsofindia.com/maps/jammuandkashmir/jammuandkashmir-district.htm - Mod.CP]

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The Americas
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[6] Canada (Edmonton)
Date: Mon 19 Mar 2012
Source: The Canadian Press [edited]
http://ca.news.yahoo.com/measles-case-edmonton-health-officials-warning-possible-exposures-205713378.html

Measles case has Edmonton health officials warning of possible exposures
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Alberta Health Services has confirmed one case of measles in the Edmonton area, and is advising of potential exposures. Officials say anyone who was in five locations in Mill Woods, a neighbourhood in southeast Edmonton, at specific times earlier in March, may be at risk of developing the contagious disease, which is spread through the air. The locations are a pharmacy, dental clinic, two medical clinics and a medical lab in Millbourne Shopping Centre.

Health officials say people who haven't been vaccinated against measles or who haven't had the disease are at the highest risk. Symptoms of measles include fever, cough, runny nose or red eyes, and a red blotchy rash that appears three to seven days after fever starts. The rash typically begins behind the ears and on the face, spreading down to the body, and finally to the arms and legs. There is no cure for measles, but it can be prevented with vaccination.

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[The location of Edmonton can be found in the HealthMap interactive map at http://healthmap.org/r/20O7. - Mod.CP]

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[7] USA (EURO-2012/Olympics travel alert)
Date: Mon 21 Maar 2012
Source: Adelaide Now [edited]
http://www.adelaidenow.com.au/sport/london-olympics/us-warns-olympic-travellers-about-measles/story-fn9dhvy9-1226305836645

US warns Olympic travellers about measles
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US health officials are urging Americans traveling to London for the Olympics to make sure they are up-to-date with measles immunizations, warning that unvaccinated tourists could become infected and spark an outbreak at home. The Centers for Disease Control and Prevention also said the Euro 2012 soccer cup in Poland and Ukraine could be possible sites for measles infections this summer, USA Today reported Tuesday.

"Disease knows no borders," said Rebecca Martin, director of the CDC's Global Immunization Division.
"We are concerned about Americans coming back from the Olympics this summer and unknowingly infecting others."

The London Olympics open on July 27 and the Euro 2012 soccer cup begins on June 8. Health experts explain that huge public events, like the Olympics, increase the likelihood of infection among unvaccinated people and affected individuals might unknowingly carry the disease home.

According to the Indiana State Health Department, during last month's Super Bowl two people who were infected with measles attended a crowded event in downtown Indianapolis and touched off an outbreak that infected 16 people, The Wall Street Journal reported.

Heath officials also said that most cases of the measles in the US are imported by travelers who have not been vaccinated. A measles outbreak in San Diego in 2008 was traced to an unvaccinated seven-year-old boy who contracted the disease in Switzerland. He passed the disease on to 11 other unvaccinated children.

More parents in the US are getting their children vaccinated than in recent years, when concerns about vaccinations prompted some parents to opt out. According to the CDC, the rate of vaccination for measles, mumps and rubella was at 91.5 percent in 2010, up from 90 percent a year earlier. Health experts say a community needs about a 95 per cent immunization rate against measles to ensure "herd" immunity, according to The Journal. Before routine vaccinations in the United States, the virus killed between 3,000 and 5,000 people each year.

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[8] USA (EURO-2012/Olympics travel alert)
Date: Wed 21 Mar 2012
Source: Top News US [edited]
http://topnews.us/content/247029-america-worried-about-europe-s-measles-outbreak

America worried about Europe's measles outbreak
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Europe is facing an outbreak of measles. As the Euro2012 football tournament is gearing near, the US is afraid that the disease would [travel] from the affected regions of Europe to America with returning travellers. The Director of CDC's Global Immunization Division, Rebecca Martin, was reported as saying, “Any disease knows no borders. We are concerned about Americans coming back from the Olympics this summer and unknowingly infecting others”.

Last year about 26 000 cases of measles were reported in the Europe and about eight deaths related to it were also registered. The disease travelled to America affecting 214 people, in 2011. Medical experts have blamed the European visitors for causing a fear of the disease in the country. Usually, about 50 cases of measles are reported in the country. But last year, the cases were staggeringly high. The medical authorities are doing their bit to prevent the innocent population of the US from being affected with the disease. It has been informed that one single case of measles costs US’s health care system $160 000 US.

It has come to light that in 1998 British autism scare prevented people from getting themselves vaccinated against measles. In 1998, parents with autistic kids were scared by a widely spread notion about combined vaccinations for measles, mumps and rubella injection. False claims were made saying that the combined vaccination could hinder the learning capabilities of the children. A review called over the claims has found that the claims were based on false scientific evidence. The false claims have prevented many parents from getting their children vaccinated. Now these children are at the greatest risk of being affected with measles.

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[9] USA (Washington)
Date: Mon 21 Mar 2012
Source: MYNorthwest .com [edited]
http://mynorthwest.com/11/648668/Washington-communities-at-risk-of-measles-outbreak

Washington communities at risk of measles outbreak
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Washington state is among the most vulnerable for the outbreak of infectious disease due to the high number of parents who choose not to let their children be immunized, according to health officials. According to figures from the Washington State Department of Health, roughly six percent of kindergarteners statewide last year did not receive at least one of their required immunizations because their parents opted out. "That's very high," said Michele Roberts, health communication manager for the state's Office of Immunization. "The year before that, we were at 6.2 percent, which that year was the highest in the nation. Most states have rates less than three percent."

In Washington state, children can receive immunization exemptions for one of three reasons: religious, philosophical, or medical. The percentage of exemptions vary greatly by county. For the 2010-2011 school year, just 1.9 percent of students K-12 in Franklin County were exempt from immunizations. During the same school year in Ferry County, 25.4 percent of students K-12 opted out. Roberts said it is those communities with high rates of exemptions that are most at risk for the outbreak of infectious diseases such as measles.

"Often these kids live in the same areas and go to the same schools, so we have pockets in our state that are really at risk," Roberts said. "I think that's why we see outbreaks happen in communities parents are seeking advice from their peers about immunisations." Other at-risk communities, said Roberts, include areas in Olympia, Snohomish, Whatcom County, San Juan County and Vashon Island, among others.

While there are similar pockets with dangerously low immunisation rates nationwide, a recent Wall Street Journal article points out that overall vaccination rates are on the rise. "Overall, more parents in the U.S. are getting their children vaccinated than in recent years, when concerns about immunization prompted some to opt out," according to the March 20 article. "Rates of vaccination for measles, mumps and rubella, considered a bellwether for U.S. rates, ticked up to 91.5 percent in 2010 from 90 percent in 2009, according to the CDC." But the article warns of a "growing" concern over concentrated areas with immunization rates "far below the threshold that is needed to prevent an outbreak for certain diseases."

Health officials here in Washington are hopeful, however, that a new law governing immunizations will decrease the number of parents who decide to opt their children out. The bill, signed into law in May 2011, requires parents receive a Certificate of Exemption from a licensed health care provider before their child is allowed to opt out of immunization requirements. The certificate verifies that parents received information about the risks and benefits of immunizations prior to making a decision. The bill has applied to all parents seeking exemptions after the law went onto effect on July 22, 2011.

"The old law made it very easy to opt out, all it took was a parent's signature," Roberts said. "We definitely expect the new law will cause a drop in the number of exemptions, but it may take a couple of years to see
that."

(By Brandi Kruse)

[A map showing the locations of the counties of Washington state can be accessed at: http://geology.com/county-map/washington.shtml. - Mod.CP]

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[10] Ecuador (Cotopaxi)
Date: Fri 23 Mar 2012
Source: The Gazette, Ecuador [In Spanish, abbrev. & machine trans, edited by Mod. JT]
http://www.lagaceta.com.ec/site /html/pagina.php?sc_id=13&c_id=70&pg_id=79523

New cases of measles in Ecuador (Cotopaxi)
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Deifilia Landeta, head of the immunization program of the Health Department of Cotopaxi, said the province during 2011 and so far in 2012, has recorded 12 confirmed cases of measles by laboratory analysis (2012 four cases) four are infants and one an 19-year-old, all cases are imported from other provinces.

He said that during 2011, Cotopaxi registered 102 suspected cases. So far in 2012 there have been 30, which shows that epidemiological activity persists. Health authorities in the province, continue working on a measles control plan. Some 300 people carry out vaccination in the seven counties and have achieved 94 percent coverage of immunization of children and adolescents, from six months to 15 years old.

Subsequently the team will undertake an assessment across the province on the results achieved in vaccination by the different health areas of Cotopaxi province. Additionally interviews will be conducted with groups of 30 children of all ages, to asses the proportion od chidden vaccinated and identify those still to be vaccinated.

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[A map of Ecuador showing the location of Cotopaxi province can be accessed at: http://www.mapsofworld.com/ecuador/ecuador-political-map.html. - Mod.CP]

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