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Published Date: 2012-04-08 17:00:24
Subject: PRO/EDR> Measles update 2012 (15)
Archive Number: 20120408.1094007

MEASLES UPDATE 2012 (15)
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In this update

Europe
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[1] Netherlands (travel alert)
[2] Spain (Murcia)

The Americas
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[3] USA (California)

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Europe
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[1] Netherlands (travel alert)
Date: Thu 5 Apr 2012
Source: Bloomberg Busness Week [edited]
http://www.businessweek.com/news/2012-04-05/dutch-soccer-fans-advised-to-get-measles-jab-for-championship

Dutch Soccer Fans Advised to Get Measles Jab for Championship
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Dutch soccer fans planning to travel to European [Soccer] Championship matches in Poland and Ukraine in June and July should make sure they're vaccinated against measles, the Netherlands' Ministry of Public Health said. Ukraine, which is organising the soccer championship together with Poland from 8 Jun to 1 Jul 2012, is suffering from a measles epidemic in the country's west near the border with its co-host, the Ministry wrote on its website today.

Measles is one of the most infectious viruses for humans. More than 6000 cases have been reported in Ukraine this year and the epidemic is expected to accelerate in the run up to the start of the matches in June, according to the Stockholm-based European Centre for Disease Prevention and Control. "Most Dutch people are well protected against measles," the ministry's National Institute for Public Health and Environment said. "The advice therefore applies to people who haven't been vaccinated against measles and who haven't had the disease in the past." Since 1976, all Dutch children are offered a jab against measles, mumps and rubella through a national vaccination program, while before the program almost all children were exposed to the disease naturally, building up lifelong immunity, according to the ministry.

The European Championship, known as Euro 2012 for this year's event, is one of soccer's biggest tournaments after the World Cup. It attracted about 1 million spectators in 2008 when it was held in Austria and Switzerland. Travellers to Ukraine are also advised to vaccinate against hepatitis A and diphtheria, tetanus and polio, according to the notice. Rabies circulates in both Poland and Ukraine, and travellers should avoid contact with cats and dogs, it said.

[Byline: Rudy Ruitenberg]
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[2] Spain (Murcia)
Date: Wed 4 Apr 2012
Source: Source: laopiniondemurcia.es [in Spanish, translated & edited by Mod. JG]
http://www.laopiniondemurcia.es/murcia/2012/04/03/brote-sarampion-beniajan-saltar-alertas-sanitarias/396171.html

An outbreak of measles in Beniaján initiates health alert
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It was only a matter of time. Measles has arrived in Murcia Region, specifically in the Beniajan community; and, even though only a few cases have been reported, an alert has been activated by the local Autonomous Community Health and Social Policy Council. "We must take every preventive measure available in order to eradicate this outbreak", said yesterday Dr. Jose Antonio Navarro, head of the Prevention and Vaccination area in the local Health Council.

People from Alicante, a neighboring province, are quite concerned about this disease. Since last January, 601 cases have been reported, eighty during the last week, with no distinction between children and adults. Local healthcare authorities have been quite active in analyzing this occurrence, in order to determine whether the outbreak in Alicante would extend to Murcia.

Dr. Navarro explained that the three cases notified in the past few days correspond to a 16-year old boy, a four-year old boy, and a ten-month old baby, all reported in the Beniajan community, and none of these patients had not been vaccinated against measles. Some measures have been taken in order to control the outbreak, including mass vaccination of all schoolchildren in the community, as well as those from the surrounding communities. "We decided to move forward with the administration of the second dose at three years of age, when it is usually administered later at six years of age", declared Dr. Navarro. A list including every child within this age group in Torreaguera and Los Ramos schools was elaborated, and parents have been informed that their children will be immunized.

Regional healthcare authorities also established contact with personnel from the surrounding communities, so they may be alert and immediately notify the occurrence of any case of measles.

Local Healthcare authorities have sent technical personnel from Murcia municipality to carry out household visits in Roma-populated slums, in order to verify their vaccination registry cards. These domiciliary visits aim to contain the spread of the disease and to immunize every non-vaccinated individual. This measure has been extended throughout the municipality area and not only to the areas affected by measles.

Dr. Navarro confirmed that measles vaccine coverage is not low, since it is more than 95% for the first dose, while it is 85% for the second dose of the vaccine. He also mentioned that they may be capable of eradicating measles in the near future, and he also said "extreme measures must be taken in order to prevent the occurrence of more outbreaks", recalling the Alicante outbreak which occurred in Jumilla and Bullas communities on April 2010 that affected nearly one hundred persons. He also mentioned that additional measures may be taken, if necessary.

The advance of that outbreak, which had not been contained, also led to a modification in the vaccination schedule for children. After the outbreaks that occurred two years ago, healthcare authorities decided to move forward the age in which the first dose is administered, now it is at twelve months instead of fifteen months. Specifically the vaccine whose schedule was modified is the triple vaccine, that protects against measles, rubella, and mumps (MMR).

At the same time -- twelve months of age -- children also receive the meningitis vaccine, which has also been brought forward, in order to allow parents to take their children to healthcare facilities for a single immunization visit. Another change that was introduced by healthcare authorities affected the diphtheria, tetanus, and pertussis vaccine -- which is administered at 6 years of age -- because of changes in its composition, since some mild reactions had been detected in children, such as reddening and pain in the area where the injection was administered.

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[Beniaján is a municipality located in the Region of Murcia, Spain, beside the mountains that close the Valley of Segura. It has a population of around 11 000 inhabitants. The province of Murcia can be found in the HealthMap interactive map of Spain at: http://healthmap.org/r/27wq. - Mod.CP]

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The Americas
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[3] USA (California)
Date: Mon 2 Apr 2012
Source: Kaiser Permanente News Center, press release [abridged & edited]
http://xnet.kp.org/newscenter/pressreleases/nat/2012/040212measlesvaccine.html

Measles-Containing Vaccines not Associated with Increased Risk of Febrile Seizures in Children Ages 4–6
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Vaccines for measles were not associated with an increased risk of febrile seizures among 4–6 year olds during the six weeks after vaccination, according to a study by the Kaiser Permanente Vaccine Study Center that appears in the current issue of Pediatrics. [A febrile seizure is a brief, fever-related convulsion, but it does not lead to epilepsy or seizure disorders. - Mod.CP] Funded by the U.S. Centers for Disease Control, the study of 86 750 children follows an earlier study published in Pediatrics that showed one particular combination of measles-containing vaccine -- the measles, mumps, rubella and chickenpox containing vaccination (or MMRV) -- was associated with an increased risk of febrile seizures in 1- to-2-year-old children, compared with same-day administration of the separate vaccine for MMR (measles, mumps, rubella) and the V (varicella) vaccine for chicken pox.

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[In the United States, children receive two doses of measles, mumps, rubella and varicella vaccines -- the first between 1–2 years and the second between ages 4–6. Among 1–2 year olds, the risk of febrile seizures 7–10 days after MMRV was double that of separate MMR+V. For children aged 4–6 receiving their second dose, no such association was found with either measles vaccine combination, according to Kaiser Permanente researchers.

This study of 4–6 year olds analyzed 86 750 children aged 48–83 months old from seven participating Vaccine Safety Datalink sites between January 2000 and October 2008 who received either MMRV; separately administered, same-day MMR plus varicella; or MMR or varicella vaccines alone. The results provide reassuring evidence that neither MMRV, nor MMR plus V, appear to be associated with an increased risk of post-vaccination febrile seizures in this 4–6 age group,” said Dr. Klein.

This study builds on the work of a previous study published in Pediatrics in June 2010 that showed that the combination vaccine for measles, mumps, rubella and chickenpox (MMRV) is associated with double the risk of febrile seizures for 1–2 year olds compared with same-day administration of the separate vaccine for measles, mumps, rubella (MMR) and the varicella (V) vaccine for chicken pox.

"While this earlier study and the resulting CDC recommendations are very important and ones our pediatricians follow, it is also important to emphasize that it is more common for a child to have a febrile seizure caused by a simple cold than by an immunization. And though febrile seizures are a very scary event for a family, they are not dangerous and do not lead to later epilepsy or seizure disorders," said Randy Bergen, MD, a Kaiser Permanente pediatrician and infectious disease specialist at Kaiser Permanente Walnut Creek Medical Center.

For more information on febrile seizures, go to: http://bit.ly/H4qB8L. - Mod.CP]

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