30,000 CASES AND COUNTING: EUROPE FACES WIDESPREAD MEASLES OUTBREAK

In October 2023, the World Health Organization (WHO) declared a measles epidemic in Europe, with over 30,000 cases reported in 40 out of 53 European countries within the first ten months of the year. These statistics are a significant increase from the previous year, in which only 941 reported cases were reported.

The 30-fold increase in measles cases has been declared a public health emergency and urgent measures are being taken to control the spread of this highly contagious disease.

The outbreak affected people of all ages, with approximately 40% of cases found in children under four years of age and 20% of cases reported in adults aged 20 and older. From January to October, approximately 20,918 people required hospitalization because of measles. Two countries reported five deaths during this period.^[1]

Declining Vaccination Rates as the Cause

Measles is disease preventable by vaccines, and the WHO had set a goal to eliminate measles in Europe by 2020. The current outbreak shows that this goal still needs to be met. The main reason for the resurgence of the disease is the decline in vaccination rates in many European countries.

The measles, mumps, and rubella (MMR) vaccine is the most effective way to prevent measles. In recent years, there has been a growing anti-vaccination movement fueled by misinformation and fear. This movement has decreased vaccination rates, leaving many individuals vulnerable to the disease.

The COVID-19 pandemic has also impacted the current measles epidemic in Europe. The disruption of routine vaccination programs and the focus on controlling the spread of COVID-19 led to a decrease in measles vaccinations.

According to the WHO, vaccination statistics clearly show a decline in vaccination rates over this period:

• The average coverage of the first measles-containing vaccine dropped from 96% to 93% between 2019 and 2022.
• The average administration of the second measles-containing vaccine dropped from 92% to 91%.
• Between 2020 and 2022, more than 1.8 million infants failed to receive their measles vaccinations.

In addition, the fear of contracting COVID-19 also led to a decrease in individuals seeking medical care for other illnesses, including measles. This delay in seeking medical care can lead to more severe complications from measles.

When vaccination rates drop, herd immunity is compromised, and outbreaks of vaccine-preventable diseases, like measles, can occur.

Herd immunity refers to the protection that mass vaccination offers to those who are vulnerable to an infectious illness. For infants and others with compromised immune systems who cannot receive the vaccine, herd immunity  is crucial.

Herd immunity is necessary to prevent deadly illnesses from spreading. Hence, it is imperative for vaccination rates to remain high to protect the entire population. As the current outbreak in Europe reveals, pockets of unvaccinated communities with low herd immunity are placing the rest of the population at risk, especially when traveling.

Resuming travel and lifting other COVID-19 measures have raised disease risk, particularly in unvaccinated communities.

If routine childhood vaccination rates fall below 95% across all communities, nations that are successfully eliminating measles are still vulnerable to outbreaks due to travel-related global measles transmission.

Measles Symptoms and Complications

Measles is a highly contagious illness. When an infected person coughs or sneezes, the measles virus spreads to other people through the air.

The virus can live on surfaces for up to two hours, making it easy to contract the disease.

Measles symptoms appear after 10-14 days. The main symptom is a rash on the face and body that lasts about a week with a high fever.^[2]

Other symptoms include:

• Cough
• Runny nose
• Red eyes
• Diarrhea
• Ear infections
• Pneumonia

Measles can provoke grave complications, especially in children and those with weakened immune systems. These include pneumonia, brain swelling, and mortality.

Before vaccination, measles was allegedly responsible for 2.6 million deaths annually.

Measles may also induce several lifelong health conditions, such as chronic immune suppression (known as immune amnesia), long-term respiratory ailments, otosclerosis (progressive hearing loss), and eye disease that might lead to vision loss.

The Consequences of a Measles Outbreak

Measles outbreaks have significant consequences for individuals and society as a whole.

Firstly, they increase infection and hospitalization rates, straining healthcare systems.The economic impact is also substantial, with losses due to illness and absenteeism and the strain on healthcare resources. Measles outbreaks can also negatively impact travel and tourism. People may need help to visit areas with ongoing outbreaks, leading to economic repercussions for the tourism industry.

Urgent Measures to Control the Measles Epidemic

In response to the current measles epidemic in Europe, the WHO has declared a public health emergency and is urging countries to take urgent measures to control the spread of the disease.

At a local level, protecting ourselves and our communities from measles requires a multi-faceted approach.

Vaccination Campaigns

The most effective way to control the spread of measles is through vaccination. Ensuring that individuals have up-to-date vaccination status is crucial.

The WHO urges countries to conduct vaccination campaigns targeting vulnerable populations and areas with low vaccination rates. In addition, the WHO is also recommending that countries implement catch-up vaccination programs for individuals who may have missed their routine vaccinations.

Their representatives are working closely with health officials to provide support and guidance in controlling the measles epidemic. The support extends to providing technical assistance, conducting training workshops, and monitoring the situation closely.

Strict Hygiene and Prevention Measures

In addition to ensuring immunity to measles, practicing good hand hygiene and cough etiquette can help reduce the spread of the virus.

If one experiences measles symptoms, seeking prompt medical attention is essential to prevent further transmission.

Travel Health Recommendations

Measles is a highly transmissible infection that can readily spread to other countries through travel. The WHO advises individuals to check their vaccination status before traveling to areas with ongoing measles outbreaks.

In addition, the WHO is recommending that countries implement travel health measures, such as screening for measles symptoms at airports and other points of entry.

Collaboration and Communication

International collaboration plays a significant role in addressing the spread of measles.

The WHO also stresses the importance of collaboration and communication between countries to control the spread of measles. Optimal collaboration involves sharing information about outbreaks and new cases, coordinating vaccination efforts, and implementing travel health measures.

We can effectively control measles transmission and protect our communities by working together.

Conclusion

The current European measles epidemic is a public health crisis requiring urgent action. The increase in measles cases, the decline in vaccination rates, and the impact of COVID-19 have all contributed to the spread of this highly contagious disease. Measles is a vaccine-preventable disease, and with proper measures in place, we can work towards eliminating it in Europe and preventing future outbreaks.

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