Measles: The Thing That Won't Leave Europe

Measles is unlikely to be eradicated in Europe anytime soon, according to the Euvac.net group, a surveillance network for vaccine-preventable diseases. The group's conclusion is based on the relatively high incidence of measles and the prevalence of unvaccinated or incompletely vaccinated children throughout the continent. The group's study of the persistence of measles in Europe, despite the fact that the measles vaccine became a part of routine vaccination more than 20 years ago, was published in the latest issue of The Lancet.

Recent 2-year surveillance data (2006-2007) from 32 European countries revealed a total of 12,132 measles cases; 85% occurred in 5 countries: Romania, Germany, the United Kingdom, Switzerland, and Italy. Most of those affected were either unvaccinated or incompletely vaccinated children; however, nearly 20% were adults. Measles caused the deaths of 7 children.

In 2006, 10 cases of acute measles encephalitis* (including the 2 deaths) were reported. Six of those affected had not been vaccinated; one had received a single vaccine dose; and the vaccination status was not known for the remainder. In 2007, 7 individuals, none of whom had been vaccinated, acquired acute measles encephalitis.

On the basis of these data, the group expresses "serious doubts" that measles will be eliminated from Europe by 2010, the current goal of the World Health Organisation. According to WHO, the elimination of measles requires the achievement and maintenance of a minimum 95% vaccination coverage with 2 doses of the measles vaccine. In European countries where there were no measles cases during 2006 and 2007 (Finland, Iceland, Slovenia, Slovakia, and Hungary), vaccination coverage (2 measles vaccine doses) has been historically and consistently high.

* As opposed to subacute sclerosing panencephalitis (SSPE), a rare, fatal complication of measles, which can develop years after the incident infection.

Photo of child with measles rash from the CDC.