Europe faces resurgence of measles due to low vaccination coverage
The United Kingdom has introduced restrictions for non-immunized children in Birmingham, while Romania has declared a national epidemic after three deaths were reported
European authorities warned of the risk posed by low vaccination coverage against measles, and the worst predictions have come true. The disease is easily preventable with two vaccine doses, and practically disappeared in Europe during the Covid-19 lockdowns. But in recent months, it has resurged, and very strongly in some areas.
Three people — two of them babies — died in Romania, which declared the measles a “national epidemic” in December. In the United Kingdom, dozens of children have been hospitalized in the city of Birmingham since November, according to local media, British authorities are forcing unvaccinated minors in the city to isolate at home if they have been in contact with someone who is sick. Austria has been fighting measles since the beginning of 2023 with several outbreaks that have led to nearly 200 cases. While in a school in Guilherand-Granges, in the French department of Ardèche, dozens of unvaccinated children were infected, with 60 cases detected and several patients hospitalized.
According to 2022 statistics from the European Center for Disease Prevention and Control (ECDC), the average vaccination coverage in the European Union is notably lower — 92.4% for the first dose and 89.7% for the second. The organization, however, warns that these percentages have been falling in countries like Romania over the last decade, dropping to 78% and 62%, respectively.
“The overall number of measles cases in the EU/EEA is steadily increasing since June 2023. Considering the suboptimal vaccination coverage for the second dose ≥95% in the majority of the EU/EEA countries more measles cases are expected in the coming months and in the spring,” warned the EDCD in its latest communicable disease threats report.
Quique Bassat, pediatrician and epidemiologist at the Barcelona Institute for Global Health (ISGlobal), explains that fighting the measles virus is very complex. “It is one of the most contagious that exists, which forces you to systematically maintain vaccination coverage above 95% to prevent its circulation. Each point that falls from that represents a significant risk, since usually the unimmunized tend to be grouped in certain areas or groups, and form pockets of susceptible population. Sooner or later, the virus will reach them and cause an outbreak,” he said.
In recent years, public health authorities have faced added difficulties, such as the anti-vaccine movement and the challenge of getting public health messages across to groups who may be cut off due to their socioeconomic or cultural situation.
The measles vaccine is administered in two doses: the first when the child turns one, and the second, when they are three or four years old, depending on the local health authorities. The measles vaccine also protects against rubella and mumps, which is why it is called the MMR vaccine.
“It’s a disease that we must have a lot of respect for because it can cause very serious illnesses and even the death of one in every 1,000 infected children. And if the death of a child is always a tragedy, it is much more so when it is due to a disease that’s so easily preventable thanks to vaccines,” explains Antoni Trilla, head of the Preventive Medicine service at the Hospital Clínic in Barcelona, Spain.
The disease is transmitted by contact with the already infected person or through aerosols (microscopic saliva droplets that float in the air). After an incubation period of between seven and 14 days, the first symptoms appear: high fever, cough and runny nose. The characteristic skin rash comes between three and five days later. The most dangerous complications that the virus can lead to are pneumonia, neurological conditions and blindness.
The World Health Organization (WHO) set the goal of 95% vaccine coverage to one day eradicate the disease. The idea is to achieve so-called herd immunity, meaning those who cannot be immunized (due to age, for example) are also protected. In other words, the whole community, not just the individual, is protected.
In Romania, two of the three deaths were seven-month-old babies, who had not yet been able to receive the vaccine. For safety reasons, it should not be administered until a child turns one, although in epidemic crisis situations, such as the one currently affecting Romania, its use can also be extended to babies between nine and 11 months old.
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