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MEASLES IN EUROPE

A reminder for travellers to be up to date with measles vaccine

The outbreaks of measles across Europe continue with Romania and Italy being the worst affected [1-2]. The following EU/EEA countries have reported measles cases in 2017: Austria, Belgium, Bulgaria, the Czech Republic, Denmark, France, Germany, Hungary, Iceland, Italy, Portugal, Slovakia, Spain, Sweden and the United Kingdom [2].

Measles is a highly infectious illness spread by airborne/droplet transmission. Symptoms include fever, runny nose, conjunctivitis and cough. A rash then usually develops, starting at the head, then spreading to the trunk and limbs, over three to four days. Individuals are infectious from their first symptoms to four days after the rash appears and the incubation period is about ten days. Complications can occur and in the UK, the death rate is approximately one in 5,000 cases. Risk of death from measles is age-related: high in children under one year of age, lower in children aged one to nine years, rising again in teenagers and adults [3].

Advice for travellers

As part of your travel preparation, make sure you are up-to-date with all currently recommended UK vaccines including measles, mumps and rubella (MMR) vaccine. Two doses of MMR in a life time are needed for a person to be considered fully protected.

MMR vaccine can be given from six months of age before travel to a risk country and/or where an outbreak is occurring.

If you have not had measles (the illness) or if you have not had two doses of MMR, you may be at risk if visiting countries reporting cases. This is especially a concern if staying with friends or family, mixing with the local population or going to mass gatherings like festivals, sports events or pilgrimages. Measles is easily passed from person to person and can be a serious illness in adults (as well as children). It is never too late to have the vaccine.

You may wish to consider carrying a record documenting vaccination against MMR when travelling abroad.

Advice for health professionals

Guidance on measles vaccination is available in Immunisation against infectious disease Chapter 21. Advice on immunisation against measles is also available for those whose immunisation status is uncertain. In the UK, measles is a notifiable disease. Any case of suspected measles should be notified to the local Health Protection Team.