The measles menace

IN 2010, the countries in the World Health Organisation (WHO) European Region committed to eliminate measles and rubella transmission…

IN 2010, the countries in the World Health Organisation (WHO) European Region committed to eliminate measles and rubella transmission by 2015. But with more than 21,000 cases of measles detected across Europe so far this year, the target looks increasingly ambitious. A high proportion of those infected were unvaccinated and the highest incidence was observed among children under one who are generally too young to be vaccinated. Most cases resulted from transmission within and between EU member states.

Surprisingly, the EU has become an exporter of measles to the rest of the world, threatening to undermine years of efforts to eliminate endemic transmission of the measles virus. And while measles transmission peaks during the winter and early spring in Europe, extensive travel and the many mass-gathering events that take place during the summer in Europe offer favourable conditions for the spread of the virus.

Almost 10 per cent of all cases in the Republic this year have been contracted by people visiting continental Europe. Of the 110 cases reported so far, one half occurred in people who were not fully vaccinated. Clearly all children, teenagers and young adults travelling to Europe must ensure they are immunised.

MMR is the vaccine used to prevent measles. It is given in two doses: the first when a child is 12 months old and the second when they are four or five years of age. The vaccine is safe and is available free from family doctors here. Two doses of MMR will protect 99 per cent of those vaccinated. However vaccination rates need to increase from the present 90 per cent to at least 95 per cent of children aged 24 months.

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The low rate almost certainly reflects a lingering concern about vaccine safety following the 1998 MMR vaccine scare. Dr Andrew Wakefield, whose claims to have found a link between MMR vaccination and autism were comprehensively discredited, has since been struck off for professional misconduct.

Such is the possible severity of measles that a dozen victims have been hospitalised in the Republic this year. Of those who contract measles, one in 15 will develop complications such as middle ear infection and one in 1,000 will get encephalitis (brain inflammation). And for every 1,000 children who get measles, one will die.

Eradicating measles would represent a major public health achievement but will require ongoing investment in resources by governments and a renewed commitment from the public to avail of the MMR vaccine.