13 June 2006

 

Measles in Germany

As of 7 June 2006, the Robert Koch Institute in Germany have reported 1,278 cases of measles in the federal state of Nordrhein Westfalen [1]. This outbreak is the largest in Germany since reporting began in 2001 [2], and although the number of cases appears to have declined, further cases have been reported in the Stuttgart area. This suggests that there may be a risk of measles in cities where FIFA World Cup Germany 2006 is being held [3].

Measles is an illness that has been well-controlled in many regions of the world [4-6]; however, outbreaks that include several European countries continue to occur in unvaccinated or under vaccinated populations [7-14].

Recommendations for travellers

This outbreak highlights the need for all travellers to be up-to-date with their routine immunisations according to age-specific UK guidelines [15]. For measles, this means two doses of MMR (measles, mumps, and rubella) vaccine with the first dose received after the first birthday (ideally at 13 months) and the second dose prior to school entry [16]. The interval between doses may be shortened to one month (three months if the child is under 18 months) when there is the need to complete the series prior to travel to high risk destinations. Two doses of vaccine will protect more than 95% of individuals.

Adolescents and adults born in 1970 or later who have not been immunised with MMR vaccine, should receive two doses of MMR separated by at least a month. Persons born before 1970 are likely to have had measles as a child and do not normally require vaccination.

A pre-travel health consultation is an ideal opportunity to assess a traveller’s vaccine status and to ensure they are fully immunised.

Links

World Health Organization. Measles: fact sheet no. 286. Geneva, Switzerland: World Health Organization; 2005. Available at: http://www.who.int/mediacentre/factsheets/fs286/en

 

References

1. Robert Koch Institute. Compulsory Notifiable Infections (Meldepflichtige Infektionskrankheiten) Week 20, 7 June 2006. Accessed 12 June 2006. Available at: http://www.rki.de/cln_011/nn_767686/DE/Content/Infekt/EpidBull

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2. PAHO. Press release - PAHO warns of measles risk for World Cup Travelers. 2 June 2006. Accessed 12 June 2006. Available at: http://www.paho.org/English/DD/PIN/pr060602a.htm

3. FIFA World Cup Germany 2006. Match Schedule. Accessed 12 June 2006. Available at: http://eur.i1.yimg.com/eur.yimg.com/i/eu/fifa/fwc061.pdf

4. World Health Organization. Progress towards measles elimination, western hemisphere, 2002-2003. Wkly Epidemiol Rec  2004;79:149-51.

5. World Health Organization. Progress towards elimination of measles and prevention of congenital rubella infection in the WHO European Region, 1990-2004. Wkly Epidemiol Rec  2005;80:66-71.

6. World Health Organization. Progress in reducing global measles deaths: 1999-2003. Wkly Epidemiol Rec  2005;80:78-81.

7. Garcia-Comas L. Measles outbreak in the region of Madrid, Spain, 2006. Eurosurveillance 30 March 2006; 11 (3). Available at: http://www.eurosurveillance.org/ew/2006/060330.asp#3

8. Muscat M, Christiansen AH, Persson K, Plesner AM, Böttiger BE, Glismann S, Romanus V. Measles outbreak in the Øresund region of Denmark and Sweden. Eurosureillance 30 March 2006; 11 (3). Available at: http://www.eurosurveillance.org/ew/2006/060330.asp#4

9. NaTHNaC. Information for travellers leaving Venezuela - Measles and Rubella vaccination. 24 May 2006. Accessed 13 June 2006. Available at: http://www.NaTHNaC.org/travel/news/measles_240506.h

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10. NaTHNaC. Measles outbreaks and travellers. 10 February 2006. Accessed 13 June 2006. Available at: http://www.NaTHNaC.org/travel/news/measles1_100206.htm

11 Fiji Government Online. Ministry of Health Issues Measles Alert. 27 May 2006. Available at: http://www.fiji.gov.fj/publish/page_6453.shtml    

12 Measles - Ukraine. ProMed Mail. 4 March 2006. Accessed 12 June 2006. Available at: http://www.promedmail.org/pls/promed/f?p=2400:1001:1784054

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1_PUB_MAIL_ID:1010,32214

13 ReliefWeb. Kenya - Measles outbreak - Information Bulletin no. 1. 30 April 2006. Accessed 12 June 2006. Available at: http://www.reliefweb.int/rw/rwb.nsf/db900SID/HMYT-6PDL54?OpenDocument

14. Centres for Disease Control and Prevention. Import-associated measles outbreak--Indiana, May-June 2005. MMWR Morb Mortal Wkly Rep  2005;54:1073-5.

15. NHS. Immunisation guidelines. On-line resource. Accessed 12 June 2006. Available at: http://www.immunisation.nhs.uk/

16. Department of Health. Measles. (Draft chapter of revised Immunisation against Infectious Diseases. November, 2005). Accessed 12 June 2006. Available at: http://www.dh.gov.uk/assetRoot/04/12/44/88/04124488.pdf