WHO calls for scaling up of measles vaccination. Children in affluent European countries have a higher risk of infection

Copenhagen, 26 February 2009

The WHO Regional Office for Europe calls on governments, health professionals, civil society and donors rapidly to scale up national immunization programmes, as outbreaks of measles grow larger and cross country borders. This highly contagious respiratory illness could spread because many children are not immunized or have received less than the required two doses of measles vaccine.

The decline in immunization rates is attributable to a combination of vaccine scepticism born of ideological positions and, ironically, the success of immunization programmes in earlier generations. In addition, some hard-to-reach vulnerable groups in every country still lack access to immunization. Further, the challenges to immunization are fed by disturbing and dangerously misleading anti-vaccination advocacy campaigns.

Paradoxically, although measles can be avoided through simple and inexpensive vaccines, children in affluent countries have a greater risk of infection. Nine of the ten countries in the WHO European Region with the lowest average measles immunization rates, from 2000 through 2007, are members of the European Union.

Over the last 12 months, over 8145 measles cases have been reported in the Region. Six western countries – Austria, Germany, Italy, Spain, Switzerland and the United Kingdom – and Israel accounted for 86% of them.

According to the latest reports, the provisional total number of measles cases in England and Wales was 1348 in 2008 (1). In Switzerland, a measles outbreak began in November 2006 with 73 reported cases, and peaked in March 2008, with 2195 reported cases for that year; 500 of them involved complications. This outbreak is continuing. In up to 98% of all cases, the sick children were unvaccinated or only partly vaccinated, mainly by the decision of their parents. In 2008, outbreaks caused by the virus strain from Switzerland were reported in Germany (50 cases), Austria (202 cases) and Norway (4 cases).

Measles can lead to serious complications, such as pneumonia, encephalitis and death. In 2005–2008, 25 deaths from measles were reported in the Region (14 in 2005, 10 in 2006 and 1 in 2008). This number is widely believed to be a significant underestimate, as measles deaths are often listed as being due to other causes, such as pneumonia and encephalitis. During a large outbreak in the Netherlands 10 years ago, concentrated in groups that chose not to have the children vaccinated for religious reasons, almost 20% of cases suffered serious complications: 3 children died; 53 were admitted to hospital with pneumonia, encephalitis or other complaints; 130 were treated for pneumonia at home; 152 had otitis media (middle-ear infection); and 87 had other complications, mostly respiratory-tract infections.

“Today we have a safe and effective vaccine to prevent measles, but children still die of the disease. This needs to change,” says Dr Nata Menabde, Deputy Regional Director at the WHO Regional Office for Europe. “The Region has achieved substantial success in controlling this disease: we are very close to reaching our goals for measles elimination by 2010. Unfortunately, in 2008 measles incidence in the Region increased from the 2007 level. We must scale up vaccination coverage to ensure that the gains made so far are not jeopardized.”

European Immunization Week 2009

The WHO Regional Office for Europe, the United Nations Children’s Fund (UNICEF) and other partner organizations will hold European Immunization Week, an annual Region-wide campaign, on 20–26 April 2009. It is expected to increase the community’s awareness of the importance of vaccination. The campaign aims to help Member States fulfil their obligations for universal immunization, and analyse and tackle deficiencies in their immunization programmes.

In 2008, 32 of the 53 Member States in the Region took part in European Immunization Week. “We are optimistic that many more countries will take part in the campaign this year. Although it seems obvious, we still have a lot of work to do to spread the word about how important vaccines can be in helping protect children,” stresses Dr Menabde.

The WHO headquarters web site offers more information on measles. The Regional Office web site provides information on:

• immunization, including why it must remain a priority in the European Region;
• European Immunization Week; and
• publications giving detailed surveillance data on the Region.

References:

 (1) Health protection report. London, Health Protection Agency, 2009 (accessed 23 February 2009).

For more information, contact:

Technical information:

Dr Rebecca Martin
Epidemiologist, Communicable Diseases
WHO Regional Office for Europe
Scherfigsvej 8, 2100 Copenhagen Ø, Denmark
Tel.: +45 3917 12 16
Fax: +45 39 17 18 63
E-mail: RMA@euro.who.int

Press information:

Ms Liuba Negru
External Relations Officer
WHO Regional Office for Europe
Scherfigsvej 8, 2100 Copenhagen Ø, Denmark
Tel.: +45 39 17 13 44
Fax: +45 39 17 18 80
E-mail: LNE@euro.who.int