The World Health Organization (WHO) has removed the Czech Republic from the list of European countries where measles had been eradicated, along with Britain, Greece and Albania. The organization made the announcement in a report on measles and rubella in Europe. Health experts blame declining vaccinations as a cause.
The removals were based on 2018 figures, and new data for 2019 shows the situation in Europe in not improving.
“Re-establishment of measles transmission is concerning. If high immunization coverage is not achieved and sustained in every community, both children and adults will suffer unnecessarily and some will tragically die,” Gunter Pfaff, chairman of the European Regional Verification Commission for Measles and Rubella Elimination, said.
Data showed 89,994 measles cases and 37 deaths across 48 of the 53 countries in the WHO European region in the first half (H1) of 2019.
The number for H1 2019 exceeded all of 2018, which had 84,462 cases. The first half of 2018 had 44,175 cases. In all of 2016 there were only 5,273 cases in Europe.
The Czech Republic reported 569 cases in H1 2019 and 217 for all of 2018. The UK had 489 for H1 2019, while Albania had 475, and Greece had 28 cases, according to WHO.
“Each of these countries are examples that have extremely high national vaccination coverage. … This is the alarm bell that is ringing around the world: being able to achieve high national coverage is not enough, it has to be achieved in every community, and every family for every child,” Kate O’Brien, director of the WHO Immunization Department, said according to press reports.
Four countries — Ukraine, Kazakhstan, Georgia and Russia — were home to 78 percent of European cases in H1 2019. Ukraine, with over 54,000 cases and 18 deaths in H1 2019, was the most affected. In Europe in H1 2019 some 60 percent of patients were below the age of 19.
Globally over 360,000 cases have been confirmed since January, the most since 2006 and almost triple the same period last year. Congo and Madagascar are also highly affected.
Measles is considered eliminated when there is no endemic disease transmission for one year or more in a specific geographic area.
While four European countries lost measles-free status, two were added: Austria and Switzerland. This means measles is considered eliminated in 35 of the 53 countries in WHO’s European region for 2018, down from 37 in 2017.
Over 20 million deaths have been prevented around the globe between 2000 and 2016 thanks to measles vaccination, according to WHO figures.
Measles is a highly contagious viral disease. It remains an important cause of death among young children globally, despite the availability of a safe, effective, and inexpensive vaccine, WHO states.
Measles is transmitted via droplets from the nose, mouth or throat of infected persons. Initial symptoms, which usually appear 10–12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.
The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhea and related dehydration, and severe respiratory infections such as pneumonia.
A measles vaccine has been in use since the 1960s. WHO recommends immunization for all susceptible children and adults for whom measles vaccination is not contraindicated.