4 European Countries Lose Measles Elimination Status

Four countries in the European Union have lost their measles elimination status. A statement issued by the World Health Organization (WHO) reports that Albania, Czechia, Greece, and the United Kingdom have lost ground in the fight to eradicate measles.

The decision was made by the European Regional Verification Commission for Measles and Rubella Elimination (RVC) upon assessing annual status updates for the 53 member states of the European Union.

“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,” said Dr. Günter Pfaff, chair of the RVC, in the statement issued by WHO.

The verification process first began in the European Union in 2012 and this marks the first time that a country has lost its measles elimination status.

The RVC meets annually to assess measles elimination status in the European Union based on annual reports submitted by each country. Conclusions are made based on surveillance data, immunization coverage, the reach of supplemental immunization campaigns, and outbreak response.

Overall, 35 European nations are now considered to have achieved or sustained measles eliminations, 2 nations have interrupted endemic transmission for 12-35 months, and 12 remain endemic for measles.

Based on the ongoing circulation of measles throughout the region, the WHO has classified the situation as a Grade 2 emergency, which provides financial and technical resources to support the affected nations.

The global incidence of measles continues to grow. The United States is also at risk of losing measles elimination status, as 1215 individual cases of the disease have been confirmed across 30 states since the beginning of 2019. Current outbreaks of measles in the United States have been linked to unvaccinated travelers who brought the disease back from nations where outbreaks are ongoing.

As such, the US Centers for Disease Control and Prevention recommends everyone aged 6 months and older should be vaccinated against the measles before traveling internationally. Infants 6 to 11 months old should receive 1 dose of the Measles, Mumps, Rubella (MMR) vaccine prior to travel and everyone over the age of 12 months should receive 2 doses.

In Contagion®’s Insights series on measles outbreaks and the role of public health, Glenn Fennelly, MD, MPH, professor and chair of pediatrics at Rutgers New Jersey Medical School and a pediatric infectious disease specialist, and Christina (Tina) Tan, MD, MPH, a state epidemiologist and an assistant commissioner with the New Jersey Department of Health, discussed a number of topics including prevention of measles. The experts noted that the risk of measles is not just limited to the European Union.

“I think it’s important to note that if you plan travel, there are many, many pockets around the world where there are major outbreaks right now: most of Europe, Israel, other parts of the Middle East, many parts of Africa, Southeast Asia, Madagascar, the Philippines, and Japan, to name a few.” Fennelly said in a segment of the program.

Although the loss of measles elimination status is a significant hurdle, the RVC was pleased with strides towards rubella elimination in the European Union. The committee concluded that the situation for rubella has improved with 39 countries achieving or sustaining elimination status, compared with 37 in 2017. Additionally, 3 countries have interrupted endemic transmission, but 11 nations remain endemic for rubella.