World Health Organization officials are warning that large measles outbreaks are continuing in Europe this year, and are urging people to seek vaccination.
Through February, more than 1,000 measles cases were reported in France, WHO said in a statement late on March 1, although the figures are preliminary reports from French health officials, and the 2011 cases have yet to be entered into the WHO measles database, officials said in interviews on March 2.
Other outbreaks have meanwhile been reported in Denmark, Germany, the Netherlands, Norway, Serbia, Switzerland, and Macedonia in 2011, WHO said, with one outbreak occurring in Geneva, WHO’s headquarters. Regardless, the agency has set regional elimination by 2015 as its goal.
Europe’s measles problem is twofold, Dr. Rebecca Martin, the organization’s program manager for preventable diseases and immunization, said in an interview. In some Eastern states of the region (such as Serbia), measles affects poorer communities disproportionately; in Western nations (such as France), the disease is in “continual circulation,” she said, including among comparably high-income families who elect not to vaccinate their children. Last year, more than 5,000 cases were reported in France.
Epidemiologic trends for measles and mumps tend to run counter to those for many other infectious diseases in the region. With measles and mumps, Dr. Martin said, wealthier Western European countries see larger outbreaks than are seen in the East. And although a number of infectious diseases are routinely imported to Europe from poorer parts of the world where they are endemic, she said, more than half of documented measles importations in Europe are from other European countries (for example, from France to Germany).
More worryingly, traveling Europeans are bringing measles with them to other parts of the world – including the Americas, where measles is no longer endemic. “In 2009 [Europe] accounted for about 60% of importations to the Americas,” Dr. Martin said. “We are exporting measles.”
Beginning on April 23, the WHO European Region will launch its annual European Immunization Week to promote coverage in the region among health care workers, educators, government officials, and the general public. “Recent outbreaks have clearly illustrated that when vaccine-preventable diseases spread, shared borders lead to common threats,” the agency noted on its website about the program.
Last summer, Dr. Martin’s team began seeking more in-depth explanations for why Europeans might hesitate to immunize; they recruited behavioral scientists to investigate the complex reasons why people refuse or do not seek vaccination when it is widely available. “In Europe, it all seems to come down to behavior,” Dr. Martin said.