27 Mar 2018
Measles in Europe reminderA reminder for travellers to mainland Europe to check they are up to date with measles vaccine
Measles continues to spread across Europe as the vaccination coverage in many countries is suboptimal . Localised outbreaks associated with European travel continue to be reported in England and Wales in 2017 and 2018 .
Between 1 January 2017 and 31 December 2017, a total of 14,600 measles cases were reported to the European surveillance system (TESSy). This total overall case number is more than triple the number of reported cases in 2016 and 2015. In 2017, most cases were reported by Romania (5,608), Italy (5,098), Greece (967), Germany (929) and France (518), accounting for, respectively 38%, 35%, 7%, 6% and 4% of all cases reported by EU/EEA countries. A further 2,239 cases reported by the Romanian Institute of Public Health in 2017 have not yet been submitted to TESSy .
Measles is a highly infectious illness spread by airborne/droplet transmission. Symptoms include fever, runny nose, conjunctivitis and cough. A rash then usually develops, starting at the head, then spreading to the trunk and limbs, over three to four days. Individuals are infectious from their first symptoms to four days after the rash appears and the incubation period is about ten days. Complications can occur and in the UK, the death rate is approximately one in 5,000 cases. Risk of death from measles is age-related: high in children under one year of age, lower in children aged one to nine years, rising again in teenagers and adults .
Advice for travellers
If you are planning a seasonal break, as part of your travel preparation, make sure you are up-to-date with all currently recommended UK vaccines, including measles, mumps and rubella (MMR) vaccine. This is especially important if you are travelling to Europe, but is advised for all travellers, as increased measles cases are being reported internationally . Two doses of MMR in a life time are needed for a person to be considered fully protected.
MMR vaccine can be given to babies from six months of age before travel to a risk country and/or where an outbreak is occurring .
If you have not had measles (the illness) or if you have never had two doses of MMR, you may be at risk if visiting countries reporting cases. This is especially a concern if staying with friends or family, mixing with the local population or going to mass gatherings like festivals, sports events or pilgrimages. Measles is easily passed from person to person and can be a serious illness in adults (as well as children). It is never too late to have the vaccine.
You may wish to consider carrying a record documenting vaccination against MMR when travelling abroad.
Advice for health professionals
Guidance on measles vaccination is available in Immunisation against infectious disease Chapter 21. Advice on immunisation against measles is also available for those whose immunisation status is uncertain. In the UK, measles is a notifiable disease. Any case of suspected measles should be notified to the local Health Protection Team.
- European Centre for Disease Prevention and Control. Rapid risk assessment: Risk of measles transmission in the EU/EEA. 21 March 2018. [Accessed 28 March 2018]
- Public Health England: Measles outbreaks confirmed in 5 areas across UK. PHE issues advice for the public to ensure they have had the MMR vaccine after outbreaks of measles are confirmed in 5 areas of England. Last updated 2 February 2018. [Accessed 28 March 2018]
- Public Health England. Measles. Chapter 21, Immunisation against Infectious Disease. 1 July 2013. [Accessed 28 March 2018]
- TravelHealthPro. Measles Worldwide. 22 February 2018. [Accessed 22 March 2018]