In recent years, Europe has witnessed an alarming surge in measles cases, raising concerns among health authorities and communities alike. As measles outbreaks continue to pose significant public health challenges, timely and accurate diagnosis plays a crucial role in controlling the spread of the disease. In this blog, we’ll explore the escalating measles situation in Europe and delve into the various test methods used for diagnosing measles.
What is Measles?
Measles is a highly contagious viral infection caused by the measles virus (MeV). It primarily affects the respiratory system but can spread throughout the body, causing many symptoms and potentially serious complications. Measles is characterized by fever, cough, runny nose, sore throat, and a characteristic red rash that typically starts on the face and spreads to the rest of the body.
Transmission of Measles
The virus is transmitted through respiratory droplets from coughing and sneezing of an infected person and can also be spread by direct contact with contaminated surfaces. Individuals who have not been vaccinated against measles or who have not previously been infected with the virus are at risk of contracting the disease.
Figure 1: Transmission of Measles
Risk Groups of Measles
Measles can be particularly severe in young children, pregnant women, and individuals with weakened immune systems. Complications of measles can include pneumonia, encephalitis (swelling of the brain), ear infections, and in severe cases, death.
The Measles Crisis in Europe:
According to the World Health Organization (WHO), Europe experienced a nearly 45-fold increase in measles cases in 2023 compared to the previous year, with over 42,200 reported cases across the region. The resurgence of measles can be attributed to factors such as declining vaccination rates, disruptions in healthcare services due to the COVID-19 pandemic, and misinformation surrounding vaccines. As a result, over 1.8 million infants missed their measles vaccinations between 2020 and 2022.
Figure 2: Rates of measles cases in Europe, January 2023 – December 2023
With millions of children remaining unprotected against measles and outbreaks occurring in various countries, urgent measures are needed to contain the spread of the disease. Health authorities are emphasizing the importance of vaccination as the primary preventive measure against measles, but effective diagnosis is also essential for identifying cases, initiating treatment, and implementing control measures.
Measles Situation by Country:
1. United Kingdom:
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- Health officials in the UK have reported a significant outbreak of highly contagious measles in the West Midlands region.
- Over 3.4 million children under 16 are unprotected, posing a risk of further spread.
- The National Health Service (NHS) is urging parents to ensure their children are fully vaccinated against measles.
2. Romania:
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- Romania has declared a national measles epidemic due to a worrying rise in cases and hospitalizations among infected children.
- The country reported 2,805 measles cases in 2023, with several deaths attributed to the disease.
- Health authorities are implementing vaccination campaigns and information campaigns to address the outbreak.
Figure 3: Number of measles cases in Europe in July 2023
3. France:
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- A measles outbreak began in a school in the southeastern commune of Guilherand-Granges in September.
- By mid-November, 64 confirmed cases were reported, with two hospitalizations.
- The regional health agency is working to contain the outbreak and promote vaccination.
Also, measles increasing in countries like Austria, Estonia, and Germany. Austria has been dealing with measles cases since the beginning of 2023, with nearly 200 cases recorded. Germany recorded 57 cases last year, which was higher than in 2022 but lower than pre-pandemic levels.
Additionally, all around the world, as of January 25, 2024, a total of 9 measles cases were reported by 4 jurisdictions: Georgia, Missouri, New Jersey, and Pennsylvania. Canada also reports some cases.
Prevention of Measles
Preventing measles relies primarily on vaccination, particularly through the measles, mumps, and rubella (MMR) vaccine, administered in two doses during childhood. National immunization programs and catch-up campaigns are crucial for ensuring widespread vaccine coverage. Public awareness campaigns debunking myths and emphasizing vaccine safety are essential, as is healthcare provider engagement to address concerns.
Additionally, robust disease surveillance and international collaboration are vital for early detection and response to outbreaks.
Vaccination Rates in Europe
Vaccination coverage rates in Europe play a critical role in determining the susceptibility of populations to vaccine-preventable diseases such as measles. The average vaccination coverage in the EU/EEA has been falling since 2020. The latest data from the ECDC show that coverage for the second dose in 2022 was around 89.7 percent.
Hungary (99 %), Slovakia and Portugal (96 %) are the EU countries with the highest levels of measles vaccination, while Estonia (68 %) and Romania (71%) have the lowest levels.
Treatment of Measles
Measles treatment involves managing symptoms and preventing complications. This includes;
- Fever reduction
- Hydration
- Rest
- Antibiotics, if necessary
- Vitamin A supplementation
- Supportive care
Isolation and infection control measures are crucial. Overall, treatment focuses on supportive care and symptom relief, as there is no specific antiviral therapy for measles.Formun Üstü
What Are The Test Methods Used in The Diagnosis of Measles?
The diagnosis of measles typically involves a combination of clinical evaluation, laboratory testing, and epidemiological assessment. Here are the primary test methods used in the diagnosis of measles:
- Clinical Evaluation:
- Healthcare professionals assess the patient’s symptoms and medical history, paying particular attention to characteristic signs of measles, such as fever, cough, runny nose, and a distinctive red rash.
- The presence of Koplik’s spots, small white spots inside the mouth, is often a telltale sign of measles infection.
- Laboratory Testing:
- Serological Testing: Blood tests can detect the presence of measles-specific immunoglobulin M (IgM) antibodies, which indicate recent or current measles infection.
- Reverse Transcription Polymerase Chain Reaction (RT-PCR): This molecular test detects the genetic material of the measles virus in respiratory specimens, such as throat swabs or nasopharyngeal swabs.
- Epidemiological Assessment:
- Healthcare providers consider the patient’s exposure history, including recent travel to regions with known measles outbreaks or contact with individuals diagnosed with measles.
- Epidemiological investigation may involve tracing contacts and identifying potential sources of infection to confirm the diagnosis and prevent further transmission.
As measles cases continue to rise in Europe, accurate and timely diagnosis is essential for effective disease management and prevention.
During the ongoing measles crisis, vaccination remains the cornerstone of efforts to protect individuals and communities from this highly contagious disease. Vigilance, prompt action, and public awareness are crucial for containing the spread of measles and safeguarding public health.
REFERENCES
- World Health Organization. (n.d.-d). Measles. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/measles
- (2024, January 31). Who: “alarming” rise of measles cases in Europe. United Nations Western Europe. https://unric.org/en/who-alarming-rise-of-measles-cases-in-europe/
- European Centre for Disease Prevention and Control. (2017, June 2). https://www.ecdc.europa.eu/en/measles
- Europe sees an “alarming” 30-fold increase in measles cases. euronews. (n.d.). https://www.euronews.com/health/2024/01/23/alarming-rise-in-measles-cases-in-europe-as-national-incident-declared-in-uk
- Bester, J. C. (2016). Measles and measles vaccination: a review. JAMA pediatrics, 170(12), 1209-1215.
- World Health Organization. (2019). Measles vaccines: WHO position paper, April 2017–Recommendations. Vaccine, 37(2), 219-222.
- Wong, C., & magazine, N. (2024, February 1). An alarming rise in measles cases is being driven by low vaccination rates. Scientific American.
- Ministerul sănătății a declarat Epidemie de rujeolă La Nivel Național. a declarat epidemie de rujeolă la nivel național. (n.d.).
- Abad, C. L., & Safdar, N. (2015). The reemergence of measles. Current infectious disease reports, 17, 1-8.
