Talking Points: Measles Outside the U.S. (April 19, 2017)
Talking Points – Measles Outside the U.S.
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The following Talking Points can be used in conversations with the media and clients when discussing the measles outbreaks, including in Belgium, Germany, Italy, Indonesia, Romania and Guinea. (Updated April 19, 2017)
1. Measles is still very common in many parts of the world, including areas in Europe, Asia, the Pacific and Africa.
2. Travelers can easily protect themselves by making certain their vaccinations are up-to-date.
3. We are here to assist our clients; the safety and well-being of our clients is our top priority.
Below you will find additional information, supporting material, and statistics supporting each talking point.
1. Measles is still very common in many parts of the world, including areas in Europe, Asia, the Pacific and Africa.
The Center for Disease Control and Prevention (CDC) has issued Watch Level 1 advisories for measles in Belgium, Germany and Italy. Prior to these nation’s being added, only Indonesia, Romania and Guinea had existing Watch Level 1 advisories for measles.
o A Watch Level 1 travel health notice from the CDC is the lowest of three advisories it issues, meaning it recommends travelers “practice usual precautions” – in this case, it means being vaccinated for measles prior to traveling.
Belgium, Germany and Italy have all reported a concerning number of measles cases in their countries.
o “In Belgium, through Mar. 31, Wallonia reported 266 measles cases. The outbreak affects all provinces of Wallonia, with the exception of the province of Luxembourg. All age groups are affected and 53% of cases are over 15 years. Most of the cases were not vaccinated or did not know their vaccination status. Nearly 40% were hospitalized. No deaths have been reported,” according to Outbreak News Today.
o Also according to Outbreak News Today, “Since the beginning of 2017 and as of 4 April 2017, Italy reported 1,333 cases of measles, with 131 cases among healthcare workers. The cases are reported from 19 of the 21 regions in Italy. A majority of the cases (93%) are from Piedmont, Lazio, Lombardy, Tuscany, Abruzzi and Sicily. Most of the cases are above 15 years and 88% of the cases were not vaccinated.”
o “According to the German National Public Health Institute, since the beginning of 2017 and as of 12 March 2017, Germany reported 272 cases. In the same period in 2016, Germany reported 18 cases,” reports Outbreak News Today.
o According to Healio, the measles outbreak in Europe is due to non-vaccinated individuals.
“Health officials warned that a recent surge in measles cases in Europe is being driven by below-target vaccination rates and is threatening the continent’s progress toward eradication.”
“In Italy, which reported 238 new cases in January, immunization coverage is just 83%, and WHO said it appeared the outbreak was going to be at least as bad and perhaps even worse in February. (By comparison, Italy reported around 850 measles cases in all of 2016.)”
o The Guardian reports that the Five Star Movement (M5S) in Italy may be contributing to the measles outbreak.
“In 2015, the M5S proposed a law against vaccinations because of “the link between vaccinations and specific illnesses such as leukaemia, poisoning, inflammation, immunodepression, inheritable genetic mutations, cancer, autism and allergies”.”
“The surge in the number of cases follows a drop in the proportion of two-year-olds given vaccinations from 88% in 2013 to 86% in 2014 and 85.3% in 2015 – well below the 95% threshold advised by the World Health Organisation.”
Several countries, including Australia, Canada and Taiwan, have reported that travelers who recently visited Indonesia have been diagnosed with measles, necessitating the CDC’s Watch Level 1 advisory.
o Some of these travelers were visiting the popular tourist destination of Bali.
The CDC also reported a measles outbreak in 13 of Guinea’s 33 prefectures. The CDC issued the Watch Level 1 advisory for Guinea on March 10, 2017.
o Outbreak News Today reports that “The number of suspected cases has increased rapidly, reaching 407 this week [March 4, 2017], compared to 234 last week. More than 3.7 million children need to be urgently vaccinated in the country.”
On November 10, 2016, the CDC announced that a measles outbreak had been confirmed in Romania.
o Outbreak News Today reports that “From September 2016 to March 17, 2017, Romania has reported 3,799 cases.”
Measles continues to be an ongoing public health issue worldwide, as well. The World Health Organization (WHO) reported that, as of April 11, 2017, there have been:
o 1,259 laboratory confirmed cases of measles in the African region
o 55 laboratory confirmed cases in the Americas region
o 1,079 laboratory confirmed cases in the Eastern Mediterranean region
o 980 laboratory confirmed cases in the European region
o 926 laboratory confirmed cases in the Western Pacific region
o 766 laboratory confirmed cases in the South-East Pacific region
The majority of measles cases that are brought into the United States come from unvaccinated U.S. residents or visitors.
Clinicians should keep measles in mind when treating patients with fever and rash, especially if the patient has recently traveled internationally.
2. Travelers can easily protect themselves by making certain their vaccinations are up-to-date.
According to the Centers for Disease Control and Prevention (CDC): “Measles is a highly contagious respiratory disease caused by a virus. It spreads through the air through coughing and sneezing. Measles starts with a fever, runny nose, cough, red eyes, and sore throat, and is followed by a rash that spreads all over the body.”
According to the CDC, “Travelers who have not been vaccinated are at risk of getting the disease and spreading it to their friends and family members who may not be up-to-date with vaccinations. Because of this risk, all travelers should be up-to-date on their vaccinations, regardless of where they are going.”
In the U.S., the vaccines that are available are the measles-mumps-rubella (MMR) and the measles-mumps-rubella-varicella (MMRV) vaccines.
o The CDC states: “MMR has been used safely and effectively since the 1970s. A few people experience mild, temporary adverse reactions, such as joint pain, from the vaccine, but serious side effects are extremely rare. There is no link between MMR and autism.”
Both children and adults who are traveling should be vaccinated. The CDC offers the following guidelines:
o Routine vaccination for children in the U.S. is between 12-15 months, but younger children traveling outside of the U.S. can receive the vaccine starting at six months old.
o Children 12 months or older, adolescents, and adults who are traveling outside the United States must have received two doses of MMR or other live measles-containing vaccine to be considered immune to measles.
o Also, those who have had the diagnosis of measles documented by a physician, have laboratory evidence of immunity, or were born before 1957 are considered immune.
3. We are here to assist our clients; the safety and well-being of our clients is our top priority.
We would not send our clients to a particular destination if we believed it to be unsafe or were unable to provide precautions to minimize risks. Should we become aware of an issue for a specific destination, we alert clients who may be planning to travel there and provide detailed information on the situation so they can make informed decisions for themselves if they still wish to travel.
The CDC has issued Watch Level 1 health notices urging travelers to practice usual precautions when visiting Belgium, Germany, Italy, Indonesia, Romania and Guinea. Additional measles cases have been reported worldwide.
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