Epidemiology
Measles Health Advisory Update 
Europe is experiencing an unusual increase in measles cases. In 2010, more than 30,000 measles cases were reported by EU and EEA/EFTA countries; this number is five times higher than the normal average for the past 5 years. During the first 6 months of 2011, more than 26,000 cases were reported and 7 deaths. Most of the cases were reported in France (14,040), Italy (4000), Spain (2407), Romania (2072), and Germany (1361). The number of cases in France accounts for more than half of all cases in 2011.

Map: Measles Cases in Germany
Map: Measles Cases in Europe


What is measles?

Measles is a highly contagious respiratory disease caused by a virus. It is easily spread through the air by breathing, coughing or sneezing. Measles begins with a fever, cough, runny nose, red eyes, and sore throat. Two or three days later, small white spots (called Koplik’s spots) may appear inside the mouth. On the third to seventh day, a red blotchy rash appears, beginning on the face and spreading to the neck, body, arms and legs. When the rash appears, fever may spike to more than 104 degrees Fahrenheit. After a few days, the fever goes away and the rash fades. Some severe cases may also include diarrhea, ear infections, pneumonia, seizures, brain damage, and even death.

How is measles prevented?

Measles can be prevented with a vaccine. Immunization is the first step and best defense towards fighting the disease. Two doses of the measles vaccine are needed for complete protection. The first dose is given at 12-15 months of age. The second dose is usually given between 4–6 years of age, but can be given earlier. Adolescents and adults should also get measles vaccine if not previously vaccinated, unless they already had measles and are immune. Anyone 18 years of age or older who was born after 1956 should have documentation of 1 or more doses of measles vaccine. Those at increased risk of exposure to measles (healthcare workers, college students, and international travelers) should have documentation of two doses of measles vaccine or a blood test that shows they are immune. Measles vaccine is often given in combination with mumps and rubella. This “measles, mumps, and rubella” vaccine is often labeled “MMR” on your vaccination records. Visit your health clinic if you have never been vaccinated or to review your vaccination records. Due to the current situation, it is strongly advised that children receive their first dose of measles vaccine on their first birthday or shortly after.

Is there a cure?

There is no specific treatment for measles. People with measles need bed rest, fluids, and control of fever. Persons with measles cannot attend daycare, school or go to work for at least four days after the rash appears. If you notice any signs or symptoms of measles, contact your healthcare provider immediately and limit contact with others.

Can I still travel in Europe?

There are no current travel restrictions related to measles outbreaks. It is a good idea to always review your vaccination records before visiting other countries to see if you may need other vaccines. DoD health officials in Europe stress the importance of adequate measles immunization, especially prior to travel and attendance at large public gatherings. Early vaccination of infants at 6-11 months of age may be considered for travel to an affected area or other special circumstances.