Title: #Risk #Assessment: Ongoing #measles #outbreak in #Romania – March 2017.
Subject: Measles Outbreak in Romania, current epidemiological situation and risk assessment.
Source: European Centre for Disease Prevention and Control (ECDC), full PDF file: (LINK). Summary.
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RAPID RISK ASSESSMENT
Ongoing measles outbreak in Romania – March 2017
Suggested citation: European Centre for Disease Prevention and Control. Ongoing outbreak of measles in Romania, risk of spread and epidemiological situation in EU/EEA countries– 3 March 2017, Stockholm. ECDC; 2017.
© European Centre for Disease Prevention and Control, Stockholm, 2017
Main conclusions and options for response
- A measles outbreak in Romania has been ongoing since February 2016 and cases continue to be reported despite implemented and ongoing response measures at national level through reinforced vaccination activities.
- As of 17 February 2017, 3 071 cases had been reported to the National Institute of Public Health in Romania since the end of September 2016.
- In 2016, measles outbreaks were seen in a number of EU/EEA countries; and an increase in the number of cases continues to be observed in 2017.
- Previous and ongoing measles outbreaks in three other EU countries have been epidemiologically linked to the current outbreak in Romania.
- However, additional knowledge on genotypic characterisation of the virus is needed to allow further insight into the epidemiological investigations.
- The latest available vaccination coverage data from the World Health Organization (WHO) in 2015 show that vaccination coverage was above the 95% target in 17 EU/EEA countries for the first dose of measles-containing vaccines (MCV) (range: 85–99%).
- In eight countries, vaccination coverage for the second dose of MCV was at least 95% (range: 74–99%).
- Therefore, the vaccination coverage in many EU/EEA countries remains suboptimal.
- Given the size of the current outbreak in Romania, the recent historical trends, and that vaccination coverage for the first and second dose of MCV in Romania is below 90%, there is a high risk of continued measles transmission within the country.
- This poses a risk of potential repeated exportation to other EU/EEA countries and possible continuous transmission in some where vaccination coverage is suboptimal.
- Response efforts are continuing in Romania and should help ensure that pockets of susceptible individuals are adequately vaccinated.
- Immunisation is the only effective preventive measure against measles.
- All countries in the EU/EEA have measles vaccination policies in place with two doses of the measles, mumps and rubella (MMR) vaccine.
- Catchup programmes exist in a number of countries for individuals having missed vaccination or being too old to have been targeted by routine programmes.
- Routine immunisation needs to be strengthened by facilitating access to vaccination, and mechanisms to identify people who are not or are incompletely vaccinated are needed.
- Additional opportunities for immunisation should be promoted and provided through a variety of supplemental immunisation activities (SIA) in countries with suboptimal vaccination coverage and/or pockets of susceptible populations.
- Vaccination coverage of ≥95% of the general population at national and subnational levels with two doses of MCV is recommended and necessary to ensure that measles circulation is interrupted, and that the introduction of measles cases does not result in secondary cases.
- This has not yet been achieved in all EU/EEA countries according to available vaccination coverage figures.
- The assessment of vaccination coverage and the availability of data at subnational level would allow geographical areas where targeted actions may be needed to be identified.
- Strengthening and ensuring high quality surveillance, including monitoring the changing epidemiology of measles, helps guide public health actions.
- All suspected cases should be detected and investigated in order to break chains of transmission as soon as possible, and performing epidemiological investigations, including an assessment of the susceptibility of contacts to consider necessary control measures.
- Adequate laboratory investigation is essential because data on viral genotype are needed to track transmission chains.
Keywords: ECDC; Updates; European Region; Measles; Romania.