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4 Feb 2013

Measles & Rubella - Multistate (EU) - Monitoring European outbreaks (ECDC/CDTR, February 4 2013)

[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]


Week 5, 27 January-2 February 2013



Rubella - Multistate (EU) - Monitoring European outbreaks

Opening date: 7 March 2012 Latest update: 19 September 2012


Epidemiological summary

No new outbreaks have been identified since the last update.

From 1 January to 31 October 2012, 26 014 cases of rubella were reported by the 26 EU/EEA countries, contributing to the enhanced surveillance for rubella. Poland and Romania accounted for 99% of all reported rubella cases. Romania in particular has experienced a significant increase in the number of reported cases compared with the same period in 2011. Other countries that reported an increased number of rubella cases in 2012 include the UK, Spain and Sweden.



ECDC assessment

As rubella is typically a mild and self-limiting disease with few complications, the rationale for eliminating rubella would be weak if it were not for the virus’ teratogenic effect. When a woman is infected with the rubella virus within the first 20 weeks of pregnancy, the foetus has a 90% risk of being born with congenital rubella syndrome (CRS), which entails a range of serious incurable illnesses. CRS surveillance plays an important role but tends to be biased towards the severe end of the spectrum as the rubella infection is known to cause a wide range of conditions from mild hearing impairment to complex malformations which are incompatible with life. Routine control of immunity during antenatal care is important for identifying susceptible women who can be immunised after giving birth and for surveillance of the size of the susceptible female population. The increase in the number of rubella cases reported in 2012 compared with 2011 and the potential for an increase in the number of babies born with CRS are of concern.



ECDC closely monitors rubella transmission in Europe by analysing the cases reported to the European Surveillance System (TESSy) and through its epidemic intelligence activities. Twenty-four EU and two EEA countries contribute to the enhanced rubella surveillance. The purpose of the enhanced rubella monitoring is to provide regular and timely updates on the rubella situation in Europe in support of effective disease control, increased public awareness and the achievement of the 2015 rubella and congenital rubella elimination target.



Measles - Multistate (EU) - Monitoring European outbreaks

Opening date: 9 February 2011 Latest update: 22 October 2012


Epidemiological summary

HPA posted an update on their website on 22 January regarding a new outbreak in the North East of the UK. Forty-six confirmed cases have been reported since the beginning of September last year with a further 50 suspected cases compared to 18 confirmed cases in 2011. The majority of cases occurred in unvaccinated school children and young adults with over half of the cases aged between 10 and 30 years. Furthermore, a quarter of cases required hospital treatment.

Nationally the HPA is seeing increasing reports of measles. To the end of September 2012, 1 389 confirmed cases of measles were reported in England and Wales compared to 1 086 for the whole of 2011. During 2012 there have been large outbreaks in the North West in Liverpool (over 500 confirmed cases) and in the South East.



ECDC assessment

So far in 2013, only the UK has reported outbreaks. In 2012, considerably fewer measles cases have been reported in the EU than in 2011, primarily due to the dramatic decrease in the number of cases reported from France. There was no increase in the number of cases during the peak transmission season from February to June and there have been very few outbreaks detected by epidemic intelligence methods in 2012. The reduction in notified cases in 2012 indicates that the incidence at EU/EEA level is back at the level before the 2010–2011 outbreaks, but does not signify a long-term downward trend in measles notifications.

ECDC closely monitors measles transmission and outbreaks in the EU and neighbouring countries in Europe through enhanced surveillance and epidemic intelligence activities. The countries in the WHO European Region, which include all EU Member States, have committed to eliminating measles and rubella transmission by 2015. Elimination of measles requires consistent vaccination coverage above 95% with two doses of measles vaccine in all population groups, strong surveillance and effective outbreak control measures.