Measles in Europe – What You Need to Know

Joint Base San Antonio, Texas (May 23, 2017) – On April 17, 2017, the Centers for Disease Control and Prevention (CDC) issued Travel Notices (Watch-Level 1, Practice Usual Precautions) regarding ongoing measles outbreaks in Belgium, Germany, Italy, and Romania. The CDC recommends that all children aged 6-11 months traveling to, or residing in, these areas receive one additional, early dose of measles vaccine.

Currently, there is an expanding measles outbreak in Europe. While Belgium, Germany, Italy, and Romania are the most severely affected countries, all European nations are experiencing at least “limited outbreaks” of the disease.

According to Dr. Caitlin Rivers, Disease Epidemiology Division, U.S. Army Public Health Center,

“Children and adults who have received both doses of the MMR (Measles, Mumps, and Rubella) vaccine are at low risk for contracting measles. People who have not completed their vaccine series should talk to their healthcare provider about what they can do to reduce their risk.”

Rivers added, “Most measles cases are in un- or under-immunized individuals. The best thing families can do to protect themselves is to follow the recommended vaccination schedule.”

Measles is a highly contagious viral illness spread through the air by breathing, coughing, or sneezing. The virus can remain in the air or on surfaces for up to two hours.

Symptoms of measles include high fever, rash, cough, runny nose, and red, watery eyes. Some infected persons may experience ear infections, diarrhea, and/or pneumonia. Brain swelling and death may occur in the most severe cases.

Operational Considerations:

Army Regional Health Command-Europe and Army Public Health Command-Europe continue to monitor local conditions; no change to mission analysis at this time.

There is minimal risk to US military personnel given proper compliance with current immunization policy.

Susceptibility and Immunization Recommendations:

Nearly all measles cases occur in unimmunized or under-immunized individuals. To date, two suspect cases are being investigated in family members.

The most vulnerable U.S. military beneficiaries are family members not subject to the U.S. immunization schedule as children (e.g., foreign-born spouses) and children aged < 12 months traveling to or residing in high-risk areas. Such children are too young to receive the first regularly-scheduled dose of measles vaccine at 12 months of age.

The following recommendations are issued in accordance with CDC and Advisory Committee on Immunization Practices guidelines:

  • Ensure all beneficiaries aged > 12 months have received at least two doses of MMR vaccine at least four weeks apart.
  • Infants aged 6-11 months should receive one additional, early dose of measles-containing vaccine. This early dose DOES NOT replace either of the two vaccine doses required after 12 months of age for long-term immunity.
  • Children should then receive the first regularly-scheduled vaccine dose at 12 months of age and the second regularly-scheduled dose four weeks later.
  • Children who have not yet received the second regularly-scheduled vaccine dose (routinely administered at 4-6 years of age) should complete the immunization series at the earliest opportunity.
  • Infants and children preparing to travel to, or reside in, Europe should receive the above-recommended immunizations prior to arrival.
  • Beneficiaries are encouraged to contact their assigned Primary Care Provider with immunization questions or to review immunization records.

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