Europe has a problem right now — a big, fat, polka-dotted public health problem. Right now, the continent is in the midst of a measles epidemic. And health officials say it isn’t going away any time soon. According to The European Centre for Disease Prevention and Control’s Communicable Disease Threats Report, there’s been an ongoing measles epidemic in Romania since February 2016. Between last September and March 31, Romania has reported 4,025 cases. Other EU outbreaks have been linked to the one in Romania. In their “Update of the Week,” the document reports cases in in Austria, Belgium, Bulgaria, Denmark, France, Germany, Hungary, Iceland, Italy, Portugal, Spain and Sweden as well.
The WHO says that over 500 cases were reported in the WHO European Region in January alone, with 17 Romanian deaths as of March 10. Italy saw 238 cases in the first month of 2017, with the outlook for February about the same. The organization says that the disease continues to spread, with the potential for large outbreaks “wherever immunization coverage has dropped below the necessary threshold of 95%,” the number needed to keep measles outbreaks at bay.
This, of course, raises the risk that not only could the EU experience more outbreaks — it looks like the number in Italy could only rise — but that the disease could hop a trans-Atlantic flight and find a cozy home in the U.S. This sounds okay at first, because according to the CDC, 91.9% of all babies 19 to 35 months old had received at least one dose of the MMR vaccine. Except there’s a problem: That’s the national number, not the state-by-state number. Only 86% of Colorado, Ohio, and West Virginia babies between 19 and 35 months had at least one MMR dose. That number’s ripe for an epidemic. “One child in 12 in the United States is not receiving their first dose of MMR vaccine on time, underscoring considerable measles susceptibility across the country,” the document reported.
The CDC reports that importation of measles continues to be a risk for the unvaccinated. In the three largest outbreaks of 2014 — a banner year for measles in the U.S., with the highest number of cases since the epidemic was eliminated — outbreaks occurred because the disease was introduced into pockets of people who were unvaccinated “for philosophical or religious reasons.”
Moreover, “unless they have other evidence of immunity,” the CDC says adults should get at least a dose of the MMR vaccine, and two doses are recommended for, among other people, international travelers. This would now include those traveling to Europe. The CDC says that “anyone who is not protected against measles is at risk of getting infected when they travel internationally.” And then they pose a risk for spreading the disease when they return to the U.S.
And that wouldn’t be difficult. According to the WHO, France, Germany, Italy, Poland, Romania, Switzerland, and the Ukraine saw 474 cases of measles in January alone, and it looks like even higher numbers will be reported for February. All of these countries have a less than 95% vaccine threshold.
Neither 2016 nor 2015 were bad years for measles in the U.S. (though any number of cases, of course, is a bad number). What we don’t want is a repeat of 2014, when international travelers brought the vaccine into unvaccinated enclaves. One large outbreak included 383 cases, primarily among the Amish in Ohio. With the measles outbreak in Europe, 2014 could easily happen again.
Let’s hope Europe gets a handle on its vaccination rates — and pray we don’t repeat 2014.