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LONDON. – The number of measles cases in Europe has hit a record high according to new figures by the World Health Organisation (WHO).

More than 41,000 people contracted measles in Europe in the first six months of 2018 – almost twice the annual number of cases seen in 2017, which had – until now – been the worst year in a decade with some 24,000 infections.

“Following the decade’s lowest number of cases in 2016, we are seeing a dramatic increase in infections and extended outbreaks,” says Dr Zsuzsanna Jakab, WHO’s European director.

At least 37 people have also died so far this year as a result of the disease.

Seven European region countries including France, Georgia, Greece, Italy, Russia, Serbia and Ukraine have seen large outbreaks of more than 1,000 cases this year. Ukraine alone accounted for over 23,000 of the people affected in Europe.

The UK has reported 760 cases so far this year – the eighth highest in the continent and already more than twice the number of cases reported in all of 2017.

According to Public Health England most cases have been in London, the south-east, the south-west, the West Midlands and Yorkshire and Humberside.

Dr Mark Muscat of WHO’s Vaccine-preventable Diseases and Immunisation programme said that a significant number of reported cases in the UK and other countries have been due to holiday makers bringing the disease back from countries with measles outbreaks.

“This is really the fear,” he said. “Every time you have an importation it can spread to susceptible individuals in families, schools or hospital settings.”

Measles is a highly contagious viral illness that causes high fever, coughing, a runny nose, sore red eyes and a blotchy red rash.

The disease spreads to other people through coughing, sneezing or breathing in the air where an infected person coughed and sneezed for up to two hours afterwards. It’s so contagious that if someone has it, 90 per cent of people close to that person who are not immune will catch the disease.

It’s extremely rare however, to catch the disease once you’ve been vaccinated.

But hesitancy over the MMR vaccine based on largely unsubstantiated allegations of side effects have continued to dissuade some parents from getting their children vaccinated. This includes lingering fears that the vaccine causes autism, which was sparked by a now widely-discredited study claiming the link by British doctor, Andrew Wakefield.

Although measles immunisation rates have increased in Europe from 88 per cent of children in 2016 to 90 per cent the following year, vaccination rates remain below the 95 per cent coverage level the WHO says is needed to ensure so-called “herd immunity” that stops spread of the disease.

“The current high number of measles cases reflects pockets of suboptimal coverage and an accumulation of susceptible individuals over time,” said Dr Muscat.

“To prevent measles and other dangerous diseases from spreading, high coverage of is needed. In the case of measles, the coverage in every community needs to be at least 95 per cent with two doses of the measles-containing vaccine to prevent outbreaks and eliminate the disease,” he said.

He added that the disease has a tendency to spread like “wildfire” seeking out people who are not protected within schools, hospitals and other settings where people are in close proximity to each other.

The WHO said that high coverage rates at national level, also disguised huge variations in vaccination rates at the community level that allow the disease to flourish.

“You need 95 per cent coverage at the community level, not just the national level,” said Dr Muscat.

“The great majority of parents get their children vaccinated according to their country’s national immunization schedule to protect them from serious vaccine-preventable diseases but there is a minority that is still not vaccinating their children,” said Dr Muscat.

Dr Pauline Paterson of the London School of Hygiene and Tropical Medicine said that mistrust of vaccines is particularly high in Europe.

“The reasons for non-vaccination can vary from issues of vaccine access, a lack of perceived need to vaccinate, and concerns around the safety of vaccination – in 2016 the Vaccine Confidence Project found that the European region was the most sceptical in the world on vaccine safety”, she said.

Italy – one of the countries hardest hit by measles this year with more than 2,000 cases until June – is one country that has taken a step back in vaccination efforts at the national level.

The country’s populist government has recently moved to overturn mandatory vaccinations for school children, suspending a 2017 law that obliged parents to prove their children had received 10 routine vaccinations, including measles, before enrolling them in a nursery or preschool.

In other countries such as Romania and Ukraine, low vaccination coverage is partly due to mistrust of vaccines with other reasons such as vaccine shortages, poor healthcare and some parents not realising how serious and even fatal the disease can be playing a part.

As of 2017, over 80 per cent (43 of 53) of countries in the European region had stopped the endemic spread of measles, meaning that the disease is no longer an ongoing threat within their borders.

However, inadequate monitoring coupled with low vaccination rates risks has brought the disease back to some of these places. The WHO has urged every country to keep pushing to increase vaccine coverage – even after achieving interruption or elimination of the disease to prevent further countries falling back into endemic status.

Dr Paterson said that understanding the reasons why people are failing to vaccinate is key to controlling the disease.

“Vaccines work. If measles is to be eliminated, we must continue to further our understanding of the underlying reasons for non-vaccination and to address them with effective evidence-based interventions,” she said.

She added: “Firstly, we need to identify the susceptible population – who is not vaccinated? If it’s children that are not being vaccinated, then why not? Do we need to increase access? Do parents have questions or concerns that are not being addressed? Are parents aware of the need for vaccination? If it’s teenagers and young adults that were not vaccinated when younger, then a catch-up programme is needed for them.”  – Daily Telegraph