Measles poses the most serious threat to babies and toddlers that have not been vaccinated, according to research in the wake of several years when outbreaks of the disease have occurred.
Experts at a European Union public health agency highlighted that the vast majority of measles cases in Europe over the last five years were reported in unvaccinated patients.
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Children younger than two years old were at a higher risk of dying from measles than older patients, said researchers from the European Centre for Disease Prevention and Control (ECDC) in Stockholm.
They analysed data to support European states in reaching the recommended 95% two-dose vaccination coverage and to identify any possible differences between age groups with the disease.
The study examined all 37,365 measles cases reported to the ECDC from 1 January 2013 to 31 December 2017, finding that 81% were patients who were not vaccinated against the disease.
Most cases were in Italy, Romania, Germany, the Netherlands and the United Kingdom, with each reporting more than 5% of the cases, they said.
In addition, these countries also had the most cases that had not been connected with importation of the disease, noted the researchers.
The study also noted that 33% of the patients were admitted to hospital and 11% had pneumonia. Most cases, 81%, involved those who were two years old and older. Of the remainder, 9% were one year old and 10% younger than one year.
However, the rate at which patients died from the disease highlighted the impact measles had on the very youngest populations.
ECDC’s analysis showed that one in 1,000 measles patients died, and of those, the greatest fatality was seen in the youngest cases.
Cases in one-year-olds were six times more likely to die compared with cases of patients who were two years old or older. Cases in infants younger than one year were seven times more likely to die.
The findings were based on ECDC data collected in the most recent years in the EU and European Economic Area and presented on Saturday at the 28th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Madrid, ahead of a new report published today.
“Countries may need to consider catch up campaigns to close vaccination gaps”
As well as the mortality risk to infants, the report – titled Measles and rubella surveillance in 2017 – also highlighted that up to 80% of teenagers and young adults who contracted measles in 2017 had not been vaccinated.
Between 1 January and 31 December 2017, it said 14,600 cases of measles were reported by EU/EEA countries, which was more than triple the number reported in 2016.
ECDC director Dr Andrea Ammon said: “It is essential that teenagers and young adults check their vaccination status as we are seeing a recurring pattern in measles outbreaks where they are being affected.
“Countries may need to consider catch up campaigns to close vaccination gaps in teenagers and young adults,” she added.
ECCMID is the annual meeting of the European Society of Clinical Microbiology and Infectious Diseases – a non-profit organisation seeking to improve the diagnosis, treatment and prevention of infectious diseases in Europe – taking place this year from 21-24 April in Madrid, Spain.
The World Health Organization has set goals for the elimination of measles and rubella. One of the main actions to achieve those goals is to maintain high rates of sustained immunisations.