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The threat rising. Since January 2018, Europe is facing its largest measles epidemic in 10 years: more than 41,000 children and adults have contracted the disease in recent months on the continent (37 died), twice as many as the whole of 2017.
In Ile-de-France, the Regional Health Agency observed 56 cases of measles during the month of October, while we observed 3 to 4 a month earlier, a strong increase according to Aurélien Rousseau, the director General of the agency at the microphone of France Bleu, especially as each patient can contaminate between 15 and 20 people.
The home would mainly affect Seine-Saint-Denis and no deaths have yet been observed, but 11 patients have been hospitalized, mainly children aged 4 years, whose vaccinations were not up to date. There is no explanation as to the origin of this epidemic outbreak apart from the insufficiency of vaccination coverage.
Advancing our immunization coverage is the only way to limit the spread of measles. Mobilization of the @seinesaintdenis and its PMI centers and the@ARS_IDF : not to vaccinate, it is not to make a personal choice, it is to run a collective danger. https://t.co/KhH80v9jB2
– Aurélien Rousseau (@aur_rousseau) November 8, 2018
Immunization coverage is not optimal
There is a minimum threshold of vaccination coverage in a population for a "group protection" to work and protects those who can not be vaccinated (neonates, immunocompromised …). This threshold depends on the contagiousness of the disease.
In France, with almost 97% immunization coverage for diphtheria, the group immunity threshold is exceeded, and the entire national community is protected, even in the case of infection by a migrant. . Similarly, Haemophilus influenzae b infections in children, rubella or mumps have almost been eliminated in the country because coverage rates for their vaccines exceed the group immunity threshold for these 3 diseases.
On the other hand, the current level of immunization coverage against measles (79%) is still insufficient to allow group immunity (group immunity threshold = 95%), and epidemic outbreaks of the large-scale disease are thus occurring. : more than 23 000 cases reported in France between 2008 and 2012, more than 1500 serious pneumonia and more than 30 encephalitis with 10 deaths). It is unbearable and dangerous at a time when more than 41,000 cases of measles are observed in Europe.
A 2-stage vaccination schedule
Traditionally, the vaccination schedule consists of the injection of one dose of MMR vaccine (Measles, Mumps, Rubella) at 12 months and a second injection between 16 and 18 months. For people who have never been vaccinated against measles, catch-up is possible. It consists of injecting two doses of vaccine at least one month apart.
In the event of an epidemic, it is possible to receive the vaccine up to 72 hours after being in contact with a person suffering from measles to avoid the occurrence of the disease (catch-up vaccination). The vaccine is extremely well tolerated and has only exceptional contraindications. It is not the same with measles.
This is not a mild illness of childhood
Measles is an infectious disease caused by a highly contagious virus that previously mainly affected young children from 5-6 months of age. This is no longer the case: one third of the cases reported in France concern people over 15 years of age. A sick person can contaminate up to 20. Measles is 10 times more contagious than flu. It is transmitted very easily from one person to another by air, during coughing, sneezing, or by contact with contaminated objects (toys, handkerchiefs …).
Often mistakenly considered as benign, "measles is not only a disease of childhood, it also affects adolescents and young adults and can lead to serious complications (pneumonia, encephalitis …) and sometimes hospitalizations ", or death, explained recently the Regional Agency of Health of Occitanie.
23,000 cases in Ukraine
Ukraine is the hardest hit country with 23000 cases in 6 months, followed by Serbia, Russia, Italy, Georgia, Greece, or France. According to Santé Publique France, "the number of measles cases has increased significantly (in France, Editor's note) since November 2017. This situation is the result of insufficient vaccination coverage in infants (79% with two doses of vaccine instead 95% needed), children and young adults ".
More precisely, 2741 cases were reported in France between 6 November 2017 and the least August 2018, 22% of them were hospitalized and three deaths occurred since January. In short, contrary to popular belief, measles is neither an eradicated disease nor a benign infantile disease. It also affects adults, can lead to complications pulmonary or neurological problems, or even be fatal.
Measles globally
Measles is still a major cause of death among children in poor health, but WHO is doing a huge job. Between 2000 and 2005, more than 300 million children aged nine months to 15 years were vaccinated or revaccinated. In 2015, nearly 77% of the world's population was vaccinated, leading to a further reduction in mortality: less than 345,000 deaths that year out of 20 million patients.
In Europe, a measles elimination plan was put in place between 2005 and 2010. Elimination occurs when no epidemic – even a small one – occurs for a year or more. It is based on vaccination, hence the logic of the compulsory vaccination in France since January 2018.
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