Trip Alert for Romania

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Measles outbreak in Romania: ECDC assesses the risk of spread to and sustained transmission in EU/EEA countries

07 Mar 2017

​​An outbreak of measles is ongoing in Romania. From the end of September 2016 to 17 February 2017 the Romanian National Institute of Public Health received reports of 3 071 cases of measles. Cases continue to be reported despite ongoing response measures at national level through reinforced vaccination activities. For example, Romania has lowered the age for administering the first vaccine dose from the usual 12 months to nine months and recommended that all children up to nine years of age are vaccinated. Considering the size and geographical spread of the ongoing measles outbreak in Romania, the likelihood of exportation of measles cases is high.

Between 1 February 2016 and 31 January 2017 ECDC received reports of 4 484 cases of measles from 30 EU/EEA countries. In 2016, measles outbreaks were seen in a number of EU/EEA countries and an increase in the number of cases continues to be observed in 2017. Previous and ongoing measles outbreaks in three other EU countries have been epidemiologically-linked to the current outbreak in Romania, however further investigations are needed to gain more insights into the epidemiological links.
Immunisation is the only effective preventive measure against acquiring measles. The latest available data from WHO (from 2015) shows that vaccination coverage for measles-containing vaccine was above the 95% target in 17 countries for the first dose and 8 countries for the second dose. Given that the vaccination coverage target is still to be reached in a number of EU/EEA countries the risk of spread and sustained transmission from areas where measles transmission is occurring in areas with susceptible populations is high.
All countries in the EU/EEA have measles vaccination policies in place with two doses using an MMR vaccine. Catch-up programmes for individuals having missed vaccination or being too old to have been targeted by routine programmes exist in a number of countries. Strengthening routine immunisation through facilitating access to vaccination, and mechanisms to identify unvaccinated or incompletely vaccinated are needed. Promoting and providing additional opportunities for immunisation through a variety of supplemental immunisation activities may be needed in countries with suboptimal vaccination coverage and/or pockets of susceptible populations.
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