A spike in measles cases across Europe led by France – caused by the difficulty of innoculating migrant, religious and complacent communities – has triggered moves to co-ordinate vaccination across the continent.
According to data released yesterday (27 April) by the World Health Organisation (WHO), France is leading a European upsurge in measles cases, having recorded almost as many in the first three months of the year – 4,937 – as for the whole of last year, when 5,090 cases were recorded there.
The UN agency said significant outbreaks were also taking place in Spain, the former Yugoslav Republic of Macedonia, Serbia and Turkey.
The figures were released at a round table on measles convened in Brussels by the United Nations and featuring delegates from Belgium, France, Germany and Switzerland.
The upsurge was blamed on the difficulty of vaccinating certain communities. These include children whose parents are unaware that measles still exists.
"Clearly the vaccination is the victim of its own success, people have come to think of it as a historic virus. This is negligent and presumptuous," said Didier Houssin, a director-general in the French Ministry of Health.
Other groups at heightened risk include Roma and other migrant communities – who do not access national health services as frequently as others – and religious groups such as children at Anthroposophic or 'Steiner' schools.
Such schools sometimes encourage the belief that it is better to succumb to diseases such as measles in order to strengthen the body's natural immunity. A rise in the measles virus in Germany in 2008 – which emerged in Anthroposophic schools – spilled over into Austria, Italy and Norway.
European concerted action
John Ryan, a head of unit in the European Commission's health and consumer protection department, said that the Hungarian EU Presidency had tabled a proposal on vaccination for adoption at the council of EU health ministers in June.
He said that the proposals included measures for closer cooperation between EU member states on vaccination, including better coordination of vaccination records.
Ryan said there were many opportunities for enhanced cooperation and coordination at EU level. Examples included developing guidance for reaching out to under-served populations, such as the Roma, and on how to adapt children from one vaccination schedule to another; strengthening EU surveillance for vaccine-preventable diseases; and providing multilingual information on vaccination for healthcare professionals and the public.
The round table heard that the upsurge in infections in France was causing deaths at the rate of one to two for each 1,000 infections. The most vulnerable groups include teenagers and university-aged adults, for whom the disease can be virulent and dangerous.
Rebecca Martin, the WHO's European programme manager for immunisation, said in relation to Roma and migrant communities: "This is a very sensitive issue and needs to be handled carefully. We at the WHO are trying to find a way of dealing with migrant health, working with the member states, but it needs time and effort to understand the communities and to explain the issues to them."