Sudden spike in number of measles cases in Europe, highest death toll in Serbia

Anti-vaccine protestors demonstrate outside the Lower House in Rome, Italy, 28 July 2017. The House gave final approval on 28 July 2017, to a decree that makes ten vaccines obligatory for children up to six years of age, attending nursery and elementary schools. [EPA/Giuseppe Lami]

The first six months of 2018 have seen a sudden increase in the number of measles cases in Europe with at least 37 deaths, the World Health Organisation (WHO) has warned.

Most cases were registered in Ukraine, while Serbia, which has a number of anti-vaccination groups active on social media, has the highest rate of infection and also the biggest number of deaths caused by complications of the disease.

Earlier this week, WHO stated that in the first half of 2018, more than 41,000 cases of measles were reported in Europe, compared to around 24,000 cases in 2017 and just over 5,000 in 2016, which was a 10-year low.

More than a half of the total number of cases in 2018, some 23,000, were registered in Ukraine, and more than 1,000 infected were registered in each of the following countries: France, Georgia, Greece, Italy, Russia and Serbia.

Deaths caused by complications of the disease were registered in all of the countries, while Serbia reported the highest number of 14 fatalities.

Serbia also had the biggest number of measles cases per one million citizens – about 650. Behind it were Ukraine with 600 cases per one million citizens and Georgia and Greece with about 300 cases each. The data pertains to the period July 2017 – June 2018.

Serbia has active anti-vaccination groups, mainly on social media. Besides a number of individuals not known to the public, who do not include medical professionals (but do include some falsely presenting themselves as doctors), these groups also boast certain “famous” people – a folk music singer, a female writer, a female scriptwriter, a professor…

Some of them oppose the vaccination of children because they are anti-globalists, others are against the so-called pharmaceutical mafia, some have doubts regarding the control and oversight of the vaccines, while others cite a parent’s right to choose whether to vaccinate their child. In the process, they all present examples and testimonies of parents whose children got sick after they were vaccinated.

Earlier this year, the Higher Public Prosecutor’s Office in Belgrade launched an investigation against anti-vaxxers who had sought to spread panic in public and present false information about the MMR (measles, mumps and rubella) vaccine on social media.

According to the Serbian Law on Protection of the Population from Infectious Diseases, immunisation is mandatory and parents who do not get their children vaccinated may pay fines ranging from 30,000 to 150,000 dinars (250-1,200 euros).

The data unveiled by Serbia’s Public Health Institute shows that the epidemic, which broke out in October 2017, is the biggest measles outbreak in Serbia in the last 25 years, with the first deaths in the last 20 years.

From the start of October 2017 to 17 August this year, Serbia registered 5,718 cases of measles, 2,877 of which were confirmed by laboratory testing, while the total number of deaths caused by complications of the disease was 15, according to a statement from the Institute.

The disease is the most prevalent among those under the age of five and over the age of 30; 94% of the infected were not vaccinated, were not completely vaccinated or their vaccination status is unknown; of the total number of the infected a third had to be hospitalised.

Since October 2017, Serbia has intensified its epidemiological surveillance measures. The public health institute has also said that intensive vaccination is being carried out on those aged from 1 to 14 who have not been vaccinated or have been incompletely vaccinated.

WHO says that the prevention of an epidemic of the highly infectious measles requires that at least 95% of children receive the MMR vaccine.

According to the organisation’s latest report, in Europe, the percentage of immunisation in 2017 went up to 90% from the previous year’s 88%, but the differences between regions are big and in some areas, the percentage exceeds 95%, while in others it is below 70%.

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