Measles outbreaks prompt travel and vaccine advisories

Apr 8, 2011 (CIDRAP News) – Measles developments at the international and US levels are sparking fresh warnings about the disease, along with renewed efforts to get children vaccinated, according to several recent reports.

The United Kingdom's Health Protection Agency (HPA) sent a letter to schools to warn families about a large measles outbreak in France, plus other outbreaks in Bulgaria, Italy, and Germany, in advance of the Easter holiday season when many families will be traveling, The Telegraph, a newspaper based in London, reported today.

The HPA letter urged parents to make sure their children are up to date with their measles, mumps, and rubella (MMR) immunizations before travel and in advance of school trips, according to The Telegraph, which also noted that measles outbreaks have been detected in Surrey and Sussex schools.

Outbreak spread in Somalia
In another international development, Somali health officials who are investigating the cause of a measles outbreak say rumors about MMR vaccine side effects may be contributing to the spread of the disease, the Integrated Regional Information Networks (IRIN), part of the UN Office for the Coordination of Humanitarian Affairs, reported yesterday.

Dr Ismail Isse Roble, who heads a medical organization in Somalia's semi-autonomous Puntland region, told IRIN that many parents believe unfounded rumors that the MMR vaccine can cause HIV in children and lead to fertility problems. He added that most children at his clinic have not been vaccinated, though the parents can afford medical care. Roble added that children in refugee camps appear to be better protected, because their families are taking the free vaccinations provided in the settings.

Over the past 5 weeks the WHO has received reports of 83 measles cases in Mogadishu, including 5 deaths. Puntland has reported 127 cases.

Roble told IRIN that he hopes religious scholars will step forward to help promote vaccine safety. "They are the ones that ordinary Somalis will listen to; it is sad that in this day and age our children must die because of ignorance and lies," he said.

Minnesota outbreak imported from Kenya
Meanwhile, Minnesota health officials have linked a recent measles outbreak that sickened 13 people to a 30-month-old child who got sick with a rash after returning from a trip to Kenya. A report on the outbreak appears in today's issue of Morbidity and Mortality Weekly Report (MMWR). All but one of the cases occurred in children under age 4. Seven of the 13 were of Somali descent.

The investigation linked the other infections to exposure to the index patient at a daycare center, two homeless shelters, an emergency department, and households. Vaccination status, known for 11 patients, revealed that 5 were too young to be vaccinated and 6, all of Somali descent, had not been vaccinated, because their parents had concerns about MMR vaccine safety.

As part of the outbreak response, Minnesota officials have held vaccination clinics at community centers and congregate living facilities and have recommended that children ages 6 to 11 months in certain congregate living centers receive a dose of the MMR vaccine.

In Minnesota's outbreak, many Somali parents feared the MMR vaccine could lead to autism, according to an Apr 2 report from Minnesota Public Radio (MPR). Somali parents in the Twin Cities recently met with Dr. Andrew Wakefield, lead author of a now-retracted 1998 Lancet study purportedly linking the MMR vaccine to autism, which led to a decline in vaccination in many countries.

Numerous studies have found no link between the MMR vaccine and autism.

Utah confirms case
Elsewhere, Utah officials have recorded the state's first measles case since 2005, the Salt Lake Tribune reported yesterday. The patient is a high school student from the Holladay area. The Salt Lake Valley Health Department (SVHD) said the student was under voluntary isolation, and a school district spokesman said 30 students were sent home from school until Apr 18, because they have not been fully immunized.

The SVHD is investigating the case to determine how the teen was exposed to measles and if others were exposed while he or she was contagious.

See also:

Apr 8 Telegraph story

Apr 7 IRIN story

Apr 8 MMWR report

Apr 2 MPR story

Apr 7 Salt Lake Tribune story

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