Dr Suzanne Cotter: How to protect your family from measles virus
This year large measles outbreaks were reported in Romania and Italy. Measles cases were also reported in Austria, Belgium, Bulgaria, the Czech Republic, Denmark, France, Germany, Hungary, Iceland, Portugal, Slovakia, Spain and Sweden. Deaths have been reported in Romania and in Portugal.
Measles is an acute viral illness which is easily transmitted by airborne respiratory droplets, or by direct contact with nasal and throat secretions of infected individuals. About 90pc of non-immune people exposed to an infected individual will get measles.
The main symptoms are fever, rash, cough, runny nose and inflammation of the eye. The first symptoms appear on average 10 days after exposure, but with a range of 7-21 days from exposure to onset of fever.
A rash usually appears four days after the start of the first symptoms.
Patients are infectious from about four days before until four days after rash appearance. Complications include pneumonia, inflammation of the brain (encephalitis), otitis media, diarrhoea. Subacute sclerosing panencephalitis (SSPE) is a rare and ultimately fatal progressive degenerative disease of the brain that may develop years after primary infection.
Those at greatest risk of complications from measles are infants and immuno-compromised individuals.
The disease is preventable by vaccination, which provides lifelong immunity in most people who get two doses of vaccine. Vaccine uptake of at least 95pc with two doses of measles containing vaccine is considered to be necessary to ensure sufficient population immunity. In Ireland, we have never (at national level) achieved a 95pc uptake of two doses of MMR. Therefore, we are at risk of measles spread.
You can protect your children from measles by ensuring that they are vaccinated on time as recommended by the national immunisation programme. The first dose of MMR is given at 12 months of age and the second dose at preschool.
You can consider getting an early MMR (between 6-11 months) if your child is going to an outbreak-affected area, but this early dose does not replace the normal dose given at 12 months of age.
For older children who are not vaccinated with two doses of MMR, speak with your GP so that they can start getting protection before travel.
For adults who never had measles and measles-containing vaccine, speak with your doctor to see whether you should get the vaccine. In general, in Ireland most people born before 1978 are likely to have had measles.
Dr Suzanne Cotter is specialist in Public Health Medicine at the HSE Health Protection Surveillance Centre