Europe measles travel alert

People travelling to Europe this summer are being warned of a measles outbreak there.
The Cayman’s Public Health Department issued a travel alert last week in response to the outbreak across Europe, where by mid-April 33 countries had reported 6,500 cases.
“Although there is no need to be alarmed at this stage, we ask that anyone returning from Europe experiencing a sudden high fever accompanied by a rash to seek medical attention immediately,” said Medical Officer of Health Dr. Kiran Kumar.
Anyone displaying symptoms should give their travel history to their doctors, he said.
There have been no reported cases of measles in the Cayman Islands since 1990.
Measles have been reported in the United Kingdom, Denmark, Germany, the Netherlands, Norway, Serbia, Switzerland, Serbia Bulgaria and Turkey in recent weeks. India has also reported
a measles outbreak.
“If you are travelling to any of the affected European countries, safeguard yourself and your family by ensuring that you and your children’s immunisations against measles are up-to-date,” advised Dr. Kumar.

Preventable disease
Measles is a highly infectious vaccine-preventable disease, and remains one of the leading causes of childhood mortality, leading to about 240,000 deaths worldwide annually, according to the World Health Organisation.
Dr. Kumar said unimmunised children were at the greatest risk of contracting measles if cases of measles are imported to Cayman.
“It is the duty of parents and guardians to ensure that their children are protected,” he said.
The Public Health Department has advised healthcare workers in the private and public sectors of the Pan American Health Organisation alert and will continue to monitor the situation and advise residents accordingly,
Dr. Kumar said.
According to the department, local immunisation coverage against measles and mumps is around 90 per cent among children aged 15 months old and about 97 per cent by the time they reach school entry age of four or five.
Endemic measles has been eliminated in the Americas, with the last case reported in 2002. In the Caribbean, there has not been an indigenous case of measles since 1991.
However, measles is still common in developing countries in Africa and Asia.
“Regionally, while there has been great progress, once again I emphasise that measles can be reintroduced as we have many residents and visitors travelling to and from the affected areas and we should therefore remain vigilant,” Dr. Kumar said.


The World Health Organi
zation recommends two doses of measles vaccine for all children and at least one dose prior to international travel for adolescents and adults who are unsure about their immunity status.
Measles is caused by a virus which normally grows in the cells lining the back of the throat and lungs. It is a human disease and is not known to occur in animals.
The first sign of measles is usually a high fever that begins 10 to 12 days after exposure to the measles virus. A runny nose and cough, along with red and watery eyes and small white spots inside the cheeks, can develop in the initial stage, followed by a rash on the face and upper neck that eventually reaches the hands and feet.
Close contact with other people for seven days following onset of rash must be avoided.  
Children are usually given measles vaccinations in a combination vaccine against measles, mumps and rubella, known as MMR, in two doses beginning at the age
of 15 months.


The resurgence of measles in some countries has been blamed, in part, on reluctance of parents to immunise their children against MMR since it was linked to autism in a now discredited article in the UK’s Lancet medical journal written by Andrew Wakefield.
“Although even though that doctor responsible for the report was striken out of the register of medical practitioners, still some people have doubts,” said Dr. Kumar. “Caribbean parents do not have a problem, but once in a while, mothers from UK are concerned and after individual discussion, they are OK.”
After first of two doses of the vaccine, it takes two to four weeks for full protection to the virus to develop. A second dose effectively boosts the first.
The previous rarity of measles, due to worldwide vaccination programmes, have also meant that people are unaware of how serious the illness can be, because they have never seen it. This has also led in some places to parents choosing not to inoculate
their children.

Anyone returning from overseas with measles symptoms should contact the Public Health Department on 244-2648 or 244-2621, or Faith Hospital on 948-2243.


Dr. Kiran Kumar