Olga Tzetzi*

President of the Association of Private Practice Paediatricians of Northern Greece, Greece

*Corresponding Author: Olga Tzetzi, President of the Association of Private Practice Paediatricians of Northern Greece, Greece.

Received: April 01, 2024; Published: May 01, 2024

Citation: Olga Tzetzi. “Threats and Outbreaks of Measles; Current Situation in Greece”. Acta Scientific Paediatrics 7.6 (2024): 01-02.

As we enter the spring and summer travel season and with the recent experience of measles cases increasing, along with the decreasing vaccination rates all over the world (mainly due to pandemic), clinicians should be alert for cases of measles. Rapid recognition of measles in healthcare is essential to prevent transmission and keep it where it belongs; eliminated. Measles cases usually originate from unvaccinated or undervaccinated population who travel internationally and are exposed abroad and then transmit the disease to other unvaccinated people.

Measles is very contagious but almost entirely preventable by vaccination. We must remember that MMR vaccine is safe and very effective. One vaccine dose is 93% effective and two doses are 97% effective. The second dose is used in order to address primary vaccine failure.

Clinical picture is very characteristic with the 3 C’s (coryza, cough, conjunctivitis), the maculopapular rash and the Koplik spots. The commonest complications are otitis media, bronchopneumonia and diarrhea. Acute encephalitis occurs in 1/1.000 cases while in 1-3/1000 cases, death occurs from respiratory and neurologic complications. People at high risk for complications are infants and children < 5 years, adults >20 years, pregant women and people with compromised immune system. SSPE is a serious long term complication (7 – 10 years after infection). Measles is transmitted by direct contact with infectious droplets or by airborn spread when an infected person breaths, coughs or sneezes. 9 out of 10 susceptible persons with close contact to a measles patient will develop measles. The virus can remain infectious in the air for up to two hours after an infected person leaves an area. 

According to WHO

• Measles vaccination averted 56 million deaths being between 2000 and 2021
• In 2021 there were an estimated 128000 measles deaths globally, mostly among unvaccinated or under vaccinated children under the age of 5 years
• In 2022, about 83% of the world’s children received one dose of measles vaccine by their first birthday through routine health services – the lowest since 2008

On the 16th of February 2024, ECDC issued a threat assessment brief, highlighting the fact that during 2023, 40 of the 53 countries in European region experienced measles outbreaks. There is an expectation for continuous increase throughout the world due to suboptimal vaccination coverage, the seasonal peak of the virus and the importation from areas experiencing high circulation. Immediate action should be taken in order to achieve vaccination coverage for measles > 95% with the second dose. Health professionals need to be aware of the clinical picture, current epidemiology worldwide (look for travel or exposure history in prior 21 days) and diagnosis of this highly contagious disease so they could attribute to early detection, diagnosis, response and control of outbreaks. They also have the responsibility to promote vaccine acceptance and uptake.

In Greece, 4046 measles cases were identified between 2004 – 2023. The nationality was known in 97.5% of the cases. 88.6% were Greek (most of them Greek Roma –usually unvaccinated) and 11.4% foreigners. No cases were recorded in the period 2020 – 2023. Our country experienced the last measles epidemic in 2017. From January 2024 till now, 8 measles cases were recorded. They were all adults.

Copyright: © 2024 Olga Tzetzi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.