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Beware of measles in France and Italy

Beware of measles in France and Italy

Canadians and Americans traveling in Europe, particularly France and Italy, need to make sure they are up to date with their measles vaccination, according to a new study published Monday in the journal Pediatrics. Babies from six months to one year of age should be vaccinated early, and travel before six months should be delayed if possible.

A risk for babies

“Last year, we started to realize that there has been an increase in measles cases in Europe in recent years, which is problematic because Europe is a frequent destination for travelers,” explains Kristina Angelo of the Travel Health Division of the U.S. Centers for Disease Control (CDC) in Atlanta, who is the lead author of the study published this morning in Pediatrics. “Since 2013, the recommendations were that people, especially children, be up to date on their vaccination schedule, but there wasn’t a particular focus on Europe. Most Americans, including doctors, don’t worry about traveling to France, Italy or Greece. That’s the mentality we want to change. Babies aged between 6 and 12 months, i.e. before the first measles vaccination, should have an early extra dose. And before six months, we advise postponing the trip.” In 2018, there were 2,900 cases of measles in France, and in the first two months of 2019, nearly 250, according to the World Health Organization. There are fewer than five cases a year in Quebec, according to the Institut national de la santé publique.

France, “a country at risk

“France has become a high-risk country, and we have to realize this,” says Jesse Papenburg, an infectiologist at the Montreal Children’s Hospital, who was asked by La Presse to comment on the Pediatrics study. “Over the past two years, we have seen many adults and children who have returned from a trip to Europe with measles. The biggest epidemic in North America in recent years, in 2011 in Quebec with over 700 cases, was also linked to a trip to Europe.” What does Dr Papenburg ofDr. Angelo’s suggestion to delay a trip to Europe with a baby under six months old? “It’s really a personal choice, on a case-by-case basis, but it’s certain that the risk is not the same as before for these European countries.”

Global alert

Things aren’t going to stop there. According toDr. Papenburg, Canada’s National Advisory Committee on Immunization is considering new measles recommendations. And just a few days ago, the CDC issued a worldwide alert. “We’re seeing an exponential increase all over the world, so people need to stop thinking that certain countries are Angelo. The World Health Organization recently reported a 300% increase in measles cases in the first months of 2019.”

Measles in Quebec

Before vaccination began in Quebec, over 100,000 children were infected each year. The last major hospitalization was in 1989, with 10,000 cases resulting in 656 hospitalizations and 7 deaths. In 2015, an outbreak affected 159 people in Lanaudière, most of them members of the Mission of the Holy Spirit, a sect opposed to vaccination.

In figures

50 %

Proportion of measles cases that went undiagnosed before health authorities intervened during a measles outbreak in New York in 2017.

7 %

Proportion of measles cases not correctly diagnosed by the first physician consulted during a measles outbreak in New York in 2017.

9 %

cases of measles that were not reported to health authorities by the physician who made the diagnosis during a measles epidemic in New York in 2017

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