Measles Outbreak in North Rhine-Westphalia (Nordrhein-Westfalen), Germany

The Public Health Agency of Canada (PHAC) is monitoring a measles outbreak in Germany , specifically in the State of North Rhine-Westphalia (Nordrhein-Westfalen). S everal World Cup 2006 matches will be held in this state between June 9 and July 9, 2006, although no games will occur at the direct sites of the outbreaks.

Between January 1, 2006 and May 3, 2006, health authorities were notified of 1018 cases of measles. The majority of cases (60%) have been reported in children aged 10 to 19 years. Of the total number of cases reported only 25 patients had received a full course of vaccination. Laboratory testing has confirmed the measles strain in this outbreak as D6.

At this time, German authorities have advised that reported cases are declining in response to public health control measures.

This outbreak was initially reported on in PHAC's International Reports of Vaccine Preventable Childhood Diseases Table, in March 2006.

Source: Eurosurveillance

Disease Information: Measles

Measles is a highly contagious and acute infectious disease caused by a virus. In severe cases, complications such as pneumonia, diarrhoea, middle ear infection and encephalitis (a dangerous infection of the brain causing inflammation) may occur. Measles mainly affects young children, but can strike older children and adults as well.

The measles virus is spread by airborne droplets or (close personal) direct contact with nasal or throat secretions of infected persons. It is less commonly spread through contact with contaminated articles, such as tissue paper that has been freshly soiled with nose or throat secretions.

For more information on measles, please visit the Travel Medicine Program's Disease Information Backgrounder on Measles.

Recommendations

Canadians travelling internationally are reminded that they should ensure their routine childhood immunizations - diphtheria, whooping cough (pertussis), tetanus, polio, measles, mumps, and rubella - are up to date before travelling, regardless of their destination.

Additionally, in light of the ongoing measles outbreak in North-Rhine Westphalia and the congregation of large numbers of spectators for World Cup 2006, the risk of contracting measles may be increased . T ravellers to the World Cup are therefore particularly advised to ensure they are immunized against measles.

Measles Vaccination Recommendations from the National Advisory Committee on Immunization:

• Children : Vaccination is recommended for all children at 12 months of age with a combined vaccine against measles, mumps and rubella (MMR) followed by a booster dose at either 18 months of age or at 4 to 6 years of age.
• Adults : Adults born before 1970 may be considered immune to measles. Adults born in 1970 or later who do not have documentation of adequate measles immunization or who are known to be seronegative should receive measles vaccine (given as MMR). For adults who have already received one dose of measles vaccine, a second dose of vaccine would provide optimal protection.

As a reminder...

The Public Health Agency of Canada routinely recommends that Canadian international travellers consult their personal physician or a travel clinic four to six weeks prior to international travel, regardless of destination, for an individual risk assessment to determine their individual health risks and their need for vaccination, preventative medication, and personal protective measures.

The Public Health Agency of Canada recommends, as well, that travellers who become sick or feel unwell on their return to Canada should seek a medical assessment with their personal physician. Travellers should inform their physician, without being asked, that they have been travelling or living outside of Canada, and where they have been.

For more information on:

Diseases

• Disease Information Backgrounder - Measles

Immunization

• Immunizations recommended for travel outside of Canada
• National Advisory Committee on Immunization's Canadian Immunization Guide

Outbreaks

• International Reports of Vaccine Preventable Childhood Infectious Diseases