Three confirmed cases of measles and two more under investigation have set Greece’s authorities on alert with the National Health Care organizatin EODY to take a series of measures to prevent an outbreak.
The patients who contracted the highly contagious measles virus are adults and had reportedly traveled to Russia and Romania
Of the confirmed cases of measles, two are in Crete and one in νorthern Greece.
Τhe Heath Ministry has set up a so-called ‘task force’ to deal with the issue with its top priority being to strengthen the vaccination coverage of the population and to deal with possible measles cases.
The establishment of the task force was reportedly deemed appropriate as there are reports of measles outbreak in Romania with more than 3,000 reported cases, in France, the United Kingdom and Austria.
The last outbreak of measles occurred in Greece in 2017-2018 with more than 3,200 cases. An 11-month baby died of the virus. In the years 2022 and 2023 no cases were reported.
The two laboratory-confirmed cases recorded so far within 2024 involved adults with prior contact with a person residing in a country with an outbreak of measles. The possibility of two other cases among the contacts of the confirmed cases (medical staff) is being investigated.
Risk of outbreak in Greece
Assess the risk of outbreaks in Greece and to propose specific actions to prevent and control the spread of the disease.
Based on international epidemiological data and the high transmissibility of the disease, the probability of outbreaks is considered high.
According to the results of a sero-epidemiological study of measles immunity in the period 2020-2021, the immunity of the Greek population is considered satisfactory since 89.8% of the participants in the study had antibodies against measles (protection from the disease), either through past illness or vaccination.
According to the above, it becomes clear that at this stage there is no reason for particular concern, but the competent authorities must be alert and the population of our country must be aware and follow the recommendations of the competent authorities.
EODY measures & priorities
In order to deal with the possibility of an outbreak of measles, the following measures were decided:
-Informing the population to check their vaccination coverage and timely completion of vaccination with two doses, according to the National Vaccination Program, in case it has not been completed and there is no previous recorded illness.
-Additional information actions with the cooperation of the Ministry of Health, Municipalities and local medical associations in areas with low vaccination coverage.
-Cooperation of EODY with the NGO “Health for All” to carry out mass vaccination in Roma settlements and refugee and migrants camps.
-Informing the medical and nursing staff and assessing their vaccination coverage.
-Advise travelers to complete measles vaccination prior to travel, particularly if traveling to countries with outbreaks, in collaboration with travel agencies.
While an immunity level of 89.8% is not bad I doubt if it is enough to prevent localised outbreaks. R0 for measles is very high and a recommended immunity level of above 95% is usually quoted, e.g. by the WHO. When the UK was declared “measles free” by the WHO some years ago it had a vaccination level around 98%. That has declined to around 86%, partly because of fallacious stories about association with autism and partly because of general vaccine reticence caused by misinformation on social media, and serious localised outbreaks are now occurring.
In addition the 89.8% is unlikely to be uniform across the whole country. It is highly probable that some areas are higher while others are significantly lower. For example it is pretty normal for vaccination levels to be low amongst Roma communities and amongst Muslims. Some orthodox priests also promote anti-vaccination theories.