Think the U.S Has a Measles Problem? Just Look at Europe
The case count for the measles outbreak linked to Disneyland is steadily ticking upwards. Health officials in more than a dozen states are tracking down thousands of people to try to make sure they don't spread the virus any further.
It sounds bad, but European health officials say they're looking at the United States with envy.
To them, America's current total of just over 100 measles cases looks comparatively good.
Last year, Europe had 3,840 measles cases. Italy alone had 1,921 cases. And that's an improvement over 2013, when there were more than 10,000 cases across Europe. France has had more than 23,000 cases in the past five years.
In comparison, the United States last year had 644 measles cases in 27 states.That's the most since measles was declared eliminated in the U.S. in 2000. When you look at that another way, it's about the same rate Britain had in 2014, when 137 cases there equaled a rate of 2.1 cases per million people. But it's much lower than Italy's rate of 32 cases per million or the Czech Republican's rate of 21 per million.
"In Europe, we are looking at the American continent as the example of measles elimination," said Niklas Danielsson, senior expert in the Vaccine Preventable Disease Programme at the European Centre for Disease Control (ECDC).
Even with regular outbreaks, the United States and other countries in the Americas have been able to stop outbreaks before they spread out of control — at least ever since the bad epidemic years of 1989-1991, when 55,000 measles cases were reported and 123 children died. Soon after federal health officials recommended in 1989 that kids start getting two vaccines instead of one, measles virtually vanished.
"We look at it with some envy," Danielsson told NBC News.
In both the U.S. and Europe, one simple thing underlies the outbreaks — a lack of vaccination.
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But the reasons why people go unvaccinated differ from country to country. Some European countries mandate vaccination, others actively encourage it, and still others leave it up to people to decide. Danielsson says none of these approaches seems to really affect vaccination rates.
Some of the countries that mandate vaccination do little or nothing to enforce it.
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"We have countries that, very early on after the introduction of the measles vaccine eliminated measles and maintained measles-free (status) since then," Danielsson said. Three examples: Bulgaria and Portugal had no cases last year; Greece had one.
"Then there are other countries that reduced the transmission of measles but never really eradicated it." They include Poland and the Czech Republic.
The solutions vary, too. In Britain, a full-court press has returned vaccinations to desired rates and brought measles cases way down.
"They spent a lot of time and effort trying to do a catch-up vaccine campaign," said Dr. Jonathan Read, an expert on population health at the University of Liverpool. Britain went through wave after wave of outbreaks of measles and mumps after the now-discredited reports by Andrew Wakefield in the 1990s linking measles, mumps and rubella (MMR) vaccines with autism.
Vaccination rates in Britain plunged to 85 percent and measles cases rose: 1,000 cases 2011, 1,900 in 2012 and again in 2013. A mumps epidemic made more than 56,000 Britons sick in 2004-2005.
Now vaccination rates are back up to 95 percent and just 137 cases were reported in Britain in 2014. Measles cases were mostly among children aged 10 to 19 who missed the normal vaccination schedule during the vaccine scare years, Read said.
"It was the legacy of those times coming to fruition," he said.