Cases among Roma community appear linked to migrant workers from Bulgaria
Transmission electron micrograph of a measles viron
Image credit: CDC/Courtesy of Cynthia Goldsmith; William Bellini
An ongoing measles outbreak in Greece has affected 126 people this year, mainly among the Roma community, report researchers this week in Eurosurveillance. It appears to be linked to the influx of Roma people from neighbouring Bulgaria, where an outbreak of the disease began in April 2009 and has since affected 20,000 people, the authors say.
Clusters of cases have been reported in a number of European countries since 2009, including in Roma communities in Poland and Ireland, the authors point out, and this threatens measles elimination targets set by the World Health Organization for this year.
“Despite a large decline in measles incidence in the past decade in Europe, the World Health Organization (WHO) target to eliminate measles in Europe by 2010 does not seem feasible,” write Danae Pervanidou, of the Hellenic Centre for Disease Control and Prevention in Athens, and colleagues.
Over the past 25 years, measles has been steadily declining in Greece. Vaccination coverage in the country is high overall — with 99% of first-grade school children (about six years old) having received one dose of a measles vaccine, and 77% two doses — but coverage is much lower among the Roma population. The last measles outbreak in Greece, which occurred in 2005–2006, also affected mainly unvaccinated Roma children.
In the current outbreak, 29% of the reported cases were diagnosed in people from Roma communities who held Bulgarian nationality. These were mostly family members of seasonal workers, the authors say, often living in poor conditions. A further 34% belonged to the Greek Roma community.
During the first seven weeks of the outbreak, people diagnosed with the disease were mainly of Bulgarian nationality. Subsequently, cases among Greek nationals began to be reported too, and since the end of May most cases have been among the Greek Roma community.
Most cases were seen in children under 14 years of age, and 27% of all cases were in children 1–4 years old. The majority were unvaccinated. “It is of concern that the age distribution of cases in the Greek Roma population (95% of cases under 15 years) is similar to the one observed in many countries in the pre-vaccination era,” the authors say.
In an effort to control the outbreak, vaccination campaigns have been organised in the country, targeting population groups at high risk of the disease known to have low vaccine coverage, particularly Roma communities.
“The occurrence of this outbreak highlights… the need to increase immunisation coverage in hard-to-reach populations [in Greece],” the authors conclude.
Reference and links
1.
Pervanidou D, Horefti E, Patrinos S, Lytras T, Triantafillou E, Mentis A, et al. Spotlight on measles 2010: Ongoing measles outbreak in Greece, January–July 2010. Euro Surveill. 2010; 15:pii=19629. Article
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