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Published Date: 2018-12-23 21:56:17
Subject: PRO/EDR> Measles update (79): Middle East, Americas, Europe, Pacific
Archive Number: 20181223.6221389
MEASLES UPDATE (79): MIDDLE EAST, AMERICAS, EUROPE, PACIFIC
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A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
Middle East
---
[1] Israel
[2] Israel: travel associated, alert

Americas
---
[3] USA: New York (Rockland County)
[4] USA: New York (Orange County)
[5] Canada: Ontario

Europe
---
[6] Vaccine hesitancy

Pacific
---
[7] Australia

******
Middle East
---
[1] Israel
Date: Sat 22 Dec 2018
Source: Haaretz [edited]
https://www.haaretz.com/israel-news/.premium-israel-s-second-measles-death-82-year-old-woman-dies-amid-outbreak-1.6767742


An 82-year-old woman died Wed [19 Dec 2018] in a Jerusalem hospital as a result of complications from measles. The woman was admitted with the disease in early December [2018] to Hadassah University Hospital Ein Karem. Some 2700 people have been diagnosed with measles in 2018 to date, with more than half of them from the Jerusalem region; the woman who died was Israel's 2nd reported death from measles.

[Byline: Ido Efrati]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

******
[2] Israel: travel associated, alert
Date: Thu 20 Dec 2018
Source: Times of Israel [edited]
https://www.timesofisrael.com/liveblog_entry/measles-reported-on-el-al-flights-from-london-frankfurt/


The Health Ministry says travelers infected with measles were on 2 Tel Aviv-bound El Al flights in the past week from London [UK] and Frankfurt [Germany]. In the 1st case, on 12 Dec 2018, a plane departing London at 10:30 p.m. had a sick passenger on board. The 2nd flight departed Frankfurt on Sun [16 Dec 2018] at 7:30 p.m. "Passengers who are not vaccinated with 2 doses against measles are invited to immediately turn to their local healthcare provider to inquire whether they need a vaccine against the measles," the ministry said.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[HealthMap/ProMED-mail maps:
Israel: http://healthmap.org/promed/p/90
Jerusalem, Israel: http://healthmap.org/promed/p/64615]

******
Americas
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[3] USA: New York (Rockland County)
Date: Mon 17 Dec 2018
Source: Daily Voice [edited]
https://dailyvoice.com/new-york/northrockland/news/new-measles-update-number-of-confirmed-suspected-cases-climbs-past-100/745841/


The number of confirmed and suspected measles cases in Rockland County has climbed past 100 for the 1st time. As of Mon 17 Dec [2018], Rockland County Department of Health officials said there are 95 confirmed cases and 7 suspected cases of measles in the county. The outbreak began with visitors to and from Israel in September 2018. Since then, the number continues to grow as unvaccinated or undervaccinated children and adults are exposed, the department said.

Most cases have mainly affected the Orthodox Jewish community in New Square, Spring Valley, and Monsey, health officials said. One suspected case has been reported at a Rockland County public elementary school. Shoppers at the Palisades Center mall and 2 other businesses in Spring Valley may have also been exposed to the measles over the Thanksgiving holiday weekend when a person with measles visited those spots.

The Health Department, along with partners, have provided more than 11 000 vaccinations since the beginning of the outbreak, officials said. In addition, hearings are being held Mon and Tue [17-18 Dec 2018] for 9 schools that have failed to provide their vaccination records to health officials. The schools face potential fines and closure.

[Byline: Kathy Reakes and Joe Lombardi]

--
Communicated by:
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[HealthMap/ProMED-mail map:
Rockland County, New York, United States: http://healthmap.org/promed/p/4302]

******
[4] USA: New York (Orange County, Goshen)
Date: Mon 17 Dec 2018
Source: Warwick Advertiser [abridged, edited]
http://www.warwickadvertiser.com/apps/pbcs.dll/article?AID=/20181217/NEWS01/181219953/0/funandgames03


The Orange County Department of Health is advising residents that as of Mon [17 Dec 2018], there are 6 confirmed cases of measles in the county. Of these, 3 cases have been laboratory confirmed in children who attend school in Orange County. The Health Department is working closely with the affected school(s) and individuals have been notified. Unvaccinated and undervaccinated persons have been excluded from school.

The Health Department [held] a free clinic on Fri [21 Dec 2018] to administer MMR (measles, mumps, and rubella) vaccine to nonimmunized individuals aged 12 months and older. This MMR vaccine clinic is in response to the measles outbreak currently affecting Orange County and surrounding counties. The best way to prevent measles is to be vaccinated.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[HealthMap/ProMED-mail map:
Orange County, New York, United States: http://healthmap.org/promed/p/4346]

******
[5] Canada (Ontario, Halton region)
Date: Fri 21 Dec 2018
Source: Global News [abridged, edited]
https://globalnews.ca/news/4780861/ontario-measles-cases-halton/


Officials in Halton region are warning the public to take precautions after diagnosing a case of measles in the area. They provided few details about the case but shared a list of specific locations in which they say members of the public may have been exposed to measles [see source URL above for locations where exposure may have occurred 13 Dec to 17 Dec 2018].

Anyone who has visited the locations during the 5-day stretch is being encouraged to make sure their immunization records are current.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[HealthMap/ProMED-mail map:
Ontario, Canada: http://healthmap.org/promed/p/63268]

******
Europe
---
[6] Vaccine hesitancy in Europe
Date: Sat 22 Dec 2018
Source: The Guardian [abridged, edited]
https://www.theguardian.com/world/2018/dec/21/measles-cases-at-highest-for-20-years-in-europe-as-anti-vaccine-movement-grows


Measles cases were at their highest for 20 years in Europe in 2018, as the antivaccine movement grows. Cases in Europe are expected to exceed 60 000 in 2018; so far this year 72 deaths have been reported.

"We're in a very vulnerable place right now," said Heidi Larson, the director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine. "There's more hyperbole in the US. But I don't know a country in the world that doesn't have some questioning going on," she said. Different vaccines trigger opposition in different countries, from MMR (measles, mumps, rubella) to the flu vaccine to HPV against the virus that causes most cervical cancers.

The World Health Organization, the EU and the US have all set up groups to investigate the causes of vaccine hesitancy and look for ways to help reassure people. Larsen said: "The reason WHO changed their tune about how important and serious this is was because they had so many member states coming to them and [asking]: can you help us?"

Recent data have consistently shown a tight correlation between vaccination rates and outbreaks of measles. A sharp slump in vaccination rates in France in 2010 was followed by a spike in measles cases the following year. In Italy, when immunisation rates fell back in 2014, cases surged from a few dozen a month to hundreds. In Romania, vaccination coverage fell below 90% in 2014. By 2017, the country was experiencing more than 1000 cases a month, up from just 1 or 2.

In Poland, a small but vocal number of populist politicians support the anti-vaxxers who want an end to mandatory vaccination. Scepticism has been highest in France, according to research by the Vaccine Confidence Project. Doubts about vaccination have been fuelled by suspicion of the pharmaceutical companies. The populist far-right leader Marine Le Pen has backed those who wanted to overturn mandatory vaccination, saying not enough was known about the long-term consequences of multiple vaccinations, and pointing to the profits made by vaccine firms.

Lisa Menning, who works on global vaccine acceptance at WHO, said some populists and anti-vaxxers "share a mistrust in authorities and even scientific expertise." She added: "We have seen how vaccination is increasingly an easily politicised issue, whether around elections, in opposing mandates, even being exploited by religious or other individuals or groups that have an interest in using vaccination for financial or political gain or for building their own prestige or celebrity." It could go both ways, she said. Other populist politicians have pressed for mandatory vaccination as an easy, often reactionary, solution to low immunisation rates.

Larson said global vaccine coverage had stagnated. She said: "It's going down in some places and we have these pockets [of low immunisation] and this is not going to get easier, especially as more and more vaccines and combinations of vaccines are being brought on board.

"Part of the challenge is that it's various things and many of them are outside the scope of an immunisation programme -- it's political, it's religious and it's increasingly part of identity for people."

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Considering that the causes of vaccine hesitancy are complex, studies on how best to address this problem need to be conducted. When an effective and safe vaccine exists but is not accepted by a portion of the population, it is a public health risk to those who are too young to be vaccinated or cannot be vaccinated because of exacerbating health problems. - Mod.LK

HealthMap/ProMED-mail map:
Europe: http://healthmap.org/promed/p/6010]

******
Pacific
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[7] Australia (Canberra)
Date: Tue 18 Dec 2018
Source: Canberra Times [abridged, edited]
https://www.canberratimes.com.au/national/act/doctors-urge-people-to-watch-for-measles-symptoms-after-canberra-case-20181218-p50mwp.html


A case of measles confirmed in Canberra, Australia, may have spread the infection. Doctors urge people to watch for measles symptoms and are calling on people travelling overseas to make sure they are vaccinated after the case of measles was confirmed.

Australian Capital Territory public health doctor Kerryn Coleman has urged anyone who has visited a number of public places in Melbourne and Canberra to watch for symptoms [see source URL above for locations the infected individual visited].

[Byline: Daniella White]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[HealthMap/ProMED-mail map:
Canberra, Australian Capital Territory, Australia: http://healthmap.org/promed/p/294]

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