The number of reported measles cases in Ukraine has increased over the past several months, with an especially high concentration of cases in western Ukraine. As of June 13, over 10,386 individuals have been diagnosed since January 2012. The epidemic has not only grown numerically, but has also expanded geographically, with cases reported across Ukraine.
Ukraine is hosting the UEFA European Football Championship (EURO 2012). Lviv, a main host city for the tournament, currently claims the highest number of incident measles cases. Mass gatherings of people in Lviv, Kyiv, Kharkiv and Donetsk, as well as increased international travel to and from Ukraine this month, heighten the risk of transmission to tourists and residents of Ukraine. An ECDC risk assessment finds that EURO 2012 visitors who are not vaccinated or immune are at risk of contracting the virus.
How did this outbreak come to be? Recent attitudes in Ukraine toward vaccination have been less than favorable. A mandatory measles and rubella vaccination campaign in May 2008 failed due to a variety of factors, including media focus on public mistrust and alleged side effects of the vaccine. The UN-backed campaign targeted 7.5 million people, but reached a mere 116,000.
For individuals who are vaccinated, there is little reason for concern. According to CDC, anyone traveling abroad should be up-to-date on their vaccinations prior to departure. In the United States, the live measles-containing vaccine (MCV) is available only in combination, as measles-mumps-rubella (MMR) and measles-mumps-rubella-varicella (MMRV). CDC recommends that international travelers receive the following doses prior to travel:
- Infants aged 6 – 11 months should have at least 1 dose of MCV. Infants vaccinated before age 12 months must be revaccinated on or after the first birthday with 2 doses of MCV separated by ≥28 days. MMRV is not licensed for children aged <12 months.
- Preschool children aged ≥12 months should have 2 MCV doses separated by ≥28 days.
- School-age children should have 2 MCV doses separated by ≥28 days.
- Adults born in or after 1957 should have 2 MCV doses separated by ≥28 days.