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Measles Surge in Europe Raises Risks for Sports Fans

April 04, 2012

A nurse prepares a dose of vaccination against measles. Source: STR/AFP/Getty Images

A nurse prepares a dose of vaccination against measles. Source: STR/AFP/Getty Images

Sports fans at the London Olympics and European Championships for soccer later this year may face a greater risk of contracting measles as vaccination rates drop across the continent, health authorities said.

More than 6,000 cases of measles have been reported this year in Ukraine, a host country for the quadrennial soccer tournament, and the epidemic is expected to accelerate leading up to the start of the matches in June, according to the Stockholm-based European Centre for Disease Prevention and Control. Measles may also be a risk during the Olympics given a resurgence in the virus in Europe, a mass gatherings and infectious disease expert said.

Measles is one of the most infectious viruses for humans, spread through coughing, sneezing and other direct contact with infected nasal and throat secretions. A measles outbreak after the Vancouver Olympics in February 2010 resulted in 82 confirmed cases, according to the British Columbia Center for Disease Control. “Sub-optimal” vaccination coverage in the province contributed to transmission, the local health authority said at the time.

“Measles is highly contagious and there is a bit of a resurgence happening in parts of Europe, in France and in parts of eastern Europe,” said Kamran Khan, a global migration and infectious diseases scientist at St. Michael’s Hospital in Toronto. “Certainly with any mass gathering, it’s a disease you want to pay attention to.”

Tracking System

Khan is assisting U.K. authorities in disease surveillance leading up to and during the Olympics. The Health Protection Agency’s preparations include development of an improved Web- based tracking system that allows clinicians to report serious infectious illnesses directly to the agency from hospital emergency rooms. It is also working with the International Air Transport Association, which will map the origins of visitors coming into London during the Games.

The HPA has taken cues from the Hajj Muslim pilgrimage in Mecca, Saudi Arabia, the largest annually recurring mass gathering in the world, with attendance exceeding 2 million people each year.

The Games are expected to gather 11 million spectators, according to Transport for London. The European Championships, also known as Euro 2012 this year, is one of the sport’s biggest tournaments after soccer’s World Cup. It attracted about 1 million spectators in 2008 when it was held in Austria and Switzerland.

Infectious Opportunities

In addition to players and spectators, the soccer tournament will bring hospitality workers and vendors from around the region, creating more opportunities for infectious disease outbreaks, Pasi Penttinen, a senior expert at the ECDC’s surveillance and response unit, said in an interview in Stockholm.

The measles outbreak in Ukraine is attributed to several causes including an ongoing shortage of vaccines since 2010 stemming from a weak economy and health financing problems, Penttinen said. There has also been a lack of public confidence in vaccines since 2008 when local media reported hospitalizations and the death of a 17-year-old after the teenager was inoculated against measles, even though no causal link was established, he said.

As a result, the national coverage rate for two doses of the measles-mumps-rubella combined vaccine, the only effective preventive measure, fell to 41 percent in 2010 from more than 95 percent in 2006, according to the World Health Organization and ECDC. A national coverage rate of at least 95 percent with two doses is considered necessary to achieve region-wide elimination.

French Cases

France reported about 15,000 cases of measles last year, half the total for Europe excluding Ukraine, according to the ECDC. An anti-vaccine movement is partly to blame for the low inoculation rates, Khan said.

The outbreak in Ukraine is mainly affecting the western regions of the country, particularly in Lviv, one of the stadium sites of the soccer tournament. While Poland is co-hosting the event, no such outbreak is occurring there.

“The Ministry of Health of Ukraine strongly recommends vaccination against measles and rubella in sufficient time before travel to Euro 2012, if football fans have not done so already,” the agency said in an e-mailed statement.

Immunization against measles prior to arrival in London as well as regular washing of hands is highly recommended, as food- related gastrointestinal infections are also likely, said Brian McCloskey, who heads the HPA’s health and emergency preparedness efforts for the Olympics.

Disease Complications

Complications from measles are particularly common among young children and can include blindness, severe diarrhea, ear infections, or pneumonia. As many as 10 percent of measles cases result in death among populations with high levels of malnutrition and inadequate health care, according to the WHO.

In the U.K. and the U.S., confidence in the MMR vaccine was shaken after a study published in The Lancet medical journal in 1998 linked the vaccine to an increased risk of autism. The Lancet retracted the study in 2010, saying some of the claims “have been proven to be false,” and the British Medical Journal called it a fraud in a report last year.

Immunization rates fell in the U.K. to about 80 percent by 2004, from 92 percent nine years earlier, as parents concerned that the treatment was risky refused the vaccine, according to the Health Protection Agency. For the quarter ended December, the coverage rate was 86 percent for England and 80 percent in London, the HPA said.

To contact the reporter on this story: Makiko Kitamura in London at

To contact the editor responsible for this story: Phil Serafino at

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