Although there are measles outbreaks occurring all over the world at the moment (sigh), Italy's outbreak is of particular concern.
This year, the country has reported 1603 measles cases (through April 16th) according to the Ministero della Salute. To put into perspective how above average that number is - there were 840 cases in all of 2016 and 250 in 2015.
Most cases have occurred in people older than 15 (the median age is 27 for people affected.) It is hypothesized that the effects of people not vaccinating their babies 20 years ago are now coming to light in these adults who are susceptible to measles.
Italy is a hot destination for travelers, especially in the summer months. The county is the fifth most visited country for international arrivals—about 50 million tourists annually. Roughly 10 percent of those tourists arrive from the United States (~4.5 million.)
Because of this, the United Stated Centers for Disease Control and Prevention (CDC) has new recommendations regarding measles vaccinations for anyone traveling to Italy - adults and children. The bottom line is that everyone traveling to Italy needs to make sure that their immunizations are up to date.
For adults, it is probably unlikely that most of us remember our last measles vaccine (usually given as one component of the MMR vaccine.) That's OK if you're living in an area that is not in the middle of a outbreak. However, given the immense crowds found in Italian tourist areas, the measles the chance of becoming infected is real and being protected needs to be given more attention.
For children, the situation is more concerning. Not only are children are more susceptible to measles, babies are not schedules to get the measles vaccine until one year old, leaving them highly vulnerable. However, in the new travel recommendations to Italy, the CDC suggests moving this time frame up so that a baby who is older that six month receives a dose of the vaccine before boarding the plane to Italy. Although this one dose does not confer full protection, it's better than nothing.
The international travel recommendations in full are:
- Infants 6 months through 11 months of age should receive one dose of MMR vaccine.
- This one shot will not provide full protection, but, will provide some protection.
- Children 12 months of age and older should receive two doses of MMR vaccine separated by at least 28 days.
- Teenagers and adults who do not have evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days.
- This may require getting your current level of antibodies measured, to determine evidence of immunity.
Other advice from the CDC is to wash your hands often and avoid touching your mouth, nose and eyes.
So, while you are packing up your flip flops and camera, remember to check in with your physician to get your and your families measles vaccines up to date - especially if you are traveling with little ones.
If you are annoyed about adding another task to your pre-trip to do list, you can thank Andrew Wakefield and his anti-vaxxing followers for promoting their dangerous and damaging message. Out of the current 1600 measles cases in Italy, 88 percent of them occurred in unvaccinated people. This is not surprising as Italy has notably high rates of negative sentiments regarding vaccination.
It is because of Wakefield that measles is popping up in large numbers in areas where it was once basically, a non-issue - something that will not change until vaccination rates get back up to protective levels.