New WHO/Europe guidelines support rapid response to measles and rubella outbreaks

Outbreaks of measles and rubella continue to occur in the WHO European Region despite generally high coverage with measles- and rubella-containing vaccines. As the measles and rubella elimination target date of 2015 for the WHO European Region approaches, timely action to quickly contain outbreaks has become increasingly important.

WHO/Europe has therefore released new “Guidelines for measles and rubella outbreak investigation and response in the WHO European Region” specifically directed to countries striving to reach the elimination goal. This new publication encourages national public health officials and health authorities to take steps to ensure implementation of appropriate response measures and rapid interruption of virus transmission during outbreaks.

The document provides guidance on: 

  • definitions of cases and outbreaks; 
  • confirming, investigating and managing an outbreak, including appropriate vaccination strategies; and 
  • learning lessons from the outbreak and developing plans for prevention of future outbreaks.

Causes of outbreaks

Several factors contribute to the continued transmission of measles and rubella viruses in the European Region: 

  • accumulation of susceptible individuals among older children and young adults who were not included or missed routine vaccination in their childhood; 
  • pockets of low vaccination coverage in some population groups due to lack of access to health services or resistance to vaccination based on religious or philosophical beliefs; 
  • declining public acceptance of immunization particularly in western Europe, due to the lack of concern about disease severity and unfounded perceptions of the risks and benefits of vaccination; 
  • lack of strong provider recommendations to vaccinate during the patient encounter; and 
  • ongoing reforms in the health systems of countries in transition.

Accelerated action

The revised Guidelines are part of stepped up efforts described in the "Package for accelerated action 2013-2015", which was presented to the Region’s ministers of health at the 63rd Session of the WHO Regional Committee on 18 September 2013. This document outlines necessary actions to be taken by WHO, Member States and other partners in order to reach the 2015 elimination goal.