Measles, “once the epidemic has started, the worst is to come”: Bassetti alarm

“AND' the measles epidemic has started and “the worst is to come”. The head of infectious diseases at the San Martino hospital in Genoa raised the alarm with Adnkronos Salute. Matteo Bassettiwhich comments i data published today by the ISS.

ISS data on measles

In the first 3 months of 2024 there were 213 cases of measles in Italy, 85% of which were confirmed (181). Thirty-four infections were reported in January, 93 in February and 86 in March. Almost 9 out of 10 infected people (88.2%) were not vaccinated, indicates the Higher Institute of Health in the latest bulletin edited by the national epidemiological surveillance on measles and rubella.

Of the total measles cases recorded from January 1st to March 31st, 18 (8.4%) are imported. The 68% of infections (146 out of 213) were reported from three regions (Lazio, which reports the highest incidence; Sicily; Tuscany). The median age of those infected is 31 years, but the highest incidence was observed in the 0-4 age group; 11 infected people were less than one year old. In 20 cases transmission occurred in hospital and 11 cases were reported among healthcare workers. Fifty-six cases (26.3%) reported at least one complication, including 23 cases of pneumonia and one case of encephalitis in a young, unvaccinated adult. During the same period, no cases of rubella were reported.

Bassetti

The data “confirm that unfortunately an epidemic started in 2024: we have significant numbers, 213 cases in 3 months, compared to 2023 with few cases. It is only the beginning, the worst is to come and I fear it will be around summer. The affected population is unvaccinated or with only one dose, between 15 and 40 years old, a range already highlighted by the ECDC report which recorded 30 thousand cases in 2023. It strikes me that no one is worried about complications: it is not a calm and manageable disease, if you catch it as an adult it can be serious and cause complications”, states Bassetti who underlines: “Vaccination is the protection tool that the National Health Service must implement. It is no longer an initiative of the individual, but the intervention of the State is needed which must protect itself with vaccinations”.

**Measles: Pregliasco, 'vaccination campaigns with active calls are needed'**

'Recover missed second doses and protect people at risk such as teachers and healthcare workers'

The return of measles in Italy, with 86 cases reported in March alone (increased by 150% compared to 34 in January) for a total of 213 since the beginning of 2024, “sees no other option other than vaccination”. For Fabrizio Pregliasco, virologist at the State University of Milan, there is “the need to promote campaigns to restore vaccination protection. Information is needed – he explains to Adnkronos Salute commenting on the latest bulletin released by the Higher Institute of Health – and it is needed a proactive commitment on the part of the Prevention Departments”, a 'call' to vaccination for the categories at highest risk of contagion.

In addition to protecting the unvaccinated, according to the expert it is necessary to “make up for the missed second doses for young people”, while “among adults we need to aim for the most exposed subjects, such as teachers and healthcare workers”.

“We certainly see a situation linked to the decline in vaccination coverage”, underlines Pregliasco. “Since measles is a disease with a very high R0 transmissibility index (each case can generate 13-15), and since contagion occurs through breathing, the only strategy – insists the doctor – is vaccination”.

Pregliasco

The return of measles in Italy, with 86 cases reported in March alone (increased by 150% compared to 34 in January) for a total of 213 since the beginning of 2024, “sees no other option other than vaccination”. For Fabrizio Pregliasco, virologist at the State University of Milan, there is “the need to promote campaigns to restore vaccination protection. Information is needed – he explains to Adnkronos Salute commenting on the latest bulletin released by the Higher Institute of Health – and it is needed a proactive commitment on the part of the Prevention Departments”, a 'call' to vaccination for the categories at highest risk of contagion.

In addition to protecting the unvaccinated, according to the expert it is necessary “make up for missed second doses for young people”while “among adults we must aim for the most exposed subjects, such as teachers and healthcare workers”.

“We certainly see a situation linked to the decline in vaccination coverage”, underlines Pregliasco. “Since measles is a disease with a very high R0 transmissibility index (each case can generate 13-15), and since contagion occurs through breathing, the only strategy – insists the doctor – is vaccination”.

Ciccozzi

“There is a 0-4 year age group in which a peak in measles incidence is clear in the first three months of 2024. I wonder how there can be this given that vaccination has been mandatory since 2017. One hypothesis is that they are not all Italian children, i.e. the information on vaccinations may not have reached some ethnic groups. And perhaps we should question ourselves on this point and act accordingly by improving communication. It is worrying that the trend of measles cases in the first three months of 2024 is increasing and this does not leave us at peace for the next few months”, says epidemiologist Massimo Ciccozzi to Adnkronos Salute.