This is how things are going with measles in the Netherlands and this is what you can expect | Domestic

Sinds begin 2024 waren er 64 meldingen over mazelen in Nederland. De GGD-regio Brabant-Zuidoost is met 55 gevallen het zwaarst getroffen.

De uitbraken heersen vooral onder bevolkingsgroepen die zich niet laten vaccineren. Van de 31 besmette mensen (tot en met 26 maart) was er slechts 1 gevaccineerd.

Volgens het OMT zijn daarbij risicogroepen in beeld gekomen: mensen met een migratieachtergrond en arbeidsmigranten. Zo was bij een van de ziekteclusters een groepje arbeidsmigranten uit Roemenië de bron.

There is currently no acute situation, the RIVM emphasizes. We are dealing with a regional outbreak, and “certainly not yet” a national one. Such an outbreak can occur in places where less than 90 percent of people are protected against measles. You are protected if you have been vaccinated or have already had measles.

It is good to know that there is usually a measles outbreak in the Netherlands every ten to fifteen years. We also had an outbreak in 2013/2014. A total of 2,700 cases were registered with the RIVM. But research showed that the actual number must be about ten times higher, because not all infections have actually been reported to the RIVM.

Because we are now once again dealing with several reports of measles, the OMT was convened last month to issue advice. In this way, the OMT tries to prevent a further outbreak and limit any damage.

However, there is also reason for concern, because there has been a declining vaccination rate in recent years. This is not only an issue in the Netherlands, but is a trend in many places in Europe. The European health agency ECDC warned in February that the number of measles cases in Europe is likely to increase because far too few people are protected against it.

According to the RIVM, a vaccination rate of at least 95 percent is required for measles to create herd immunity. In the Netherlands, approximately 85 percent of school-age children had been vaccinated against measles by 2022, according to the most recent figures from the RIVM. A few years earlier that was still more than 90 percent. In addition, the vaccination rate among babies fell below 90 percent in 2022 for the first time in years.

The OMT points out that the Netherlands may experience a measles wave within a few years. That’s how it is. A previous study has shown that children living in the so-called Bible Belt and born after the previous outbreak (in 2013/2014) have limited immunity. Only about half of these children have been vaccinated.

Although there are currently no reports of measles in humans within the Reformed community, this may be the case in a few years. Then many unvaccinated children enter secondary school – a major hotspot for the disease.

But the OMT adds that it is difficult to predict exactly how the spread of measles will progress.

The OMT now advises daycare centers to, among other things, exclude brothers and sisters of measles patients. It is better for them to stay at home until the disease is no longer contagious. Usually such a contagious period lasts two weeks. Groups in daycare centers must also have as little contact with each other as possible if an infection has occurred.

In addition, it should be easier for minors who have not yet been vaccinated to get a vaccination. This concerns children aged between fourteen months and eighteen years who still want to be vaccinated with the MMR injection. In addition to measles, it also protects people against mumps and rubella.

Children now receive two MMR injections through the government program. A child receives the first injection when he or she is fourteen months old and provides 95 percent protection. The second injection follows when a child is nine years old. This provides 99 percent protection.

But if a child has not followed the national program, he or she should be able to catch up with the vaccination program in an easily accessible manner, the OMT believes. The team advises GGDs to maintain an extra stock of MMR injections for, among other things, catch-up vaccinations.

It is important to emphasize that this is not about early vaccination. The OMT advises against this in principle, because in the long term it actually means that children are less well protected against measles.

There are also gains to be made by bringing the MMR vaccine to the attention of the group of unvaccinated people to bring. This can be done through personal conversations with healthcare providers and a district or target group-oriented approach. There may be several reasons why people do not have their child vaccinated: religious objections, fear of side effects, distrust in the government or practical obstacles. A conversation can sometimes remove fears and obstacles.

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