Rising measles cases in Spain have already caused 50 hospitalizations this year | Society

Fifty people have been hospitalized in Spain this year due to complications from measles, an infection caused by a highly contagious and potentially fatal virus but which is easily preventable with the MMR vaccine, which also protects against rubella and mumps.

This is evidenced by the data of the Ministry of Health and Autonomous Regions, where not a single death was recorded. The disease, which had virtually disappeared from the country during the pandemic, reappeared in some communities in late February due to cases imported from other countries. Since then, the upward trend has continued and has accelerated since late May, with more cases reported in the last three weeks than in the first five months of 2024. In the rest of Europe the situation is more complex: almost 11,000 infections and 16 deaths have been reported over the past year.

A total of 123 cases of the disease were confirmed in Spain in 13 autonomous communities until June 16, according to the latest Weekly Epidemiological Bulletin published by the Carlos III Institute of Public Health (ISCIII), although the actual figure is higher due to delays in notification. . Only Asturias, Cantabria, Navarre and La Rioja, in addition to Ceuta and Melilla, have not confirmed a single case of the disease. Of the cases, 24 are imported, 44 are associated with one of the above cases, and the remaining 48 are still under investigation or the source of infection has not been established.

A risk report released this week by the Department of Health’s Center for Alerts and Emergency Coordination (CCAES) highlighted that 40.4% of diagnosed cases – 43 of 106 confirmed cases as of the document’s closing date – required hospitalization, although an increase notifications in recent days means that figure has certainly risen to almost fifty.

Three out of every four patients were not vaccinated, which is significant considering that less than 5% of the population is unimmunized. Another 10% were incomplete and received only one dose of the vaccine, while 18% received the full two-dose regimen. According to data provided by some of the hardest-hit communities – Castile-La Mancha, Catalonia, Madrid and the Valencian Community – many of the cases affecting vaccinated people are forms of so-called “modified measles”, a benign manifestation of the infection.

According to CCAES, vaccination coverage for the first dose (administered after 12 months) exceeds 97% in Spain based on 2022 data, while for the second dose (after three to four years) it remains at 93.9%, slightly lower 95% recommended stopping the circulation of the virus among the population. Of the 21 outbreaks reported in the country this year, nine have already been closed. Of these, 30% have only two cases, 65% have three to ten, and only one reaches 14.

The increase in cases has prompted communities to focus public health efforts on contact tracing and increase efforts to promote vaccination among the unvaccinated. Catalonia has gone the furthest, launching an “active SMS campaign” for all families with children aged 4 to 10 whose medical records do not indicate they have been properly vaccinated. In addition, according to the Generalitat report, the health system has included “a warning that is activated when a person born between 1966 and 1980, who does not know that he has been correctly vaccinated, comes to a consultation for any reason for the purpose of vaccination.” refuse opportunistic vaccination.

The years chosen are not random, as they coincide with periods of people’s childhoods that coincide with the introduction of the vaccine in Spain, which gradually spread, causing a progressive decline in the circulation of the virus. This meant that, unlike those born before 1966, many minors were not naturally infected but also did not receive two doses of the vaccine (as those born after 1980 did), so they were susceptible to infection.

Gregorio Montes Salas, secretary general of the Spanish Society of Preventive Medicine, Public Health and Health Management (SEMPSPGS) and professor of specialty at the University of Extremadura, believes that “analyzing the immune status” of the population is the best way to identify and vaccinate unimmunized groups. “Coverage in Spain is good and outbreaks of imported cases are small due to the protection of vaccines. But there are groups of the unimmunized population to whom immunization recommendations should be sent,” he says.

Diego García Martínez de Artola, representative of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and microbiologist at the Nuestra Señora de la Candelaria Hospital (Tenerife), insists on the need to protect the most vulnerable sectors of the population. “There are people with weakened immune systems who are susceptible to the disease and the development of severe forms. Another group are babies, who lose the protection their mother gives them during pregnancy after six months and cannot be vaccinated until they are one year old. This is an infection that can be fatal in three cases out of a thousand infections,” he says.

Castile-La Mancha, with 33 cases, is the worst-affected community according to ISCIII data. “Transmission of the virus occurs among unvaccinated populations from other countries, mainly from Romania (hardest hit in Europe by the current outbreak), who work in the agricultural sector and move from one community to another,” following the planting calendar, the spokesperson explains.

Catalonia, with 19 infections according to ISCIII, is the second largest problem. A report published on May 29 found that half of the 16 confirmed cases reported so far had to be hospitalized. Three suffered serious complications: two from pneumonia and one from a “respiratory superinfection.”

The Community of Madrid, with 15 cases according to the Ministry of Health (14 according to ISCIII), is another of the hardest hit. The largest outbreak was reported in a family originally from Mexico: seven cases (none of whom had been vaccinated), of which “six were admitted to private hospitals in the region,” according to Community sources. Two others hospitalized also had not been vaccinated: a 41-year-old man who developed pneumonia and had to be treated in the intensive care unit, and another who experienced an “exacerbation of asthma.”

According to a spokesman for the Ministry of Health, twenty cases have been reported in the Valencian Community (14 according to ISCIII), of which six had to be hospitalized.

According to the European Center for Disease Control and Prevention (ECDC), the current surge in cases on the continent has not yet stopped. “They are expected to continue to rise in the coming months due to suboptimal vaccination coverage in several countries,” the agency said in its latest risk report last Friday. After Romania, which has reported nearly 9,000 cases, the countries with the most cases since January are Austria (446), Italy (399), Germany (333) and France (165).

Josefa Masa Calles of the ISCIII National Epidemiological Center believes that as long as the virus maintains such high circulation in Europe, it is “inevitable” that imported cases will continue to arrive in Spain, which in some cases could lead to “small outbreaks.” “Communities have acted quickly and have succeeded in breaking chains of transmission, supported by vaccination coverage. In this situation, the most important thing is to popularize vaccination among unimmunized groups,” he emphasizes.

According to the CCAES report, in Spain “the risk in the general population is low” because the vast majority are vaccinated, but the risk among “susceptible (unvaccinated) people exposed to measles virus will be high and could cause serious illness.” “.