May 2017 - Measles Outbreaks in Europe

Measles outbreaks are occurring in a number of European countries including Romania, Austria, Germany and Italy. In Romania, over 3,000 cases and 17 deaths have been reported since September 2016.

Cases continue to occur in Ireland. There was a national outbreak in 2016. This involved 40 cases occurring in the South, the South East, the North East, the East and the Midwest. Most cases had not had MMR vaccine.

Measles is a highly infectious virus. The main features are fever, cough, red and painful eyes, and a rash. It can cause severe disease resulting in complications such as pneumonia and encephalitis and occasionally death. Although it is most common in young children, it can affect anyone at any age.

Vaccination with MMR vaccine is the only way to protect against measles

Two doses of MMR vaccine are required to give the best protection. In Ireland, the first dose is given at 12 months by GPs and the second dose is given to Junior Infants in school by HSE vaccination teams or by GPs in Donegal, Sligo and Leitrim.

What should young adults and parents do?

Make sure you or your children are up to date with your MMR vaccines.

Please go to your GP for MMR vaccination if:

  • you have not had 2 doses of MMR vaccine
  • you have a preschool or primary school child who never had MMR vaccine
  • you have a primary school child who missed out on the 2nd dose
  • you are not sure if your child has had 2 doses of MMR  vaccine

What about children under 12 months of age?

There is no change to the routine recommendations from the National Immunisation Advisory Committee (NIAC): MMR vaccine is recommended at 12 months and at 4-5 years of age.

However, MMR vaccine is recommended for children aged 6-11 months of age, travelling to other countries or regions where measles outbreaks are reported.

MMR vaccine may take up to 4 weeks to be effective.

The vaccine is available to healthcare professionals to order free of charge through the National Cold Chain Service.

NOTE: If MMR vaccine is given before 12 months of age, this dose is not counted as part of the childhood vaccination programme. MMR vaccine should be repeated at 12 months of age, at least one month after the first vaccine with a further dose at 4 - 5 years of age.

What about children under 6 months of age?

The MMR vaccine is not recommended before the age of 6 months for infants travelling to areas where there is a measles outbreak.

The vaccine is not effective if given before 6 months of age.

Travelling abroad?

All individuals travelling to Europe and other regions experiencing measles outbreaks or where measles cases continue to occur should ensure that they receive the MMR vaccine if needed

What about Health Care Workers?

Health Care Workers (HCWs) in  Ireland should have 2 doses of MMR vaccine. Two of the cases in last year’s outbreak in Ireland were HCWs.

Further information is available at the links below:

  • Health Protection Surveillance Centre

  • European Centre for Disease Prevention and Control,%20European%20Union%20countries.pdf



For babies born 1 July 2015 - 30 September 2016

This page provides a brief summary of the disease and the vaccine that is available to prevent it. Links to more detailed information are provided at the bottom of the page.

What are measles, mumps and rubella?

Measles, mumps and rubella (German measles) are highly infectious diseases caused by viruses.

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How do people get measles, mumps and rubella?

Measles, mumps and rubella (German measles) are spread by close contact with an infected person.

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What are the symptoms of measles, mumps and rubella?

Measles causes fever, cough, red and painful eyes, and a rash.

Mumps causes swollen neck glands and a fever.

Rubella (German measles) causes a rash, fever and swollen glands. If a pregnant woman gets rubella in early pregnancy it may cause major birth defects in the baby.

If 1000 people get measles

  • 1 or 2 will die
  • 50 will get an ear infection
  • 40 will get pneumonia or bronchitis
  • 5 will have convulsions (fits)
  • 160 will get diarrhoea
  • 1 will develop encephalitis (swelling of the brain)
    For every 10 children who develop encephalitis
    - 1 will die and
    - up to 4 will have brain damage.

1 in 8000 children under two years of age get SSPE (brain degeneration), which may be many years after measles and is always fatal.

1 in 6000 will get a blood clotting problem.

If 1000 people get mumps:

  • 50 will get viral meningitis
  • 1 will get encephalitis (brain inflammation)
  • 400 men who have mumps will get swollen testicles
  • 300 will get fever, a headache, and swollen salivary glands under the jaw, and

1 in 20,000 will  become deaf.

Mumps can also rarely cause infertility in men.

Of the people who get rubella (German measles):

  • About 1 in 2 will get a rash and painful swollen glands; and more than half of women with rubella get painful joints.
  • 1 in 3000 get thrombocytopenia (bruising or bleeding of the skin);
  • 1 in 6000 get encephalitis (inflammation of the brain);
  • If a pregnant woman gets rubella in early pregnancy 9 in 10 babies will have a major birth defect, such as deafness, blindness, brain damage or heart defects.

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Who should get MMR vaccine?

MMR vaccine protects against measles, mumps and rubella (German measles). It is a live vaccine which means it contains weakened forms of the measles, mumps and rubella viruses.

MMR vaccine is given to babies at 12 months of age.

Children should get a second dose at 4-5 years of age. This is usually given at school by the HSE’s school immunisation teams but in some areas it is given by the child’s GP.

Two doses of MMR vaccine are required to give the best protection.

Some children may have missed their two doses of MMR vaccine and this has led to recent outbreaks of mumps and measles.

Older children and young adults whohave not completed (or are not sure they have completed) their two dose MMR vaccination schedule should be vaccinated as soon as possible.

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Who should not get the MMR vaccine?

The MMR vaccine is safe for most people.

However, you or your child should not get the vaccine if they have had a severe allergic reaction (anaphylaxis) to a previous MMR vaccine or any part of the vaccine or a severe allergic reaction to an antibiotic called neomycin.

The vaccine should not be given to anyone who is pregnant.

You should delay getting the vaccine if your child:

  • is ill with a fever
  • has had another live vaccine, e.g. the BCG vaccine, within the previous four weeks
  • is on high dose steroids
  • is having any treatment such as chemotherapy or radiotherapy
  • is on treatment with Protopic ointment for severe eczema
  • has any illness or disease that affects their immune system

If your child is on any of the treatments listed above you should discuss vaccination with your child’s doctor.

If a person’s immune system is severely affected, by illness or treatment, they may not be able to get the vaccine.

If you have any concerns, talk to your family doctor or public health nurse.

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Should my child get MMR vaccine if they have an egg allergy?

Yes - MMR vaccine can be given to children with a severe egg allergy.  A severe allergy to the MMR vaccine is extremely rare even in children with a serious egg allergy.  It is not necessary to avoid the MMR vaccine if your child dislikes eggs or has diarrhoea or stomach pains after eating eggs and you do not need to take any special precautions.  If you have any doubts, talk to the doctor or nurse giving the immunisation.

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Is there a link between the MMR vaccine and autism or bowel disease?

We know that vaccines don’t cause autism, diabetes, multiple sclerosis, allergies, asthma or attention deficit disorder (hyperactivity). However, when things happen around the same time we can think that there is a link between the two things. For example, the signs of autism usually become noticeable at about the age when children are given the MMR vaccine, but one does not cause the other.  The majority of children are immunised, therefore children with and children without conditions such as autism, asthma or attention deficit disorder are just as likely to have received the same immunisations.

Over the past 30 years, more than 500 million doses of MMR vaccine have been given in over 90 countries.  Experts from around the world, including the World Health Organization, agree that there is no link between the MMR vaccine and autism or inflammatory bowel disease.

Studies to see if children who have been immunised are more likely to have these conditions have shown that there is no link between the conditions and vaccines.  Extensive research into the MMR vaccine, involving thousands of children, was carried out in the UK, the USA, Sweden, and Finland.  This research showed that there is no link between MMR and autism.  A study looked at the vaccination records of every child born in Denmark from 1991 to 1998 (over half a million children). During that time, 82% of children born in Denmark received the MMR vaccine. The researchers found that the risk of autism was the same in immunised children and in children who had not been immunised.  

The General Medical Council in the UK in May 2010 decided that Dr Andrew Wakefield should be removed from the medical register after finding him guilty of serious professional misconduct and unethical behaviour in relation to research he carried out on children.  Dr Wakefield used the results of this research to falsely represent a link between the MMR vaccine and autism.

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What to expect after getting MMR vaccine?

After getting the vaccine, your child may have discomfort, redness or swelling around the area where the injection was given. They may be irritable and have a fever.

If this happens you can give them paracetamol or ibuprofen. You should also give them plenty to drink. Make sure they are not too warm and that their clothes are not rubbing against the injection area.

Children usually recover from these minor side effects within a day or two

Of the people who are immunised:

  • 1 in 10 will have discomfort, redness or swelling where the injection was given, or will have a fever
  • 1 in 20 will get a rash six to 12 days later(this is not contagious)
  • 1 in 20 get swollen glands, a stiff neck, or joint pains
  • 1 in 100 may develop swelling of the salivary glands under the jaw in the third week after vaccination (this is not contagious)
  • 1 in 1000 will have a convulsion (fit)
  • 1 in 22,000 will get a temporary blood clotting problem / bruising or bleeding
  • 1 in 10,000,000 may develop encephalitis (inflammation of the brain)

Serious side effects are very rare.

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How does MMR vaccine work?

The vaccine works by stimulating the immune system to build up protection against these diseases.

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How effective is MMR vaccine?

The full course of MMR vaccine offers good protection against measles for 99% of people, against rubella (German measles) for 95% of people and against mumps for 88% of people.

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For more information

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This page was updated on 5 December 2017