title: Who gets measles in Europe?
abstract: BACKGROUND
  Measles outbreaks continue to occur in Europe as a result of suboptimum vaccination coverage. This article aims to describe individuals susceptible to measles, and provide an overview of affected groups and the public settings in which measles transmission occurred in Europe in 2005-2009.
  
  
  METHODS
  Individuals susceptible to measles were described and categorized on the basis of factors leading to nonvaccination and vaccine failure. A literature search was conducted to identify affected groups and public settings in which measles transmission occurred.
  
  
  RESULTS
  Most individuals susceptible to measles are previously uninfected and unvaccinated. The reasons for nonvaccination in individuals eligible for vaccination ranged from lack of information to poor access to health care. Several outbreaks have emerged in Roma and Sinti, Traveller, anthroposophic, and ultra-orthodox Jewish communities, and immigrants identifying them as being particularly at risk. Public settings for transmission included mostly educational and health care facilities.
  
  
  CONCLUSIONS
  Improved efforts are needed to strengthen immunization programs, identify barriers for measles-containing vaccine uptake, and explore methods to target vulnerable populations that are not being reached with routine immunization delivery services. Specific measures are needed to prevent and control measles in educational and health care facilities. Failure to identify who gets measles and implement the elimination strategies raises concerns for the successful and sustainable elimination of measles in Europe.
authors.affiliation: Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark. markmuscat1@gmail.com
authors.forename: Mark
authors.initials: M
authors.lastname: Muscat
mesh_terms: D004196:Disease Outbreaks / Q000706:statistics & numerical data; D004198:Disease Susceptibility; D005060:Europe / Q000453:epidemiology; D006801:Humans; D017589:Immunization Programs; D008457:Measles / Q000453:epidemiology* / Q000276:immunology; D008458:Measles Vaccine / Q000008:administration & dosage*; D011159:Population Surveillance; D012307:Risk Factors; D013997:Time Factors
chemical_list: D008458:Measles Vaccine