Rapid communication Open Access
Like 1


We report a measles outbreak in two Portuguese health regions (Algarve and Lisbon and the Tagus Valley) since February 2017, and which by 31 May resulted in 28 confirmed cases, of which 16 were unvaccinated. Thirteen cases were healthcare workers. One unvaccinated teenager died. Genotype B3 was identified in 14 cases from both regions. This outbreak occurs after 12 years without endemic measles transmission, and in a context of high measles vaccination coverage and immunity.


Article metrics loading...

Loading full text...

Full text loading...



  1. Republic of Portugal – Directorate-General of Health (DGS). Programa Nacional para a Eliminação do Sarampo [National Programme for Measles Elimination]. Lisbon: DGS; Mar 2013. Portuguese. Available from: https://www.dgs.pt/documentos-e-publicacoes/programa-nacional-de-eliminacao-do-sarampo-jpg.aspx
  2. World Health Organization (WHO) Regional Office for Europe. 4th Meeting of the European Regional Verification Commission for Measles and Rubella Elimination (RVC). Copenhagen: WHO; 2016. Available from: http://www.euro.who.int/__data/assets/pdf_file/0011/304958/4th-RVC-meeting-report.pdf?ua=1
  3. Republic of Portugal – Directorate-General of Health (DGS). Avaliação do programa nacional de vacinação e melhoria do seu custo-efetividade: 2.° inquérito serológico nacional: Portugal Continental 2001-2002. [Evaluation of the National Immunisation Programme and improvement of its cost-efectiveness: 2nd National Serological Survey – Continental Portugal 2001-2002]. Lisbon: DGS; 2004. Portuguese. Available from: www.dgs.pt/ficheiros-de-upload-1/2-inquerito-serologico-nacional-livro-pdf.aspx
  4. European Commission. Commission Implementing Decision of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council. Luxembourg: Publications Office of the European Union. L262 Sep 27, 2012. Available from: http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ%3AL%3A2012%3A262%3ATOC
  5. Republic of Portugal. Directorate-General of Health (DGS). Despacho N.° 15385-A/2016 [Dispatch No. 15385-A/2016]. In Diário da República, Serie II; 21 Dec 2016. Portuguese. Available from: https://dre.pt/home/-/dre/105574339/details/maximized?serie=II&dreId=105574337
  6. World Health Organization (WHO). Eliminating Measles and rubella - Framework for the verification process in the WHO European Region 2014. Copenhagen: WHO; 2014. Available from: http://www.euro.who.int/__data/assets/pdf_file/0009/247356/Eliminating-measles-and-rubella-Framework-for-the-verification-process-in-the-WHO-European-Region.pdf
  7. Grammens T, Schirvel C, Leenen S, Shodu N, Hutse V, Mendes da Costa E, et al. Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges. Euro Surveill. 2017;22(17):30524.  https://doi.org/10.2807/1560-7917.ES.2017.22.17.30524  PMID: 28488998 
  8. World Health Organization (WHO). Measles Nucleotide Surveillance (MeaNS) Database. Geneva: WHO. [Accessed 5 Jun 2017]. Available from: http://www.hpa-bioinformatics.org.uk/Measles/Public/Web_Front/main.php
  9. Republic of Portugal – Ministry of Education and Ministry of Health. Despacho N.o 3668-A/2017 [Dispatch No. 3668-A/2017]. In Diário da República, II Serie 28 Apr 2017. Portuguese. Available from: https://dre.pt/application/file/a/106955144
  10. Republic of Portugal – Directorate-General of Health (DGS). Sarampo: Procedimentos em Unidades de Saúde. [Measles: Procedures in Healthcare Units]. Lisbon: DGS. Apr 2017; Normative Document No. 4/2017. Portuguese. Available from: http://www.dgs.pt/saude-publica1/sarampo.aspx
  11. Republic of Portugal – Directorate-General of Health (DGS). Sarampo. Informações à Comunidade Educativa [Measles. Informations to Schools]. Lisbon: DGS; Apr 2017. Guideline No. 6/2017. Portuguese. Available from: https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n0062017-de-19042017-.aspx
  12. Republic of Portugal – Directorate-General of Health (DGS). Sarampo. Medidas Especiais [Measles. Special Measures]. Lisbon: DGS; Apr 2017. Guideline No. 7/2017. Portuguese. Available from: www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n0072017-de-20042017-pdf.aspx
  13. Republic of Portugal – Directorate-General of Health (DGS). Sarampo. [Measles]. Lisbon: DGS. [Accessed 5 Jun 2017]. Portuguese. Available from: http://www.dgs.pt/saude-publica1/sarampo.aspx
  14. World Health Organization (WHO). WHO vaccine-preventable diseases: monitoring system. Geneva: WHO. [Accessed 5 Jun 2017]. Available from: http://apps.who.int/immunization_monitoring/globalsummary
  15. Republic of Portugal – Administration of the Lisbon and the Tagus Valley Health Region (ARSLVT). Perfil de Saúde. [Health Profile]. Lisbon: ARSLVT; 2015. Portuguese. Available from: http://www1.arslvt.min-saude.pt/Documents/ARS_Perfil%20de%20Saude_Final.pdf
  16. Hahné SJ, Nic Lochlainn LM, van Burgel ND, Kerkhof J, Sane J, Yap KB, et al. Measles Outbreak Among Previously Immunized Healthcare Workers, the Netherlands, 2014. J Infect Dis. 2016;214(12):1980-6.  https://doi.org/10.1093/infdis/jiw480  PMID: 27923955 
  17. Muscat M, Marinova L, Mankertz A, Gatcheva N, Mihneva Z, Santibanez S, et al. The measles outbreak in Bulgaria, 2009-2011: An epidemiological assessment and lessons learnt. Euro Surveill. 2016;21(9):30152.  https://doi.org/10.2807/1560-7917.ES.2016.21.9.30152  PMID: 26967661 
  18. Moghadam M, Afsarkazerooni P, Ebrahimi M, Soltani M, Razmpoor A, Pirasteh E, et al. Measles outbreak in South of Iran, where vaccine coverage was high: a case-series study. Iran J Public Health. 2014;43(3):375-80. PMID: 25988100 
  19. World Health Organization. Measles vaccines: WHO position paper – April 2017. Wkly Epidemiol Rec. 2017;92(17):205-27. PMID: 28459148 
  20. Republic of Portugal – Directorate-General of Health (DGS). Programa Nacional de Vacinação 2017. [National Immunisation Programme 2017]. Lisbon: DGS; 2016. Portuguese. Available from: https://www.dgs.pt/documentos-e-publicacoes/programa-nacional-de-vacinacao-2017-pdf.aspx
  21. Republic of Portugal. Directorate-General of Health (DGS), Directorate of Disease Prevention and Health Promotion. Programa Nacional de Vacinação. Boletins de Vacinação N.° 1, 6-8, 10. [National immunisation programme. Vaccination Bulletins No. 1, 6-8, 10]. Lisbon: DGS; [Accessed 7 Jun 2017]. Portuguese. Available from: https://www.dgs.pt/paginas-de-sistema/saude-de-a-a-z/programa-nacional-de-vacinacao/relatorios-e-publicacoes.aspx
  22. European Centre for Disease Prevention and Control (ECDC). Communicable Disease Threats Report. Week 19, 7-13 May 2017. Stockholm: ECDC; May 2017. Available from: http://ecdc.europa.eu/en/publications/Publications/Communicable-disease-threats-report-13-may-2017.pdf
  23. European Centre for Disease Prevention and Control (ECDC). Measles and rubella monitoring, January 2017 - Disease surveillance data: 1 January 2016 – 31 December 2016. Stockholm: ECDC; 2017. Available from: http://ecdc.europa.eu/en/publications/Publications/measles%20-rubella-monitoring-170424.pdf

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error