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Wednesday, Jul 02, 2025

Measles Complications and Vaccination Efforts in Belgrade

The rise of measles cases prompts public health officials to stress the importance of vaccination against the highly contagious virus.
Measles, one of the most infectious viral diseases, is primarily transmitted through direct contact with an infected person, respiratory droplets emitted during coughing or sneezing, and, in rare instances, indirect contact with freshly contaminated surfaces.

The incubation period for the measles virus ranges from seven to 18 days, during which initial symptoms such as fever, nasal discharge, cough, and conjunctivitis may appear.

These symptoms typically last for two to four days before a spike in body temperature exceeding 40 degrees Celsius and the emergence of a characteristic maculopapular rash, initially appearing on the face and behind the ears before spreading to the trunk and extremities.

An infected individual remains contagious from the last day of the incubation period, through four days before the rash appears, and for four days following the rash's onset.

Dr. Ivana Begović Lazarević, an epidemiologist at the City Institute of Public Health in Belgrade, highlights that complications from measles are more frequent in children under five years old and adults over 20. Such complications may include pneumonia, otitis media, diarrhea, encephalitis, and vision loss.

Pneumonia occurs in approximately one in 20 cases of measles, and around 60 percent of measles-related fatalities result from this complication.

Encephalitis is observed in approximately one in 1,000 affected individuals, with a corresponding mortality rate among those with this complication.

Vaccination is recognized as the only effective preventive measure, providing solid and long-lasting immunity.

The MMR (measles, mumps, and rubella) vaccine is administered in two doses: the first dose is typically given to children between 12 and 15 months of age, followed by a second dose around the age of seven as part of preparation for school enrollment.

As of 2024, Belgrade records a modest increase in MMR vaccination coverage, with 89 percent of children at two years of age vaccinated, although the desired coverage of 95 percent necessary for effective herd immunity has not yet been reached.

This threshold is crucial to ensure that if measles does occur within a community, the virus struggles to find new individuals to infect, limiting outbreaks to isolated cases.

The previous year saw two reported measles epidemics in the region, with the first documented in February, resulting in 101 cases and officially concluded in September.

Despite this, new individual cases began to arise rapidly, including smaller outbreaks within a healthcare facility and among family units.

The second epidemic was reported in December and has continued into the current year, with 56 registered cases noted thus far.

Dr. Begović Lazarević emphasizes the importance of vaccination for all parents of children who have reached 15 months of age but have not yet been vaccinated, urging them to consult their pediatrician promptly for the first MMR dose.

Additionally, children in the pre-school age group who missed the second dose preparation for school should receive it as they enter the second or third grade to promote community immunity.

Discussion of the MMR vaccine extends beyond individual health; it plays a vital role in building herd immunity that protects children unable to be vaccinated due to underlying health conditions.

It is noted that some parents refuse vaccination due to debunked fears linking the MMR vaccine to autism.

The origins of this misconception trace back to a 1998 publication by a researcher with financial interests that falsely suggested a connection between the MMR vaccine and autism.

Numerous thorough studies involving over 14 million children globally have since established that no causal relationship exists between the MMR vaccine and autism.

Indicators of autism spectrum disorder can often be detected through magnetic resonance imaging as early as six months of age, prior to any MMR vaccination.

Parents' decisions driven by fear of vaccination inadvertently increase the risk of their children contracting measles and facing its numerous complications.
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