The Autonomous Province of Bolzano-South Tyrol in northern Italy, Lazio in central Italy, and the island of Sardinia in the southwest of Italy.

June to September 2006

Three clusters of measles cases occurred between June and September 2006, mainly in the Roma/Sinti (often referred to as gypsies) populations in:

• the Autonomous Province of Bolzano-South Tyrol in northern Italy [17 cases];
• Lazio in central Italy [161 cases]; and
• he island of Sardinia in the southwest [9 cases]

Even though most Roma/Sinti do not object to immunisation, none of the Roma/Sinti patients in the above outbreaks had been vaccinated against measles.

State of Illinois

2006 - ongoing

Illinois has reported more than 600 cases of mumps so far this year. A total of 86 cases of mumps with 4 under investigation have been reported in DuPage county with several cases occurring on university campuses:

• Wheaton College has reported 61 cases with 2 under investigation,
• Benedictine University has reported one case with one under investigation, and
• Elmhurst College has reported one case.

There were 19 cases of mumps reported in DuPage County during the first five months of 2006.

Prior to 2006, Illinois averaged about 10 cases per year. DuPage County averages from 0 to 3 cases per year over the past 5 years.

Austria : the provinces of Kärnten, Niederösterreich, and Wien.

January 1, 2006 to July 3, 2006.

The outbreak is estimated to include at least 150 cases in three provinces.

Case histories are known for 46 of the cases, 45 of the cases occurred in patients aged between 16 and 32 years old.

Mumps is not a notifiable disease in Austria

South-eastern provinces and central and western regions of Poland.

January and May 2006

60 cases of measles were reported, of which 43 (72%) were laboratory confirmed, 16 (27%) clinically diagnosed.

The most affected age groups were adults aged over 19 years (43 cases, 72%). Only eight of the patients had been vaccinated with two doses of measles vaccine (full vaccination course in Poland). Fifteen had been vaccinated with one dose, and the remaining 37 persons were either unvaccinated or their vaccination status was unknown.

In 2004, only 11 measles cases were reported and in 2005, only 13 cases were reported.

England and Wales: the largest outbreaks have occurred in the Surrey and Sussex and the South Yorkshire areas

January 1, 2006 to May 31, 2006.

449 confirmed cases of measles in England and Wales to the end of May 2006.

England and Wales had a total of 438 cases for the whole of 2003.

Federal state of Nordrhein-Westfalen, Germany

January 1 to May 3, 2006.

Over 1018 cases have been notified to health authorities. At this time, between 120 and 140 cases are being notified to health authorities per week. School-age children account for over 60% of all reported cases.

The overwhelming majority of the patients (>90%) have not been vaccinated.

The measles virus strain has been confirmed as D6 in this outbreak, which is the same strain that is currently causing a large outbreak in the Ukraine.

The D4 strain has also been confirmed, but only in two cases.

United States : Multi-state: Iowa, Kansas, Nebraska, and Illinois

December 2005 to April 19, 2006

Iowa : 975 confirmed, probable, and suspect reports of mumps cases in 66 of 99 counties .

Kansas : 147 reports of confirmed and probable mumps cases in 31 of 105 counties.

Nebraska : 109 reports of suspected mumps cases in 18 of 93 counties.

Illinois : 72 reports of mumps cases, 35 of which have been confirmed.

The Centers for Disease Control and Prevention ( CDC) has confirmed the strain in this outbreak as genotype G.

Federal state of Nordrhein-Westfalen, Germany

January to April 12, 2006.

660 cases

the overwhelming majority of the patients (>90%) have not been vaccinated

United States : State of Iowa

December 2005 and April 10, 2006

515 confirmed, probable, and suspect cases of mumps

Madrid , Spain.

January 26 - March 16, 2006

59 cases; 50 of which have been laboratory confirmed

49 of the cases were in unvaccinated patients.

Genotype B3 confirmed in samples from 13 patients.

Øresund region of Denmark and Sweden:

• Denmark : Zealand, mostly in the greater Copenhagen area.
• Sweden : Western part of Skåne

Denmark : late-January to March 11, 2006

Sweden : February 3 to March 15, 2006

Øresund Region: 18 Cases

Denmark : Nine cases -all nine Danish cases were in unvaccinated patients and were confirmed serologically.

Sweden : Nine cases - all nine Swedish patients were also unvaccinated

Denmark : The measles virus was has been identified as genotype B3, in seven of the patients.

Sweden : The measles virus was has been identified as genotype B3 with a sequencing pattern identical to the Danish ones, in one patient.

Venezuela : State of Miranda and the capital district of Caracas

Late-February to March 27, 2006

12 laboratory confirmed cases

Lower Juba - southern Somalia

Mudug - northeastern Somalia

N/A

Two new cases

N/A

Germany

• Western Germany - Nordrhein Westfalen,
• Southern Germany - Baden Wuerttemberg

Nordrhein Westfalen : Between mid-January and March 23, 2006

Baden Wuerttemberg : early-January to March 17, 2006

Nordrhein Westfalen : 246 cases of measles were notified in the federal region of Nordrhein Westfalen – most of them in patients aged 10-19 years. Of these cases, 107 have been laboratory confirmed. This is more than 20 times the number reported during the same period in 2005. Over 90% of the patients had not been vaccinated against measles, or vaccinated incompletely (only one dose).

Baden Wuerttemberg : 58 measles cases have been reported, most of them in patients aged 1-9 years. Nine cases were laboratory confirmed, and seven cases have been found to be caused by measles genotype B3. None of the patients had been immunised. The patients belong to a social group where measles vaccination is viewed as unnecessary.

N/A

England and Wales - cases have occurred in all regions apart from the North East.

January to mid-March (epidemiological weeks 1 to 11)

72 cases of measles have been confirmed. Ages of cases have ranged from under one to 35 years.

Only two of the cases had received one dose of measles, mumps, and rubella (MMR) vaccine and three others had been vaccinated with single measles vaccine.

Bangladesh : Chandpur district of Chittagong division

January

One case confirmed in a nine year-old girl

The virus is closely related to viruses from western Uttar Pradesh in India.

Ukraine : All 27 administrative territories of the country are now reporting cases. All but five of these territories have reported at least 100 cases each.

February 2005 to the end of February 2006.

19 673 cases; 17 281 (88%) occurred during January and February 2006.

Measles cases from the current outbreak in Ukraine have been imported into Belarus (2 cases), the Russian Federation (9 cases), Spain (1 case) and the United States (2 cases). Measles virus of D6 genotype has been identified from cases in Ukraine and from imported cases.

Greece : Cases were reported from 14 of the 52 districts of Greece

September 2005 to February 2006

171 cases of measles were reported, of which 53 (31%) have been laboratory confirmed. 159/171 patients (93%) are from northern Greece

Of 110 patients with known vaccination status, 98 (89%) were unvaccinated for measles and 12 (11%) had had one dose of measles-containing vaccine.