Four confirmed measles cases in North Macedonia, authorities probe links

Health authorities have confirmed four measles cases in North Macedonia: one foreign national and three citizens who live in Veles, Shtip and Skopje. Among the domestic cases there are two infants under 12 months and one person older than 40; the three local patients were not vaccinated, the Ministry of Health said.

Investigations under way; no epidemic declared

The Institute of Public Health and regional centres for public health are completing epidemiological analyses to determine whether the cases are linked, officials said. At present, the ministry maintains there are no grounds to declare an epidemic.

Health Minister Sasho Klekovski urged immediate precautions and explained steps being taken. "Infants under 12 months are not covered by the vaccine and you must protect them by vaccinating everyone around them," he said.

He called on the public to check vaccination status and on health professionals to ensure they have two doses or evidence of past infection. "We have initial cases and what we are doing, given the epidemics in Kosovo and Bulgaria, is to call on citizens and institutions to be cautious. For citizens: get vaccinated, check whether you have two doses of the vaccine or whether you have had the disease. I particularly appeal to healthcare workers to do this, because they are in contact and are most at risk. For citizens, if you have fever and a rash, do not go to the doctor — call your doctor. Measles are highly contagious and every visit to a waiting room increases the risk of spreading measles. The main contact point for measles is basically waiting rooms in health facilities. The virus is active for about two hours in the air and that is a relatively wide risk zone and I think we must be maximally cautious about that," Klekovski said.

Protocols for health facilities were already prepared and distributed, the ministry added. Authorities have asked all health workers to check their vaccination records. Guidance for kindergartens and schools has been circulated through the relevant ministries, and measures at border crossings have been activated; travellers to Kosovo and Bulgaria are advised to verify their vaccine status before travel.

One infant was hospitalised at the Clinic for Infectious Diseases and has since been discharged to home care in good condition. An order has been issued for the Clinic for Pediatric Diseases to prepare to receive such cases because the Infectious Diseases Clinic is not equipped to treat infants, and the Commission for Infectious Diseases is convening.

"So we have four, of which three domestic cases; their connection is being investigated and will be published; we have recommendations for citizens and institutions, whether health or educational, and now it's up to us to make sure these three cases do not become more cases. We all must be more vigilant, both kindergartens and schools. I also appeal to parents that they should not take children to a waiting room in a health facility if there is fever, redness of the eyes, rash; likewise do not take them to kindergartens. There are enough vaccines; we have 14,000 vaccines in stock currently available. We have the possibility to increase quantities. Last time when epidemics were declared about 50,000 vaccines were used, generally because there is a large backlog from previous generations due to insufficient vaccination coverage," Klekovski added.

Photo: press material from the event