The 2019 measles epidemic in Bosnia and Herzegovina: What is wrong with the mandatory vaccination program?

Jurica Arapović; Željana Sulaver; Borko Rajič; Aida Pilav

doi:10.17305/bjbms.2019.4266

Authors

Jurica Arapović Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina https://orcid.org/0000-0002-7674-6795
Željana Sulaver Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina https://orcid.org/0000-0002-2873-081X
Borko Rajič Department of Paediatrics, University Clinical Hospital Mostar, University of Mostar, Mostar, Bosnia and Herzegovina https://orcid.org/0000-0002-8057-2820
Aida Pilav Public Health Institute of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina https://orcid.org/0000-0002-6765-0812

DOI:

https://doi.org/10.17305/bjbms.2019.4266

Keywords:

Bosnia and Herzegovina, epidemic, measles, MMR, vaccination

Abstract

Measles is a highly contagious and communicable viral disease which may be prevented by a sustained vaccination program. Due to missed vaccination, two major epidemics of measles (1997–1999 and 2014–2015) have been recorded after the war in Bosnia and Herzegovina (BH) with over 10,000 patients registered. According to the World Health Organization, BH is categorized as a country with endemic transmission of measles. The last measles epidemic was between 2014 and 2015, with 5,083 documented patients in the Federation of BH. In the first four months of 2019, more than 700 measles cases were registered in the same region. Significant transmission rate has been observed in Sarajevo Canton (SC) with 570 documented measles cases. Out of 570 measles cases in SC, 92.5% were unvaccinated. The most affected were children up to 6 years of age (62.8%), with one documented case of death (7-month old infant). In addition to this report, we discussed key stakeholders and possible circumstances responsible for the epidemic. The measles epidemic is still ongoing.