Por Ismael Buendia 
The Andalusian Ministry of Health and Consumption has published the new measles surveillance and control protocol on which it has been working for over two months. Among other news, this protocol establishes that healthcare centers will assess the susceptibility to measles of their professionals, even in the absence of suspected cases, and will update their vaccination schedules.
The aim of this measure is to prevent contagion among professionals who may come into contact with a suspected case, which occurred earlier this week when a new outbreak was declared at the Axarquía Hospital in Málaga, in Vélez-Málaga, consisting of a confirmed case who had been in contact with the infected person in emergency situations at the hospital, as reported by the board in a press release.
The protocol, which has already been communicated to all public and private healthcare centers in the autonomous community, also includes the search and location of contacts in healthcare centers and the participation of private IT centers; Defining circuits to improve coordination and the adoption of measures in cases and outbreak situations; In addition to advancing second doses of vaccine in children between 12 months and 3 years, if they are in contact with a measles case.
The General Directorate of Public Health and Pharmaceutical Planning has also updated the section on the use of multifunctional immunoglobulin for contacts and, for control purposes, plans the role of size and risk in containing the outbreak.
Finally, among the news, two new annexes were included, one on general information and viral vaccination recommendations, and another on the decision-making algorithm for post-exposure prophylaxis. Since the beginning of the year, 67 confirmed cases of measles have been reported in Andalusia, which is more than nine compared to last week, four of which are from a family outbreak in Malaga, still under confirmation, all in adults; Three imported cases from Morocco (one in Almería and two in Málaga), also in adults; The case of a 45-year-old woman from Málaga with an unknown source and a case in Seville of a 13-month-old child, with a vaccination history two weeks before symptoms began.
This case is awaiting genotype determination to see if it is a post-Phaune measles. Therefore, eleven outbreaks have been declared in total so far in 2025, six of which are still active and five have already been closed. Thus, Málaga has a family outbreak with three confirmed cases, with an unknown source declared on March 18; A more recent one, declared on April 14 with the four cases confirmed this week in the same family; In addition to the focus declared in the healthcare field, especially at the Axarquía Hospital in Málaga, declared on April 29.
In the province of Huelva, a family outbreak in Moguer is currently active, with two cases confirmed in two Moroccan workers, declared on March 29, and the family focus from Morocco to Lucena del Puerto, with four cases in a family of Moroccan origin. Finally, in El Ejido (Almería), a family outbreak with two confirmed cases in two Moroccan workers sharing a home also declared on April 10.
So far, 28% of the cases have been imported, these imported cases coming from Morocco (17), Belgium (1), and Denmark (1). Of the non-imported cases, 14 are isolated cases where the source of infection is unknown (seven cases in the capital Málaga, two in Marbella, one in Álora, one in Calañas, one in Huelva, one in Palos de Frontra, and one in Seville).
In addition, eight cases are under one year old, from an inactive outbreak in a nursery in Fuengirola (Málaga). 36% are 15 years old and 64% are adults (between 18 and 70). Only two cases (3%) had a documented history of vaccination with one dose, the rest of the cases were either unvaccinated or their vaccination status could not be determined (including minors from Morocco and Russia).
36% of the specified cases required hospitalization. In Almería, there were seven cases (one in Adra, three in Ejido, one in Níjar, one in Roquetas de Mar, and one in Vera), in the capital Granada; In Huelva, 16 cases (one in Calañas, two in Gibalón, one in the capital Huelva, four in Lucena del Puerto, two in Moguer, three in Palos de Frontra, one in San Bartolomé, and two in San Juan del Puerto); In Málaga, 39 cases (one in Álora, one in Casabermeja, one new in Fuengirola, 16 in the capital Málaga, two in Marbella, seven in Mijas, one in Ojén, one in Rincón de Victoria, and one in Torrox) and in Seville, two cases were reported in the capital.
In Málaga, most cases are concentrated in the Costa del Sol Health District (19 cases) and the Malaga District (17 cases). In recent weeks, the incidence of confirmed cases has been decreasing. Additionally, for eight weeks, cases have only occurred in adults, mainly between 26 and 47, with the exception of the 13-month-old child suspected to be post-immune.
Most of these cases are imported from Morocco, related to the imported or associated case, reducing many isolated cases of unknown origin (two cases in the last six weeks). Currently, the active outbreaks are family outbreaks in adults with a small number of cases and, in general, with two generations of cases.
Health and consumption authorities remind, as confirmed by the recorded data, that measles is an easily transmitted infection, can be severe, and can affect both unvaccinated children and adults. For this reason, they recommend vaccination for minors according to established guidelines and for adults who are not vaccinated to protect those who cannot be vaccinated (children under 12 months, who represent 14% of the cases reported in Andalusia).
The epidemiological situation in the Andalusian region, especially in Morocco, which has been facing a significant measles outbreak since October 2023 and has spread to the country with over 40,000 reported cases, including 150 deaths; 3,012 cases in 15 countries of the European Union as of April 15 (Romania leads with 5,104, followed by the Netherlands with 251 and France with 180. Spain accounted for 179); 712 confirmed cases in the United States, with two deaths, as of April 11 and 731 in Canada as of April 11; the presence of susceptible populations that may be important in some districts and the onset of the spring season, provide the latest data for the new week of April in Canada.
FUENTE