Por Redaccion 
The Health and Consumer Department of the Andalusian Government has published the new Measles Surveillance and Alert Protocol that has been in development for over three months. Among other updates, this protocol establishes that health centers will review the measles susceptibility of their professionals, even in the absence of suspected cases, and will update their vaccination schedule.
The aim of this measure is to prevent contagion among professionals who may attend a suspected case that arrives at the consultation or hospital emergency department, as happened this week when a new outbreak was declared at La Axarquía Hospital in Málaga, in Vélez-Málaga, consisting of one confirmed case imported from Morocco, and two probable cases pending confirmation, which are the healthcare professionals who attended to the infected person in the hospital’s emergency department.
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 involvement of private centers in the same; it defines the protocols to improve coordination and the implementation of measures in cases and outbreak situations; as well as advancing the second dose 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 Regulation has also updated the section on the use of polyvalent immunoglobulin for contacts and, for outbreak control, plans to advance the second dose from 15 months of age in all children aged 15 months or older who have not completed the triple viral vaccine regimen in the affected area, conducting active surveillance of susceptible populations or other control measures, depending on the magnitude and risk of outbreak spread.
Finally, among the new additions, two new annexes have been included, one on general information and vaccination recommendations with the triple viral vaccine and another on decision algorithm for post-exposure prophylaxis for measles.
Current Incidence
Since the beginning of the year, 67 confirmed cases of measles have been reported in Andalusia, which is nine more than last week, four of which are from a family outbreak in Málaga, pending confirmation, all adults; three cases imported from Morocco (one in Almería and two in Málaga), also in adults; the case of a 45-year-old woman from Málaga, of unknown origin, and one case in Seville in a 13-month-old child with a history of vaccination two weeks before the onset of symptoms. This case is pending genotyping to determine if it is a post-vaccination measles case.
Therefore, in 2025, a total of eleven outbreaks have been reported so far, with six still active and five already closed. Thus, Málaga has a family outbreak with three confirmed cases, of unknown origin declared on March 18; a more recent one, declared on April 14 with four confirmed cases in the same family this week; in addition to the outbreak declared in the healthcare setting, specifically at La Axarquía Hospital in Málaga, declared on April 29.
In the province of Huelva, there are currently active a family outbreak in Moguer, with two confirmed cases of two Moroccan worker siblings, declared on March 29, and the family outbreak imported from Morocco in Lucena del Puerto, with a total of four cases in a Moroccan family. Finally, in El Ejido (Almería), a family outbreak was also declared on April 10 with two confirmed cases in two Moroccan workers sharing a residence.
So far, 28% of cases have been imported cases, these imported cases come from Morocco (17), Belgium (1), and Denmark (1). Of the non-imported cases, 14 cases are isolated cases with an unknown source of infection (seven cases in Málaga capital, two in Marbella, one in Álora, one in Calañas, one in Huelva, one in Palos de la Frontera, and one in Seville).
In addition, eight cases are under 1 year old, from an inactive outbreak in a nursery in Fuengirola (Málaga). 36% have been under 15 years old and 64% adults (range 18 to 70 years). Only two cases (3%) had a documented vaccination history of one dose, the rest of the cases were not vaccinated or their vaccination status could not be determined (including minors from Morocco and Russia). 36% of cases required hospitalization.
By provinces, Almería has recorded seven cases (one in Adra, three in El Ejido, one in Níjar, one in Roquetas de Mar, and one in Vera), Granada capital has three; Huelva has 16 cases (one in Calañas, two in Gibraleón, one in Huelva capital, four in Lucena del Puerto, two in Moguer, three in Palos de la Frontera, one in San Bartolomé de la Torre, and two in San Juan del Puerto); Málaga has 39 cases (one in Álora, one in Casabermeja, nine in Fuengirola, 16 in Málaga capital, two in Marbella, seven in Mijas, one in Ojén, one in Rincón de la Victoria, and one in Torrox) and Seville has recorded two cases in the capital. In Málaga, the majority of cases are concentrated mainly in the Costa del Sol Health District (19 cases) and Málaga District (17 cases).
Decrease in incidence and increase in imported cases
In recent weeks, the incidence of confirmed cases has shown a decreasing trend. Also, for the past eight weeks, cases have occurred only in adults, mainly between 26 and 47 years, except for the case of the 13-month-old child from Seville suspected to be post-vaccination. Most of these cases are imported from Morocco, related to imported cases or associated with outbreaks, with a significant decrease in isolated cases of unknown origin (two cases in the last six weeks). The active outbreaks at the moment are family outbreaks in adults with a small number of cases and generally with two generations of cases.
Health and Consumer Department reminds, as confirmed by the recorded data, that measles is an infection that is easily transmitted, can be severe, and can affect both unvaccinated children and adults. For this reason, it recommends vaccination of minors according to established guidelines and of adults who are not sure if they have been vaccinated to protect those who cannot be vaccinated (children under 12 months, representing 14% of the cases reported in Andalusia).
The epidemiological situation in the surroundings of Andalusia, especially Morocco, which has been experiencing a significant measles outbreak since October 2023 and has spread throughout the country with over 40,000 reported cases, including 150 deaths; 3,012 cases in 15 countries of the European Union until April 15 (Romania has 5,104, followed by the Netherlands with 251 and France with 180. Spain had 179); 712 confirmed cases in the United States, with two deaths, until April 10, or 731 in Canada until April 11; as well as the presence of susceptible pockets that may be significant in some districts and the seasonality of measles (spring), predicts new outbreaks in the coming weeks and months. The Health and Consumer Department will provide a weekly report on Tuesdays with updated data.
The link to the new protocol on the Health and Consumer Department’s website is: