Since the vaccination of Dutch children against the measles through the National Immunisation Programme started in 1976, the incidence of measles has greatly decreased. Local epidemics do still occur, however; these are largely confined to minority groups of orthodox Protestants who object to vaccination on religious grounds. A local epidemic of the measles has been developing in the Netherlands since May of this year, predominantly within unvaccinated groups where the highly contagious virus can easily spread. We describe an unvaccinated 10-year-old boy with an uncomplicated case of the measles and an unvaccinated 9-year-old boy who developed encephalitis as a complication of the measles. From the waning of maternal antibodies until the first regular vaccination and where herd immunity is lacking, children are at risk of the measles. For this reason, an extra (age < 12 months) or early (12-14 months) vaccination is being offered during the current epidemic for all children aged 6 to 14 months who live in areas with low (< 90%) vaccination coverage.
Conflict of interest: W. Opstelten, W.L.M. Ruijs, R.S. van Binnendijk, T.F.W. Wolfs and S.J.M. Hahné are members of the Measles Outbreak Management Team of the National Institute for Public Health and the Environment (RIVM). Financial support: none declared.