Measles outbreak in the Netherlands

Measles is becoming increasingly widespread in the Netherlands. The National Institute for Public Health and the Environment (RIVM) reports that the number of infections has now reached 108 (March 2025). This is 45 cases more than two weeks ago. Especially elementary school in the regions of Amsterdam, Brabant-Zuidoost, Haaglanden and Rotterdam-Rijnmond have been affected by the contagious disease.

Vaccination rate under pressure

A major reason for the increase in measles infections is declining vaccination rates in certain regions. The World Health Organization (WHO) recommends a vaccination rate of 95% to ensure group immunity. However, in some districts in the Netherlands, vaccination rates are below 60%. This significantly increases the risk of outbreaks.

International distribution

In addition to the situation in the Netherlands, there are also major outbreaks in countries such as Morocco, Romania, Spain, Vietnam and the United States. Travelers bring the virus back to the Netherlands, after which it spreads further among unvaccinated persons. This explains why many infections occur within families.

What are measles?

Measles is a highly contagious viral disease spread by coughing, sneezing and talking. Measles can cause serious complications, including pneumonia, meningitis and, in rare cases, blindness or death. Of patients, 1 to 5 percent develop pneumonia. About one in 1,000 infected persons develops meningitis.

How do you recognize measles?

Symptoms of measles develop 10 to 14 days after coming in contact with the virus. These symptoms can last up to over a week. It starts with a fever, a nasty cough and a stuffy nose. Your eyes are red and sensitive to light. At first it may seem like just a bad cold, but then after a few days, red spots appear on your face. Soon they spread all over your body. You may even see small white spots in your mouth. These are the classic signs of measles.

For most people, it is a nasty but temporary illness. Still, measles can be dangerous, especially for babies, pregnant women who have not been vaccinated and people with weak immune systems. In them, the symptoms can be more severe and sometimes even lead to hospitalization. Although measles during pregnancy does not cause abnormalities in the baby, in rare cases it can cause miscarriage or premature birth. Therefore, it is important to be alert to the symptoms and seek protection whenever possible.

What to do if measles is suspected at school or child care center

If you suspect a child has measles, it is important to act quickly and carefully to prevent further spread. Therefore, follow the steps below:

1. Isolate the child and inform the parents.

• Do not allow the child to interact with other children.
• Ask parents/caregivers to pick up the child immediately.
• Advise them to contact their doctor by phone and not to stop by the practice or ER, due to risk of infection.

2. Contact the GGD

• Report the (possible) infection to your area's public health department.
• The GGD assesses whether there is an outbreak and conducts source and contact investigations if necessary.
• They also advise on possible measures within the school or shelter.

3. Inform staff and parents

• Always do this in consultation with the GGD.
• Inform them about:
  • The potential contagion.
  • Symptoms of measles.
  • What they can do in case of questions or concerns.

4. Check vaccination status

• Ask if children and staff are fully vaccinated against measles (BMR vaccination).
• In consultation with the Public Health Service, unvaccinated persons may be temporarily excluded from shelter or education to prevent further spread.

5. Follow hygiene measures strictly

• Ensure good ventilation in all rooms.
• Encourage regular hand washing.
• Clean shared materials and surfaces extra well.

As a parent, teacher or educational worker, are you at risk of contracting measles?

Generally, as an adult, you are at no or minimal risk if:

• you have had two BMR vaccinations (or demonstrable natural immunity from previously passed measles).
• You were born before 1965 (most people from that generation went through measles).
• You have a functioning immune system.

You do run a risk if you:

• Have not been vaccinated with the BMR vaccine or have been vaccinated only once.
• You have a weakened immune system (e.g., due to medication or illness).
• You are pregnant and are not immune.

Importance of vaccination

The National Vaccination Program has offered a vaccine against measles since 1976, which has greatly reduced the disease. However, the recent rise in the number of cases emphasizes the importance of high vaccination coverage. Last year, the RIVM recorded 202 cases of measles in the Netherlands. This is the largest number since 2013. Vaccination not only protects individuals but also prevents large-scale outbreaks in society.

Want to know more about measles and vaccinations? Visit the RIVM website or contact your doctor for advice.