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"textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Measles is a highly contagious disease caused by the measles virus (MeV), part of the <span class="elsevierStyleItalic">Paramyxoviridae</span> family and <span class="elsevierStyleItalic">Morbillivirus</span> genus. While measles primarily affects children, it can occur in individuals of any age who are unvaccinated or have not previously been infected.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The virus spreads through respiratory droplets or airborne transmission and has a high R0 (basic reproduction number), with one infected individual causing 12–18 secondary cases in a fully susceptible population.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Typical symptoms include fever, cough, conjunctivitis, coryza, and a rash that appears 3–4 days after the initial symptoms, starting on the head and spreading down the body. Characteristic white spots inside the cheeks, known as Koplik’s spots, are also common. In young children, measles can lead to severe complications such as pneumonia, laryngotracheitis, gastroenteritis, pancreatitis, encephalitis, and, in some cases, death.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Survivors of encephalitis often suffer from permanent brain damage or developmental delays. Encephalitis and death from respiratory or neurological causes occur in approximately 1 out of every 1,000 reported cases of measles.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The disease can also cause long-term complications, including subacute sclerosing panencephalitis, a rare but fatal outcome.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Vaccination is the most effective method to prevent measles. The vaccine is typically administered as part of the measles-mumps-rubella (MMR) or measles-mumps-rubella-varicella (MMRV) vaccine. A first dose is recommended for children at 12 months of age, with a second dose given between ages 3 and 4.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Spain implemented a measles elimination plan in accordance with the 1998 recommendations of the World Health Organization Regional Office for Europe.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Due to high vaccination coverage and enhanced surveillance, Spain has been free of endemic measles transmission since 2014 and received WHO certification for elimination in 2017.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> However, nine European countries, including Bosnia and Herzegovina, France, Germany, Italy, Kazakhstan, Romania, Serbia, and Ukraine, still had endemic measles transmission at that time. Outside Europe, imported cases in Spain have primarily come from Africa and Asia. Recent outbreaks have been linked to low vaccination rates. For example, in November 2017, an imported case from Romania triggered an outbreak in Valencia (Spain) which affected 154 people and spread to the neighboring Catalonia region.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In the first half of 2024, Spain reported 123 confirmed measles cases, with 24 imported, 54 related to importation, and 48 under investigation.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Measles remains a global public health threat, and the high mobility of people facilitates its transmission across distant regions. Given the virus’s high transmissibility, 90–95% of the population must be immune to interrupt its spread, requiring a vaccination coverage rate (with two doses) of over 90%.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Some measles cases have occurred among healthcare workers, despite the importance of ensuring immunity in healthcare settings. A study conducted in Spain found that around 40% of healthcare workers with measles were unvaccinated,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> highlighting the need to review vaccination protocols for healthcare staff. When healthcare workers contract measles, it can spread to patients and colleagues, posing significant health risks and financial burdens due to outbreak containment measures and disruption of hospital operations. Healthcare personnel should be immunized upon employment, and if they lack a documented history of infection or vaccination, they should undergo an antibody test or receive the vaccine. Studies in Spain show that around 90% of healthcare workers have immunity, a rate lower than recommended by the Measles and Rubella Elimination Plan.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Hernández-Aceituno et al.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> report a measles case involving an unvaccinated two-year-old girl in Tenerife (Canary Islands), who visited a primary healthcare center and hospital emergency department in 2024. The virus spread to two children under the vaccination age and a fully vaccinated 26-year-old nurse. The outbreak led to the screening of 407 contacts. Fortunately, despite the nurse living with nine individuals and traveling on two flights, no further secondary cases occurred. This study that we publish in this number underscores the importance of full vaccine coverage in minimizing secondary infections.</p></span>"
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