Measles in Macedonia: four confirmed cases, two of them babies, and the three local patients never travelled abroad

Macedonia has four laboratory-confirmed cases of measles. One is imported, in a foreign national from Kosovo, and three are Macedonian citizens from Veles, Štip and Skopje. Of them, two are babies under 12 months old, and the third patient is over 40. All are unvaccinated - the babies because they are too young for the vaccine, the adult because he never got it.

Health Minister Sašo Klekovski says that, for now, there are no grounds to declare an epidemic. The three local cases hadn't travelled abroad, so the Institute of Public Health and the public health centres are finishing their analysis of whether and how they are connected. That's the detail to listen to carefully: if none of them had been out of the country, where did they get infected?

In the neighbourhood, epidemics have already been declared - in Kosovo and in Bulgaria. The ministry says protocols have been issued for healthcare facilities and border crossings, and kindergartens and schools have received guidance on preventive measures.

The waiting room is the most dangerous place

The minister's most concrete advice isn't about the vaccine, it's about the waiting room. If you have a fever, a cough, red eyes and a rash - don't go to the doctor, call the doctor. According to Klekovski, waiting rooms in healthcare facilities are the main point of contact, and the virus stays active in the air for about two hours after an infected person leaves the room. Contagiousness starts roughly four days before the rash and lasts another four days after it.

There's a separate appeal to healthcare workers: check your own vaccination records, because you're the most exposed. Does anyone actually know how many of the people who are supposed to protect us in hospital don't have two doses?

The Institute of Public Health links the appeal to insufficient MMR vaccine coverage in the country. Two doses protect against measles, rubella and mumps. Babies under 12 months can't get it - the only thing protecting them is whether everyone around them got it. That's the one number that really matters in this story: how many people around a baby are vaccinated.