When news that a young unvaccinated child in the Finnish region of Ostrobothnia had contracted measles broke on Thursday, Markus Granholm, a physician in the city of Jakobstad (Pietarsaari in Finnish) was not surprised. He had been vocal for years that if the vaccination rates of the population in this western coastal area don't rise, it was just a matter of time before a measles outbreak.
Finland's National Institute for Health and Welfare (THL) had also issued warnings of a high risk of a measles epidemic in the area near Jakobstad.
"We've been expecting this for years, and now it has happened," Granholm says.
One isolated case is far from an outbreak, but Granholm is fairly certain that more cases will soon appear, as measles is highly contagious and it has been estimated that some 300 people were exposed to the sick child. The latest figures show that most of the people believed to have been in contact with the disease have been tracked down.
"If there aren't any new cases before Christmas; that was that. But I would consider it a big surprise if more cases don't pop up within a few weeks," he says.
Large Laestadian population
The pre-school measles case took place in Larsmo (Luoto in Finnish), a majority Swedish-speaking municipality that lies between the western coastal cities of Kokkola and Jakobstad. The region is the area of Finland with the largest percentage of unvaccinated people.
It also contains a large population of Laestadians, members of a Lutheran revival movement that started in Lapland in the mid-19th century. Among other things, the conservative religious congregation frowns on pre-marital sex and alcohol consumption.
Shortly before the diagnosis, the child that contracted measles had visited a Laestadian prayer room in Risohäll, a meeting place for the Swedish language branch of the movement known as the LFF. The organisation's chair Jens Björkskog denies that decisions about vaccination are tied to the movement, saying they are strictly a personal matter.
"If anything, vaccination is a good thing," Björkskog commented.
Coverage had dropped to 75 percent
Local doctor Granholm says the problem has continued in the Jakobstad area for years. He says it was at its worst about six years ago, when two women with children led an effective campaign with blog posts that convinced many people to refuse vaccinations.
The vaccination rate in the municipality of Larsmo is now estimated at 75 percent, when a rate of 95 percent is considered to be required to provide sufficient protection.
He hopes that the recent case of a small child contracting measles will stir the inhabitants of Larsmo to take the recommended vaccinations.
Hundreds of people in the area have volunteered for measles vaccinations since the child fell ill two days ago, which Granholm says is a step in the right direction.
"If we can get the coverage back up to more than 95 percent, then the few families that aren't vaccinated won't pose as big a risk to the rest of the population," he says.