A measles outbreak at the Hospital de Santo António, in Porto, Portugal has been reported by the Directorate-General for Health this week, according to a Jornal de Noticias report (computer translated).

There are currently seven confirmed cases, including five health workers infected. Three are hospitalized, one in serious situation. There are 32 other cases under investigation.
The report notes that “Patient Zero” is a 27-year-old man who is clinically cured, has contracted the disease in France. On February 26, she had the first symptoms (rash, internal cheek stains, muscle aches and tiredness) and was not vaccinated.
Graça Freitas made a strong call for vaccination because “the disease mainly affects unvaccinated people.” He called on parents not to delay the vaccination at 12 months and 5 years and asked “a lot of attention to health professionals,” who should receive two doses of vaccine regardless of the year of birth.
Europe measles cases up 400 percent in 2017
How do they know unvaccinated started the epidemic? He might came across a vaccinated one a day before.
http://www.sciencemag.org/news/2014/04/measles-outbreak-traced-fully-vaccinated-patient-first-time
How did they measure it objectively?
I remember Patient Zero – the HIV one. He was not the case.
They know it because they have a crystal ball;-)
The reason is very simple to understanding (but not to performing). If we analyze possible scenarios of spreading of the infection, huger ammount of receptive people in the population, especially in “critical points”, i.e., the babies, is conditio sine qua non. Therefore, in general, the high frequency of outbreaks can have two explanations. The first is a widespread failure of the vaccine itself, the second is a negative influence of anti-vaccination movement.