Experts have expressed concern at the return of measles to countries which had previously eliminated the disease. Armenia, Austria, Azerbaijan, Spain, Uzbekistan and the United Kingdom have officially lost their measles-free status.
In another thirteen countries, including France, Germany, Italy, Poland and Romania, the disease is considered to be ‘endemic’. The situation is an ‘extreme challenge’ for the region, according to an expert at the WHO Regional Office for Europe.
Read: Measles in Europe: How to get back on track
Glossary
- Endemic: the disease regularly occurs in a country.
- Re-established: the return of a disease that was previously under control.
- Measles-free: no local cases for at least 12 months.
- Eliminated: no circulating measles for three years, with high vaccine coverage and good disease surveillance systems to identify cases.
- Eradicated: the complete global elimination of a disease. Smallpox is the only human disease ever to be eradicated.
The WHO European Region of 53 Member States aims to eliminate measles and rubella, and has adopted the European Immunization Agenda 2030 to support these efforts. The most recent verified data (2024) showed that Europe recorded 127,320 cases, with very large outbreaks in Romania (30,000 cases) and Kazakhstan (28,000).
At its 14th meeting, The European Regional Verification Commission for Measles and Rubella Elimination (RVC) said 32 (60%) Member States have eliminated endemic measles (interruption for at least 36 months) and 49 (92%) have eliminated rubella. (No report was submitted by Israel.)
‘The RVC noted with concern the loss of measles elimination status in some countries, including those with high-performing immunization programmes,’ the Commission said.
As the vast majority of reported infections were among unvaccinated or under-immunised individuals, the Commission reiterated that ‘high immunization coverage is the only means to prevent measles outbreaks’.
At least 95% coverage with two doses of measles- and rubella-containing vaccine are needed, alongside high-quality epidemiological surveillance to detect cases quickly.
‘Increased measles transmission and outbreaks in 2023 and 2024 present an extreme challenge for many countries in the European Region and globally,’ said Dr Dragan Jankovic, Team Lead, Disease control and elimination, Vaccine-preventable diseases and immunization programme, WHO/Europe.
‘Measles outbreaks in 2024 demonstrated that even with strong health systems in high-income economies and timely detection of cases, measles outbreaks can happen, and the measles virus can reestablish itself as endemic,’ he told Vaccines Today. ‘This is possible in all countries if they do not know and address their risks with respect to immunity gaps, response capacity and vaccine acceptance among medical staff and the public.’
The path to measles and rubella elimination is clear, Dr Jankovic added, but reaching this goal requires more engagement and commitment from all stakeholders.
Read: How Regions Earn and Keep Their “Measles-Free” Status | History of Vaccines
