Measles cases in Europe and Central Asia doubled last year compared to 2023, the World Health Organisation (WHO) and UNICEF have warned in what is being called a “wake-up call”.
There were 127,350 reported infections in the region in 2024, which is the highest number since 1997.
It is around a third of last year’s total worldwide cases of 359,521.
More than 40% of the European cases were children under five, as the two global bodies appealed for urgent action to increase vaccination levels.
In 2023, half a million children across the region missed the first dose of the vaccine (MCV1) that should be given through routine immunisation services, said the organisations.
Two doses of the measles vaccine are believed to be 97% effective in preventing the disease, which typically affects the respiratory system and leads to symptoms such as fever, cough, runny nose and a rash.
Measles is one of the most contagious viruses for humans. In serious cases, infections can cause complications including pneumonia, encephalitis, dehydration and blindness.
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More than half of the European region cases had to be treated in hospital, and 38 people died.
‘Measles is back’
WHO’s Europe director Dr Hans Kluge said: “Measles is back, and it’s a wake-up call.” He added: “Without high vaccination rates, there is no health security… The measles virus never rests – and neither can we.”
The nation with the most infections last year was Romania which had 30,692, followed by Kazakhstan with 28,147.
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Fewer than 80% of eligible children in Bosnia and Herzegovina, Montenegro, North Macedonia and Romania were vaccinated with MCV1 in 2023 – which is well below the 95% coverage rate needed to prevent an outbreak.
In Montenegro, fewer than 50% of children have been vaccinated against measles for at least the past five years. In Bosnia and Herzegovina, the figure was less than 70%.
UK officials said last month there have been more than 200 reported cases in the country and that many more were expected.
Vaccination rates not back to pre-pandemic levels
Measles cases in the region have generally been declining since 1997, when 216,000 were reported, reaching a low of 4,440 cases in 2016, according to the WHO and UNICEF.
However, a resurgence was seen in 2018 and 2019 with 89,000 and 106,000 cases reported for those years respectively.
After a drop in immunisation coverage during the COVID pandemic, cases rose significantly again in 2023 and 2024.
Vaccination rates in many countries are yet to return to pre-pandemic levels, increasing the risk of outbreaks.
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Measles is spread when an infected person breathes, coughs or sneezes.
A rash usually appears a few days after the cold-like symptoms. The rash starts on the face and behind the ears before spreading to the rest of the body.
A person is infectious from when they first have symptoms (around four days before the rash appears) until four days after they get the rash.
There are things people can do to reduce the risk of spreading or catching measles.
Do: Wash hands often with soap and warm water. Use tissues when coughing or sneezing. Throw used tissues in the bin.
Don’t: Do not share cutlery, cups, towels, clothes, or bedding.
Information from NHS website
‘Never too late to be vaccinated’
Concerns about the safety of the measles vaccine have lingered for decades, after British physician Dr Andrew Wakefield and colleagues published a paper in 1998 – which has long since been retracted – linking the measles, mumps and rubella (MMR) vaccine to autism.
No evidence for any causal link has ever been found and Wakefield had his licence to practise medicine in the UK revoked.
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“It’s never too late to get vaccinated,” said Dr Ben Kasstan-Dabush, from the London School of Hygiene and Tropical Medicine, who warned that misinformation can unfortunately travel rapidly. “Even a small decline in vaccine uptake can have devastating consequences.”
In the US, an outbreak in Texas and New Mexico, which led to the country’s first measles deaths in a decade, has seen 28 more infections this week, taking the total to 256.
It is the first major challenge for new health secretary and long-time vaccine sceptic Robert F Kennedy Jr.
