European Region reports highest number of measles cases in more than 25 years

Measles is one of the most contagious viruses affecting people.

According to an analysis by WHO and the United Nations Children’s Fund (UNICEF), 127 350 measles cases were reported in the European Region for 2024, double the number of cases reported for 2023 and the highest number since 1997.

Children under 5 accounted for more than 40% of reported cases in the Region – comprising 53 countries in Europe and central Asia. More than half of the reported cases required hospitalization. A total of 38 deaths have been reported, based on preliminary data received as of 6 March 2025.

Measles cases in the Region have generally been declining since 1997, when some 216 000 were reported, reaching a low of 4440 cases in 2016. However, a resurgence was seen in 2018 and 2019 – with 89 000 and 106 000 cases reported for the 2 years respectively. Following a backsliding in immunization coverage during the COVID-19 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.

“Measles is back, and it’s a wake-up call. Without high vaccination rates, there is no health security. As we shape our new regional health strategy for Europe and central Asia, we cannot afford to lose ground. Every country must step up efforts to reach under-vaccinated communities,” warned Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “The measles virus never rests – and neither can we.”

The European Region accounted for a third of all measles cases globally in 2024. In 2023 alone, 500 000 children across the Region missed the first dose of the measles vaccine (MCV1) that should be given through routine immunization services.

“Measles cases across Europe and central Asia have soared over the past 2 years – pointing to gaps in immunization coverage,” said Regina De Dominicis, UNICEF Regional Director for Europe and Central Asia. “To protect children from this deadly and debilitating disease, we need urgent government action including sustained investment in health-care workers.”

Measles is one of the most contagious viruses affecting people. As well as hospitalization and death caused by complications including pneumonia, encephalitis, diarrhoea and dehydration, measles can cause long-term, debilitating health complications such as blindness. It can also damage the immune system by “erasing » its memory of how to fight infections, leaving measles survivors vulnerable to other diseases. Vaccination is the best line of defence against the virus.

Less than 80% of eligible children in Bosnia and Herzegovina, Montenegro, North Macedonia and Romania were vaccinated with MCV1 in 2023 – far below the 95% coverage rate required to retain herd immunity. In both Bosnia and Herzegovina and Montenegro the coverage rate for MCV1 has remained below 70% and 50% respectively for the past 5 or more years.

Romania reported the highest number of cases in the Region for 2024, with 30 692 cases, followed by Kazakhstan with 28 147 cases.

Measles remains a significant global threat. In 2024, 359 521 cases of measles were reported worldwide. Transmission of the virus across borders and continents occurs regularly, and outbreaks of this highly infectious disease will occur wherever the virus finds pockets of un- or under-vaccinated people, particularly children.

UNICEF and WHO are working together with governments, and with the support of partners including the European Union and Gavi, the Vaccine Alliance, to prevent and respond to measles outbreaks – by engaging with communities, training health-care workers, strengthening immunization programmes and disease surveillance systems, and initiating measles immunization catch-up campaigns. UNICEF and WHO are calling for governments with active outbreaks to urgently intensify case finding and contact tracing and conduct emergency vaccination campaigns. It is imperative that countries analyse the root causes of outbreaks, address weaknesses in their health systems, and strategically utilize epidemiological data to identify and close coverage gaps. Reaching hesitant parents and marginalized communities and tackling inequitable access to vaccines must be central to all efforts.

Countries that do not have current measles outbreaks should be prepared, including through identifying and addressing gaps in immunity, building and sustaining public trust in vaccines and maintaining strong health systems.