“Measles is back, and it’s a wake-up call,” warned Dr. Hans Kluge, the World Health Organization (WHO) regional director for the European region.
A total of 127,350 cases were reported in the region in 2024, double the number of cases reported for 2023 and the highest number since 1997, according to analysis by WHO and the UN Children’s Fund (UNICEF).
Among the most contagious viruses affecting people, measles can damage the immune system by “erasing” its memory of how to fight infections, leaving survivors vulnerable to other diseases.
As well as hospitalisation and death caused by complications including pneumonia, encephalitis, diarrhoea and dehydration, measles can also cause long-term, debilitating health complications such as blindness.
Deaths reported
There were an estimated 107,500 measles deaths globally in 2023, mostly among unvaccinated or under vaccinated children under five, according to WHO.
“Measles remains a significant global threat,” the UN agencies said, pointing to the 359,521 cases reported for 2024 worldwide.
Current outbreaks and deaths have been reported worldwide, including in the Democratic Republic of the Congo, the United States and countries in every other region.
Based on preliminary data received as of 6 March 2025, a total of 38 deaths have been reported for WHO’s European region, which comprises 53 countries in Europe and Central Asia.
Post-COVID-19 surge
The region accounted for one third of all measles cases globally in 2024.
UN agencies pointed to a resurgence in 2018 and 2019, with 89,000 and 106,000 cases respectively, after a period of decline since 1997, with 216,000 reported cases, that reached a low of 4,440 in 2016.
Following a backsliding in immunisation coverage during the COVID-19 pandemic, cases rose significantly again in 2023 and 2024, the UN agencies said, adding that vaccination rates in many countries are yet to return to pre-pandemic levels, increasing the risk of outbreaks.
Transmission of the virus across borders and continents occurs regularly, and outbreaks of this highly infectious disease will occur wherever the virus finds pockets where vaccine levels are insufficient – particularly children, they cautioned.
Currently, children under five accounted for more than 40 per cent of reported cases in the region, and more than half of all cases required hospitalisation.
Calls for urgent government action
“Measles cases across Europe and Central Asia have soared over the past two years, pointing to gaps in immunisation coverage,” said Regina De Dominicis, UNICEF regional director for Europe and Central Asia.
In 2023 alone, 500,000 children across the region missed the first dose of the measles vaccine (MCV1) that should be given through routine immunisation services.
“To protect children from this deadly and debilitating disease, we need urgent government action including sustained investment in health care workers,” she said.
‘No health security’ without vaccines
WHO’s Dr. Kluge said “we can’t afford to lose ground” as the agency shapes its regional health strategy to tackle such serious issues.
“Without high vaccination rates, there is no health security,” Dr. Kluge said.
“Every country must step up efforts to reach under-vaccinated communities. The measles virus never rests and neither can we.”
Indeed, vaccination is the best line of defence against the virus, the UN agencies insisted.
Outbreak hot spots
The latest analysis found that Romania reported the highest number of cases – 30,692 – in the region for 2024, followed by 28,147 in Kazakhstan.
At the same time, less than 80 per cent of eligible children in Bosnia and Herzegovina, Montenegro, North Macedonia and Romania were vaccinated with MCV1 in 2023.
In both Bosnia and Herzegovina and Montenegro, the coverage rate for MCV1 has remained below 70 per cent and 50 per cent respectively for the past five or more years.
That is far below the 95 per cent coverage rate required to retain herd immunity, the UN agencies noted.
Catch-up campaigns
UNICEF and WHO are working with governments and health partners, including the European Union and the GAVI Alliance, to prevent and respond to measles outbreaks by engaging with communities.
Efforts include training healthcare workers, strengthening vaccine programmes and disease surveillance systems and initiating measles immunisation catch-up campaigns.
The UN agencies are calling for governments with active outbreaks to urgently intensify case finding, contact tracing and conduct emergency vaccination campaigns.
Analysing root causes
“It is imperative that countries analyse the root causes of outbreaks, address weaknesses in their health systems and strategically utilise epidemiological data to identify and close coverage gaps,” the UN agencies stated.
Reaching hesitant parents and marginalised communities and tackling inequitable access to vaccines must be central to all efforts, they added.
They also warned that 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.
