Measles Surge in Europe and Central Asia Reaches Highest Level in Decades, Prompting Urgent Health Warnings from WHO and UNICEF

Measles cases in the region had been declining significantly since their peak of approximately 216,000 cases in 1997, reaching a historical low of 4,440 cases in 2016.

The European Region, encompassing 53 countries across Europe and Central Asia, reported a dramatic surge in measles cases in 2024, with 127,350 cases—doubling the previous year's count and marking the highest incidence since 1997, according to an alarming analysis by WHO and UNICEF.

Children under the age of five have been particularly impacted, comprising over 40% of the reported cases. The severity of the outbreak is underscored by the hospitalization rate, with more than half of all reported cases requiring hospital treatment. Tragically, preliminary data as of 6 March 2025 confirms 38 deaths directly linked to measles complications.

Measles cases in the region had been declining significantly since their peak of approximately 216,000 cases in 1997, reaching a historical low of 4,440 cases in 2016. However, notable resurgence occurred in 2018 and 2019, with approximately 89,000 and 106,000 cases reported respectively. A subsequent decline in vaccination rates during the COVID-19 pandemic created vulnerabilities, leading to sharp increases in measles cases in recent years.

Dr. Hans P. Kluge, WHO Regional Director for Europe, emphasized the urgency of the situation: "Measles is back, and it’s a wake-up call. Without high vaccination rates, there is no health security. Every country must immediately step up efforts to reach under-vaccinated communities. The measles virus never rests—and neither can we."

The European Region accounted for a third of global measles cases in 2024. Disturbingly, about 500,000 children missed their initial measles vaccination (MCV1) dose in 2023 alone, primarily due to disrupted routine immunization services.

"The rapid escalation of measles cases highlights severe gaps in immunization coverage across Europe and Central Asia," warned Regina De Dominicis, UNICEF Regional Director. "Urgent government action, including sustained investment in health care workers and improved community outreach, is essential to safeguard children."

Measles is among the most contagious viruses, capable of causing severe complications such as pneumonia, encephalitis, diarrhea, dehydration, and long-term effects like blindness and immune system impairment. Vaccination remains the most effective method of prevention.

Vaccination coverage in several countries remains critically low. Bosnia and Herzegovina, Montenegro, North Macedonia, and Romania all reported MCV1 coverage rates below the essential 95% threshold for herd immunity in 2023. Particularly alarming, coverage rates in Bosnia and Herzegovina and Montenegro have remained below 70% and 50%, respectively, for more than five consecutive years.

Romania recorded the highest number of cases in the region in 2024, totaling 30,692, followed closely by Kazakhstan with 28,147 cases.

Globally, measles continues to pose a significant public health threat, with 359,521 reported cases in 2024. Frequent international transmission emphasizes the urgent need to identify and vaccinate populations at risk, particularly children.

UNICEF and WHO, supported by international partners like the European Union and GAVI Alliance, are intensifying collaborative efforts to halt the outbreak. Strategies include community engagement, extensive healthcare worker training, robust immunization programs, improved disease surveillance systems, and emergency vaccination campaigns.

Countries experiencing outbreaks must urgently intensify case detection, contact tracing, and vaccination initiatives, addressing systemic health infrastructure weaknesses. Simultaneously, regions currently unaffected should proactively prepare by addressing immunity gaps, bolstering public trust in vaccines, and maintaining robust health systems to prevent future outbreaks.