The document summarizes measles and rubella surveillance data from the WHO European Region from December 2020 to November 2021. It finds that 148 measles cases were reported in this period, with the majority (89%) occurring in 11 countries including Turkey, France, Poland, and Belgium. 103 rubella cases were reported in the same period, with over 90% concentrated in 5 countries including Italy, Germany, Turkey, and Ukraine. Overall measles and rubella cases have declined in the region since 2018 but surveillance and vaccination efforts need to remain vigilant to prevent further outbreaks.

1. Vaccine-preventable Diseases and Immunization programme
Division of country health programmes
Data as of 18 January 2022
Measles and rubella monthly update—
WHO European Region
www.euro.who.int

2. Measles
Updates including 2021
2

3. 3
Measles cases—WHO European Region,
December 2020–November 2021
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city
or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there November not yet be full agreement. © WHO 2022. All rights reserved.
Top 10 countries
Country Cases
Turkey 40
France 15
Poland 15
Belgium 14
Ukraine 14
Italy 8
Georgia 7
Germany 7
Kyrgyzstan 6
Belarus and Finland** 3
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022
** Belarus and Finland had three cases each for rolling 12-months.
22 (42%) countries reported measles cases in the rolling 12-months.
* San Marino submitted the last report for September 2020

4. 4
Measles incidence per million population—
WHO European Region, December 2020–November 2021
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city
or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there November not yet be full agreement. © WHO 2022. All rights reserved.
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2019 Revision.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022
Top 10 countries
Country Cases Incidence
Georgia 7 1.76
Belgium 14 1.20
Kyrgyzstan 6 0.91
Finland 3 0.54
Turkey 40 0.47
Ireland 2 0.40
Poland 15 0.40
Albania 1 0.35
Ukraine 14 0.32
Belarus 3 0.32
* San Marino submitted the last report for September 2020

5. 3
6
7
7
8
14
14
15
15
40
0 5 10 15 20 25 30 35 40 45
Belarus
Kyrgyzstan
Germany
Georgia
Italy
Ukraine
Belgium
Poland
France
Turkey
Number of cases
Belarus and Finland*
5
Ten countries with the highest numbers of measles cases—
WHO European Region, December 2020–November 2021
Out of 148 measles cases reported for December 2020 to
November 2021, 132 (89%) cases were reported by these 11
countries.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022
* Belarus and Finland had three cases each for rolling 12-months.
22 (42%) countries reported measles cases in the rolling 12-months.

6. 6
Measles cases by month—WHO European Region,
2019–November 2021
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
2019
(n=104442)
2020
(n=12201)
2021
(n=138)
Number
of
cases
Month
Lab confirmed Epi linked Clinically compatible

7. 30604
33254
26788
32857
18869
28413
5273
25872
88693
104442
12201
138
93 94 95 95 94 94 93
95 95 96
94
80
82 83
89 89 89 88
90 91 92 91
0
20
40
60
80
100
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021*
0
20000
40000
60000
80000
100000
120000
%
Coverage
Year
Number
of
cases
Measles cases MCV1 coverage MCV2 coverage
7
Measles cases, MCV1 and MCV2 coverage by year—
WHO European Region, 2010–November 2021
Data source: 1) Measles cases – monthly aggregated and case-based data reported by Member States to WHO/Europe or via ECDC/TESSy as of 18 January 2022.
2) MCV1 and MCV2 coverage - WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 04 October 2021.
MCV1: first dose of measles-containing vaccine
MCV2: second dose of measles-containing vaccine
*January –November 2021

8. 8
Measles genotypes by week of sample collection—
WHO European Region, week 49, 2018 to week 47, 2021
Data source: WHO measles nucleotide surveillance online database (MeaNS) data as of 18 January 2022
0
20
40
60
80
100
120
140
160
180
200
49
50
51
52
1
2
3
4
5
6
7
8
9
10
11
12
13
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15
16
17
18
19
20
21
22
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24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
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24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
2018 2019 2020 2021
Number
of
sequences
reported
Week of sample collection
C2 D4 D9 H1 B3 D8
2018 2019 2020 2021

9. Measles
Latest update for 2020
9

10. 10
Measles cases—WHO European Region, 2020
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city
or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there November not yet be full agreement. © WHO 2022. All rights reserved.
Top 10 countries
Country Cases
Uzbekistan 4053
Kazakhstan 3269
Russian Federation 1100
Romania 976
Kyrgyzstan 715
Turkey 603
Bulgaria 245
France 240
Ukraine 211
Tajikistan 168
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022

11. 11
Measles incidence per million population—
WHO European Region, 2020
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city
or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there November not yet be full agreement. © WHO 2022. All rights reserved.
Top 10 countries
Country Incidence
Kazakhstan 174.1
Uzbekistan 121.1
Kyrgyzstan 109.59
Romania 50.73
Bulgaria 35.26
Tajikistan 17.61
Russian Federation 7.54
Turkey 7.15
Belgium 5.18
Georgia 5.01
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2019 Revision.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022

12. 12
Ten countries with the highest numbers of measles cases—
WHO European Region, 2020
168
211
240
245
603
715
976
1100
3269
4053
0 500 1000 1500 2000 2500 3000 3500 4000 4500
Tajikistan
Ukraine
France
Bulgaria
Turkey
Kyrgyzstan
Romania
Russian Federation
Kazakhstan
Uzbekistan
Number of cases
Out of 12 201 measles cases reported for 2020, 11 580 (95%) cases were
reported by these 10 countries.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022

13. 13
Measles cases by month—WHO European Region,
2018–2020
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2018
(n=88693)
2019
(n=104442)
2020
(n=12201)
Number
of
cases
Month
Lab confirmed Epi linked Clinically compatible
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022

14. 14
Measles cases and incidence by age group* and vaccination
status—WHO European Region, 2020
*Age was unknown for 31 cases.
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2019 Revision.
390
71
17 12 9 9 3
0
50
100
150
200
250
300
350
400
450
0
500
1000
1500
2000
2500
3000
3500
4000
4500
<1
(n=4202)
1–4
(n=3211)
5–9
(n=1010)
10–14
(n=652)
15–19
(n=463)
20–29
(n=1061)
30+
(n=1571)
Incidence
per
million
population
Number
of
cases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022

15. Rubella
Updates including 2021
15

16. 16
Five countries with the highest numbers of rubella cases—
WHO European Region, December 2020–November 2021
4
8
14
19
51
0 10 20 30 40 50 60
Italy
Germany
Turkey
Ukraine
Poland
Number of cases
Out of 103 rubella cases reported for December 2020 to November
2021, 96 (93%) cases were reported by these 5 countries.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022
10 (20%) countries reported rubella cases in the rolling 12-months.

17. 17
Rubella cases by month—WHO European Region,
2019–November 2021
0
20
40
60
80
100
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
2019
(n=630)
2020
(n=190)
2021
(n=93)
Number
of
cases
Month
Lab confirmed Epi linked Clinically compatible
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022

18. Rubella
Latest update for 2020
18

19. 19
Five countries with the highest numbers of rubella cases—
WHO European Region, 2020
15
15
17
27
96
0 10 20 30 40 50 60 70 80 90 100
Turkey
Italy
Germany
Ukraine
Poland
Number of cases
Out of 190 rubella cases reported for 2020, 170 (89%) cases
were reported by these 5 countries.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022

20. 20
Rubella cases by month—WHO European Region,
2018–2020
0
20
40
60
80
100
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2018
(n=839)
2019
(n=630)
2020
(n=190)
Number
of
cases
Month
Lab confirmed Epi linked Clinically compatible
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 18 January 2022

21. 21
Links to measles and rubella information
• WHO EpiData
www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/surveillance-and-data/who-epidata
• Country slides for measles and rubella
www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/active/measles_monthlydata/en/
• WHO EpiBrief
www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/surveillance-and-data/who-epibrief