The document provides information on measles and rubella cases in the WHO European Region from January to December 2019. It shows that: - Ukraine reported the highest number of measles cases in 2019 with 57,282 cases, followed by Kazakhstan, Russia, Georgia and Turkey. - Ten countries accounted for 88% of the 104,248 total measles cases reported in the region. - The highest measles incidence per million was reported in Ukraine, Georgia, North Macedonia, Kazakhstan and Bosnia and Herzegovina. - Poland, Ukraine, Germany, Turkey and Russia reported 90% of the total 628 rubella cases in the region.

1. Vaccine-preventable Diseases and Immunization programme
Division of Health Emergencies and Communicable Diseases
Data as of 07 February 2020
Measles and rubella monthly update
for the WHO European Region

2. Measles
Updates including 2019
2

3. 3
Measles cases in the WHO European Region,
January–December 2019
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 may not yet be full agreement. © WHO 2020. All rights reserved.
Top 10 countries
Country Cases
Ukraine 57282
Kazakhstan 13326
Russian Federation 4153
Georgia 3920
Turkey 2890
France 2637
Kyrgyzstan 2284
North Macedonia 1884
Romania 1706
Uzbekistan 1692
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 07 February 2020

4. 4
Measles incidence per million population in the WHO
European Region, January–December 2019
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 may not yet be full agreement. © WHO 2020. All rights reserved.
Top 10 countries
Country Incidence
Ukraine 1302.05
Georgia 980.79
North Macedonia 904.27
Kazakhstan 718.33
Bosnia and Herzegovina 424.42
Kyrgyzstan 355.99
San Marino 324.87
Lithuania 301.13
Bulgaria 176.43
Albania 167.31
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 07 February 2020

5. 5
Ten countries with the highest numbers of measles cases in
the WHO European Region, January–December 2019
1692
1706
1884
2284
2637
2890
3920
4153
13326
57282
0 10000 20000 30000 40000 50000 60000 70000
Uzbekistan
Romania
North Macedonia
Kyrgyzstan
France
Turkey
Georgia
Russian Federation
Kazakhstan
Ukraine
Number of cases
Out of 104 248 measles cases reported for January to December 2019,
91 774 (88%) 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 07 February 2020

6. 6
Measles cases by month in the WHO European Region,
2017–December 2019
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
2017
(n=25872)
2018
(n=88695)
2019
(n=104248)
Numberofcases
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 07 February 2020

7. 7
Measles cases and incidence by age group and vaccination
status in the WHO European Region, January–December 2019*
*Age was unknown for 740 cases.
1060
415
228
181 158 145
42
0
200
400
600
800
1000
1200
0
5000
10000
15000
20000
25000
30000
<1
(n=11563)
1–4
(n=18894)
5–9
(n=13136)
10–14
(n=9910)
15–19
(n=8151)
20–29
(n=16780)
30+
(n=25074)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence
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 07 February 2020

8. 8
Measles cases, MCV1 and MCV2 coverage by year in the
WHO European Region, 2009–December 2019
Data source: 1) Measles cases – monthly aggregated and case-based data reported by Member States to WHO/Europe or via ECDC/TESSy as of 07 February 2020.
2) MCV1 and MCV2 coverage - WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2019.
*January–December 2019
MCV1: first dose of measles-containing vaccine
MCV2: second dose of measles-containing vaccine
7884
30604
33254
26788
32857
18869
28413
5273
25872
88695
104248
94 93 94 95 95 94 94 93
95 95
73
80
82 83
89 89 89 88
90 91
0
20
40
60
80
100
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
0
20000
40000
60000
80000
100000
120000
%Coverage
Year
Numberofcases
Measles cases MCV1 coverage MCV2 coverage
*

9. 9
Measles genotypes by week of sample collection in the WHO
European Region, week 1, 2017 to week 52, 2019
Data source: WHO measles nucleotide surveillance online database (MeaNS) data as of 07 February 2020
0
20
40
60
80
100
120
140
160
180
200 1
2
3
4
5
6
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17
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31
32
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50
51
52
1
2
3
4
5
6
7
8
9
10
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17
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19
20
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50
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52
1
2
3
4
5
6
7
8
9
10
11
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13
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19
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25
26
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28
29
30
31
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34
35
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37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
2017 2018 2019
Numberofsequencesreported
Week of sample collection
H1 D4 D9 B3 D8
2017 2018 2019

10. Measles
Latest update for 2018
10

11. 11
Measles cases in the WHO European Region, 2018
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 may not yet be full agreement. © WHO 2020. All rights reserved.
Top 10 countries
Country Cases
Ukraine 53218
Romania 6398
Serbia 5076
Israel 3161
France 2919
Italy 2686
Russian Federation 2290
Georgia 2203
Greece 2193
Albania 1466
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 07 February 2020

12. 12
Measles incidence per million population in the WHO
European Region, 2018
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 may not yet be full agreement. © WHO 2020. All rights reserved.
Top 10 countries
Country Incidence
Ukraine 1202.77
Serbia 576.64
Georgia 550.35
Albania 508.54
Israel 377.14
Romania 328.00
Montenegro 323.35
Greece 208.42
Kyrgyzstan 175.13
Slovakia 104.90
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 07 February 2020

13. 13
Ten countries with the highest numbers of measles cases in
the WHO European Region, 2018
1466
2193
2203
2290
2686
2919
3161
5076
6398
53218
0 10000 20000 30000 40000 50000 60000 70000
Albania
Greece
Georgia
Russian Federation
Italy
France
Israel
Serbia
Romania
Ukraine
Number of cases
Out of 88 695 measles cases reported for 2018, 81 610 (92%) 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 07 February 2020

14. 14
Measles cases by month in the WHO European Region,
2016–2018
0
2000
4000
6000
8000
10000
12000
14000
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
2016
(n=5273)
2017
(n=25872)
2018
(n=88695)
Numberofcases
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 07 February 2020

15. 15
Measles cases and incidence by age group and vaccination
status in the WHO European Region, 2018*
*Age was unknown for 7 cases.
698
352
247
195
170
117
30
0
100
200
300
400
500
600
700
800
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
<1
(n=7696)
1–4
(n=16113)
5–9
(n=14116)
10–14
(n=10490)
15–19
(n=8776)
20–29
(n=13873)
30+
(n=17624)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence
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 07 February 2020

16. Rubella
Updates including 2019
16

17. 17
Five countries with the highest numbers of rubella cases in
the WHO European Region, January–December 2019
34
45
56
138
292
0 50 100 150 200 250 300 350
Russian
Federation
Turkey
Germany
Ukraine
Poland
Number of cases
Out of 628 rubella cases reported for January to December
2019, 565 (90%) 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 07 February 2020

18. 18
Rubella cases by month in the WHO European Region,
2017–December 2019
0
20
40
60
80
100
120
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
2017
(n=702)
2018
(n=838)
2019
(n=628)
Numberofcases
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 07 February 2020

19. Rubella
Latest update for 2018
19

20. 20
Five countries with the highest numbers of rubella cases in
the WHO European Region, 2018
20
22
58
235
437
0 50 100 150 200 250 300 350 400 450 500
Italy
Turkey
Germany
Ukraine
Poland
Number of cases
Out of 838 rubella cases reported for 2018, 772 (92%) 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 07 February 2020

21. 21
Rubella cases by month in the WHO European Region,
2016–2018
0
20
40
60
80
100
120
140
160
180
200
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
2016
(n=1322)
2017
(n=702)
2018
(n=838)
Numberofcases
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 07 February 2020

22. 22
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