1) Measles cases in the WHO European Region increased in 2020, with over 12,000 cases reported compared to around 10,000 cases in 2019. The majority of cases occurred in 10 countries, led by Uzbekistan, Kazakhstan, and Russia. 2) For measles, the highest incidence rates per million were seen in Kazakhstan, Uzbekistan, and Kyrgyzstan. Children under 5 accounted for the majority of cases. 3) Rubella cases in the region decreased to 184 in 2020 from 629 in 2019, with over 90% occurring in 5 countries led by Poland.

1. Vaccine-preventable Diseases and Immunization programme
Division of country health programmes
Data as of 03 February 2021
Measles and rubella monthly update—
WHO European Region
www.euro.who.int

2. Measles
Updates including 2020
2

3. 3
Measles cases—WHO European Region,
January–December 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 may not yet be full agreement. © WHO 2021. All rights reserved.
Top 10 countries
Country Cases
Uzbekistan 4053
Kazakhstan 3269
Russian Federation 1100
Romania 976
Kyrgyzstan 708
Turkey 611
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 03 February 2021

4. 4
Measles incidence per million population—
WHO European Region, January–December 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 may not yet be full agreement. © WHO 2021. All rights reserved.
Top 10 countries
Country Incidence
Kazakhstan 174.10
Uzbekistan 121.10
Kyrgyzstan 108.52
Romania 50.73
Bulgaria 35.26
Tajikistan 17.61
Russian Federation 7.54
Turkey 7.24
Belgium 5.95
Ukraine 4.82
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 03 February 2021

5. 168
211
240
245
611
708
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
5
Ten countries with the highest numbers of measles cases—
WHO European Region, January–December 2020
Out of 12 205 measles cases reported for January to December
2020, 11 581 (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 03 February 2021

6. 6
Measles cases by month—WHO European Region,
2018–December 2020
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 03 February 2021
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=104443)
2020
(n=12205)
Number
of
cases
Month
Lab confirmed Epi linked Clinically compatible

7. 7
Measles cases and incidence by age group* and vaccination
status—WHO European Region, January–December 2020
*Age was unknown for 35 cases.
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 03 February 2021
391
71
18 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=4213)
1–4
(n=3200)
5–9
(n=1011)
10–14
(n=651)
15–19
(n=464)
20–29
(n=1062)
30+
(n=1569)
Incidence
per
million
population
Number
of
cases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

8. 30604
33254
26788
32857
18869
28413
5273
25872
88693
104445
12205
93 94 95 95 94 94 93
95 95 96
80
82 83
89 89 89 88
90 91 91
0
20
40
60
80
100
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
0
20000
40000
60000
80000
100000
120000
%
Coverage
Year
Number
of
cases
Measles cases MCV1 coverage MCV2 coverage
8
Measles cases, MCV1 and MCV2 coverage by year—
WHO European Region, 2010–December 2020
Data source: 1) Measles cases – monthly aggregated and case-based data reported by Member States to WHO/Europe or via ECDC/TESSy as of 03 February 2021.
2) MCV1 and MCV2 coverage - WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020.
MCV1: first dose of measles-containing vaccine
MCV2: second dose of measles-containing vaccine
*
*January–December 2020

9. 9
Measles genotypes by week of sample collection—
WHO European Region, week 1, 2018 to week 52, 2020
0
20
40
60
80
100
120
140
160
180
200
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
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
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
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
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
48
49
50
51
52
2018 2019 2020
Number
of
sequences
reported
Week of sample collection
H1 D4 D9 B3 D8
2018 2019 2020
Data source: WHO measles nucleotide surveillance online database (MeaNS) data as of 03 February 2021

10. Measles
Latest update for 2019
10

11. 11
Measles cases—WHO European Region, 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 2021. All rights reserved.
Top 10 countries
Country Cases
Ukraine 57332
Kazakhstan 13326
Russian Federation 4171
Georgia 3920
Turkey 2892
France 2637
Kyrgyzstan 2303
North Macedonia 1884
Uzbekistan 1750
Romania 1736
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 03 February 2021

12. 12
Measles incidence per million population—
WHO European Region, 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 2021. All rights reserved.
Top 10 countries
Country Incidence
Ukraine 1303.19
Georgia 980.79
North Macedonia 904.27
Kazakhstan 718.33
Bosnia and Herzegovina 424.42
Kyrgyzstan 358.95
San Marino 324.87
Lithuania 301.49
Bulgaria 178.14
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 03 February 2021

13. 13
Ten countries with the highest numbers of measles cases—
WHO European Region, 2019
1734
1750
1884
2303
2637
2892
3920
4171
13326
57332
0 10000 20000 30000 40000 50000 60000
Romania
Uzbekistan
North Macedonia
Kyrgyzstan
France
Turkey
Georgia
Russian Federation
Kazakhstan
Ukraine
Number of cases
Out of 104 443 measles cases reported for 2019, 91 949 (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 03 February 2021

14. 14
Measles cases by month—WHO European Region,
2017–2019
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=88693)
2019
(n=104443)
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 03 February 2021

15. 15
Measles cases and incidence by age group* and vaccination
status—WHO European Region, 2019
*Age was unknown for 740 cases.
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2019 Revision.
1063
416
229
181 158 145
42
0
200
400
600
800
1000
1200
0
5000
10000
15000
20000
25000
30000
<1
(n=11594)
1–4
(n=18942)
5–9
(n=13169)
10–14
(n=9930)
15–19
(n=8167)
20–29
(n=16794)
30+
(n=25107)
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 03 February 2021

16. Rubella
Updates including 2020
16

17. 17
Five countries with the highest numbers of rubella cases—
WHO European Region, January–December 2020
13
15
17
26
96
0 20 40 60 80 100 120
Italy
Turkey
Germany
Ukraine
Poland
Number of cases
Out of 184 rubella cases reported for January to December 2020,
167 (91%) 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 03 February 2021

18. 18
Rubella cases by month—WHO European Region,
2018–December 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=629)
2020
(n=184)
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 03 February 2021

19. Rubella
Latest update for 2019
19

20. 20
Five countries with the highest numbers of rubella cases—
WHO European Region, 2019
34
48
57
142
285
0 50 100 150 200 250 300
Russian Federation
Turkey
Germany
Ukraine
Poland
Number of cases
Out of 629 rubella cases reported for 2019, 566 (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 03 February 2021

21. 21
Rubella cases by month—WHO European Region,
2017–2019
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
2017
(n=702)
2018
(n=839)
2019
(n=629)
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 03 February 2021

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