The document provides data on measles and rubella cases in the WHO European Region from April 2019 to March 2020. It shows that Ukraine had the highest number of measles cases, while Poland had the most rubella cases. Monthly case numbers of both diseases fluctuated throughout this period. Genetic sequencing data on measles virus strains is also presented. Overall the data aims to monitor trends in vaccine-preventable diseases in the region.

1. Vaccine-preventable Diseases and Immunization programme
Division of Health Emergencies and Communicable Diseases
Data as of 01 May 2020
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,
April 2019–March 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 2020. All rights reserved.
Top 10 countries
Country Cases
Ukraine 23322
Kazakhstan 10841
Uzbekistan 4936
Russian Federation 2724
Turkey 2543
France 2198
Romania 1477
Kyrgyzstan 1249
Bulgaria 1171
Italy 1134
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 01 May 2020

4. 4
Measles incidence per million population—
WHO European Region, April 2019–March 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 2020. All rights reserved.
Top 10 countries
Country Incidence
Kazakhstan 584.38
North Macedonia 531.33
Ukraine 530.12
Bosnia and Herzegovina 325.96
San Marino 295.33
Georgia 253.71
Kyrgyzstan 194.67
Bulgaria 167.28
Uzbekistan 149.66
Lithuania 102.91
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 01 May 2020

5. 5
Ten countries with the highest numbers of measles cases—
WHO European Region, April 2019–March 2020
1134
1171
1249
1477
2198
2543
2724
4936
10841
23322
0 5000 10000 15000 20000 25000
Italy
Bulgaria
Kyrgyzstan
Romania
France
Turkey
Russian Federation
Uzbekistan
Kazakhstan
Ukraine
Number of cases
Out of 59 328 measles cases reported for April 2019 to March 2020,
51 595 (87%) 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 01 May 2020

6. 6
Measles cases by month—WHO European Region,
2018–March 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
2018
(n=88693)
2019
(n=104431)
2020
(n=9341)
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 01 May 2020

7. 7
Measles genotypes by week of sample collection—
WHO European Region, week 14, 2017 to week 13, 2020
0
20
40
60
80
100
120
140
160
180
200
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15
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51
52
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52
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52
1
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5
6
7
8
9
10
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12
13
2017 2018 2019 2020
Numberofsequencesreported
Week of sample collection
H1 D4 D9 B3 D8
2017 2018 2019 2020
Data source: WHO measles nucleotide surveillance online database (MeaNS) data as of 01 May 2020

8. Measles
Latest update for 2019
8

9. 9
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 2020. All rights reserved.
Top 10 countries
Country Cases
Ukraine 57332
Kazakhstan 13326
Russian Federation 4167
Georgia 3920
Turkey 2890
France 2637
Kyrgyzstan 2303
North Macedonia 1884
Uzbekistan 1750
Romania 1728
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 01 May 2020

10. 10
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 2020. 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 01 May 2020

11. 11
Ten countries with the highest numbers of measles cases—
WHO European Region, 2019
1728
1750
1884
2303
2637
2890
3920
4167
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 104 431 measles cases reported for 2019, 91 937 (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 01 May 2020

12. 12
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=104431)
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 01 May 2020

13. 13
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=11593)
1–4
(n=18940)
5–9
(n=13166)
10–14
(n=9929)
15–19
(n=8165)
20–29
(n=16792)
30+
(n=25106)
Incidencepermillionpopulation
Numberofcases
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 01 May 2020

14. 14
Measles cases, MCV1 and MCV2 coverage by year—
WHO European Region, 2010–2019
Data source: 1) Measles cases – monthly aggregated and case-based data reported by Member States to WHO/Europe or via ECDC/TESSy as of 01 May 2020.
2) MCV1 and MCV2 coverage - WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2019.
MCV1: first dose of measles-containing vaccine
MCV2: second dose of measles-containing vaccine
30604
33254
26788
32857
18869
28413
5273
25872
88693
104431
93 94 95 95 94 94 93
95 95
80
82 83
89 89 89 88
90 91
0
20
40
60
80
100
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

15. Rubella
Updates including 2020
15

16. 16
Five countries with the highest numbers of rubella cases—
WHO European Region, April 2019–March 2020
28
47
49
97
254
0 50 100 150 200 250 300
Italy
Turkey
Germany
Ukraine
Poland
Number of cases
Out of 533 rubella cases reported for April 2019 to March 2020, 475
(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 01 May 2020

17. 17
Rubella cases by month—WHO European Region,
2018–March 2020
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
2018
(n=838)
2019
(n=633)
2020
(n=119)
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 01 May 2020

18. Rubella
Latest update for 2019
18

19. 19
Five countries with the highest numbers of rubella cases—
WHO European Region, 2019
34
45
57
142
292
0 50 100 150 200 250 300 350
Russian Federation
Turkey
Germany
Ukraine
Poland
Number of cases
Out of 633 rubella cases reported for 2019, 570 (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 01 May 2020

20. 20
Rubella cases by month—WHO European Region,
2017–2019
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=633)
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 01 May 2020

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