This document provides a summary of measles and rubella surveillance data in the WHO European Region from March 2018 to February 2019. It finds that over 100,000 measles cases were reported, with 92% occurring in 10 countries, led by Ukraine with over 72,000 cases. Measles incidence was highest in Ukraine, Georgia, and Albania. For rubella, over 800 cases were reported total, with 92% in 5 countries led by Poland and Ukraine. Overall the data monitors the ongoing measles and rubella situation in the WHO European Region.

1. Measles and rubella monthly update for the
WHO European Region
Data as of 28 March 2019
Vaccine-preventable Diseases and Immunization programme
Division of Health Emergencies and Communicable Diseases

2. Measles
Updates including 2019
2

3. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 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 2019. All rights reserved.
Measles cases in the WHO European Region, March 2018–February 2019
3
Top 10 countries
Country Cases
Ukraine 72408
Kazakhstan 3990
Israel 3541
Georgia* 3017
Serbia 2947
Italy 2498
France 2474
Russian Federation 2212
Kyrgyzstan 2043
Albania 1376
*Based on data from March 2018 to January 2019

4. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
Measles incidence per million population in the WHO European Region,
March 2018–February 2019
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
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 2019. All rights reserved.
4
Top 10 countries
Country Incidence
Ukraine 1645.29
Georgia* 772.18
Albania 468.93
Israel 418.91
Serbia 336.34
Kyrgyzstan 333.12
Montenegro 297.19
Kazakhstan 216.80
Slovakia 118.17
Greece 114.52
*Based on data from March 2018 to January 2019

5. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
1376
2043
2212
2474
2498
2947
3017
3541
3990
72408
0 10000 20000 30000 40000 50000 60000 70000 80000
Albania
Kyrgyzstan
Russian Federation
France
Italy
Serbia
Georgia
Israel
Kazakhstan
Ukraine
Number of cases
*
Ten countries with the highest numbers of measles cases in the WHO European
Region, March 2018–February 2019
Out of 105 266 measles cases reported for March 2018 to
February 2019, 96 506 (92%) cases were reported by these
10 countries.
5
*Based on data from March 2018 to January 2019

6. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
Measles cases by month in the WHO European Region, 2017–February 2019
6
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
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
2017
(n=25869)
2018
(n=83540)
2019
(n=34300)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

7. Measles genotypes by week of sample collection in the WHO European Region,
week 9, 2016 to week 8, 2019
7Data source: WHO measles nucleotide surveillance online database (MeaNS) data as of 28 March 2019
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180
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2016 2017 2018 2019
Numberofsequencesreported
Week of sample collection
D4 D9 B3 D8
2016 2017 2018 2019

8. Measles
Latest update for 2018
8

9. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 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 2019. All rights reserved.
Measles cases in the WHO European Region, 2018
9
Top 10 countries
Country Cases
Ukraine 53218
Serbia 5076
Israel 3140
France 2913
Italy 2686
Russian Federation 2256
Georgia 2203
Greece 2193
Romania 1471
Albania 1466

10. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
Measles incidence per million population in the WHO European Region, 2018
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
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 2019. All rights reserved.
10
Top 10 countries
Country Incidence
Ukraine 1209.25
Serbia 579.32
Georgia 563.84
Albania 499.60
Israel 371.47
Montenegro 322.62
Greece 196.82
Kyrgyzstan 179.85
Slovakia 104.96
Republic of Moldova 84.14

11. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
1466
1471
2193
2203
2256
2686
2913
3140
5076
53218
0 10000 20000 30000 40000 50000 60000
Albania
Romania
Greece
Georgia
Russian Federation
Italy
France
Israel
Serbia
Ukraine
Number of cases
Ten countries with the highest numbers of measles cases in the WHO European
Region, 2018
Out of 83 540 measles cases reported for 2018,
76 622 (92%) cases were reported by these 10 countries.
11

12. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
Measles cases by month in the WHO European Region, 2016–2018
12
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
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=25869)
2018
(n=83540)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

13. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
Measles cases and incidence by age group and vaccination status in the WHO
European Region, 2018*
13
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
*Age was unknown for 8 cases.
615
324
236
184 166
115
29
0
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700
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2000
4000
6000
8000
10000
12000
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16000
18000
20000
<1
(n=6639)
1-4
(n=14602)
5-9
(n=13365)
10-14
(n=9795)
15-19
(n=8465)
20-29
(n=13495)
30+
(n=17171)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

14. 14
Measles cases, MCV1 and MCV2 coverage by year in the WHO European Region,
2009–2018
Data source: 1) Measles cases – monthly aggregated and case-based data reported by Member States to WHO/Europe or via ECDC/TESSy as of 28 March 2019.
2) MCV1 and MCV2 coverage - WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 8 Nov 2018.
7884
30604
33254
26788
32857
18869
28413
5273
25869
83540
94 93 94 95 95 94 94 93
95
73
80
83 83
89 89 89 88
90
0
20
40
60
80
100
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
%Coverage
Year
Numberofcases
Measles cases MCV1 coverage MCV2 coverage
MCV1: first dose of measles-containing vaccine
MCV2: second dose of measles-containing vaccine

15. Rubella
Updates including 2019
15

16. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
16
22
54
218
440
0 50 100 150 200 250 300 350 400 450 500
Spain
Italy
Germany
Ukraine
Poland
Number of cases
Five countries with the highest numbers of rubella cases in the WHO European
Region, March 2018–February 2019
16
Out of 815 rubella cases reported for March 2018 to
February 2019, 750 (92%) cases were reported by
these 5 countries.

17. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
Rubella cases by month in the WHO European Region, 2017–February 2019
17
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
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
2017
(n=703)
2018
(n=850)
2019
(n=144)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

18. Rubella
Latest update for 2018
18

19. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
16
21
58
235
450
0 50 100 150 200 250 300 350 400 450 500
Turkey
Italy
Germany
Ukraine
Poland
Number of cases
Five countries with the highest numbers of rubella cases in the WHO European
Region, 2018
19
Out of 850 rubella cases reported for 2018, 780 (92%)
cases were reported by these 5 countries.

20. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 28 March 2019
Rubella cases by month in the WHO European Region, 2016–2018
20
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
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=703)
2018
(n=850)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

21. • 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
21
Links to measles and rubella information