February 2020, 2/2020

1. Vaccine-preventable Diseases and Immunization programme
Division of Health Emergencies and Communicable Diseases
Data as of 05 March 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,
February 2019–January 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 43675
Kazakhstan 13002
Russian Federation 3800
Turkey 2975
Georgia 2830
France 2602
Uzbekistan 2070
Kyrgyzstan 1891
North Macedonia 1738
Romania 1517
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 05 March 2020

4. 4
Measles incidence per million population—WHO European
Region, February 2019–January 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
Ukraine 992.76
North Macedonia 834.19
Georgia 708.07
Kazakhstan 700.86
Bosnia and Herzegovina 424.42
San Marino 324.87
Kyrgyzstan 294.74
Lithuania 293.52
Bulgaria 187.71
Albania 142.66
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 05 March 2020

5. 5
Ten countries with the highest numbers of measles cases—
WHO European Region, February 2019–January 2020
1517
1738
1891
2070
2602
2830
2975
3800
13002
43675
0 5000 10000 15000 20000 25000 30000 35000 40000 45000 50000
Romania
North Macedonia
Kyrgyzstan
Uzbekistan
France
Georgia
Turkey
Russian Federation
Kazakhstan
Ukraine
Number of cases
Out of 87 620 measles cases reported for February 2019 to January 2020,
76 100 (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 05 March 2020

6. 6
Measles cases by month—WHO European Region,
2018–January 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 05 March 2020
0
2000
4000
6000
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10000
12000
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16000
18000
20000
Jan
Feb
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Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
2018
(n=88695)
2019
(n=104392)
2020
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible
(n=2450)

7. 7
Measles genotypes by week of sample collection—WHO
European Region, week 5, 2017 to week 4, 2020
Data source: WHO measles nucleotide surveillance online database (MeaNS) data as of 05 March 2020
0
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1
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4
2017 2018 2019 2020
Numberofsequencesreported
Week of sample collection
H1 D4 D9 B3 D8
2017 2018 2019 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 4154
Georgia 3920
Turkey 2890
France 2637
Kyrgyzstan 2303
North Macedonia 1884
Uzbekistan 1743
Romania 1709
Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 05 March 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 05 March 2020

11. 11
Ten countries with the highest numbers of measles cases—
WHO European Region, 2019
1709
1743
1884
2303
2637
2890
3920
4154
13326
57332
0 10000 20000 30000 40000 50000 60000 70000
Romania
Uzbekistan
North Macedonia
Kyrgyzstan
France
Turkey
Georgia
Russian Federation
Kazakhstan
Ukraine
Number of cases
Out of 104 392 measles cases reported for 2019, 91 898 (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 05 March 2020

12. 12
Measles cases by month—WHO European Region,
2017–2019
0
5000
10000
15000
20000
25000
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=104392)
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 05 March 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.
1062
416
229
181 158 145
42
0
200
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600
800
1000
1200
0
5000
10000
15000
20000
25000
30000
<1
(n=11585)
1–4
(n=18930)
5–9
(n=13155)
10–14
(n=9927)
15–19
(n=8164)
20–29
(n=16790)
30+
(n=25101)
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 05 March 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 05 March 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
88695
104392
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. 34
49
55
128
281
0 50 100 150 200 250 300
Russian Federation
Turkey
Germany
Ukraine
Poland
Number of cases
16
Five countries with the highest numbers of rubella cases—
WHO European Region, February 2019–January 2020
Out of 609 rubella cases reported for February 2019 to January
2020, 547 (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 05 March 2020

17. 17
Rubella cases by month—WHO European Region,
2018–January 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 05 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
2018
(n=838)
2019
(n=633)
2020
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible
(n=51)

18. Rubella
Latest update for 2019
18

19. 34
45
57
142
292
0 50 100 150 200 250 300 350
Russian Federation
Turkey
Germany
Ukraine
Poland
Number of cases
19
Five countries with the highest numbers of rubella cases—
WHO European Region, 2019
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 05 March 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 05 March 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