Elimination of measles in the WHO European Region-challenges persist

Background: Measles incidence in the 53 Member States of the World Health Organization (WHO) European Region has fallen dramatically in recent decades. The European Regional Verification Commission for Measles and Rubella Elimination (RVC) verified that 43 member states had interrupted endemic measles transmission for ≥12 months by the end of 2017. However, measles incidence in the region increased sharply in 2018 compared to 2017. The purpose of this article is to assess the current status of measles in the Region in relation to its elimination goal. It also discusses challenges and actions needed to reach this goal.

Methods: Measles surveillance data presented for 2017 and 2018 (as of 1 February 2019) were submitted by all 53 member states. The measles elimination status of countries was obtained from the 2018 report of the seventh meeting of the RVC.

Results: In 2017, 25,863 measles cases were reported in 44 countries of the WHO European Region. In 2018, 82,596 measles cases were reported in 47 countries. Most cases were reported by Ukraine (64%) and Serbia (6%). Age was known in 82,588 cases: 8% were <1 year old, 17% were 1-4 years old, 38% were 5-19 years old and 37% were ≥20 years old. Data on vaccination status were provided for 76% of the cases, of which 62% were unvaccinated. Seventy-two measles-related deaths were reported from 10 countries.

Conclusions: For the elimination of measles in the European Region, a high population immunity rate and accurate epidemiological surveillance remain essential. Long-term political commitment by all Member States in these areas is crucial to attain the elimination goal.