Key points

  • A large epidemic of measles has affected the EU/EEA Member States in the past three years, with 44 074 cases reported to ECDC between 1/1/2016 and 31/3/2019
  • This is an exceptionally high number of cases compared to the previous three years (2012–2015).
  • Member States presented heterogeneous epidemiological profiles, proportion of susceptible individuals and vaccination coverage data over time.
  • Based on ECDC’s epidemiological assessment, there is a high risk of continued widespread circulation of measles in EU/EEA in the near future, as long as significant immunity gaps and suboptimal vaccination coverage remain.
  • The three of the main factors driving this risk are
    • A large pool of individuals susceptible to measles in the EU/EEA, due to low historical and current vaccination coverage
    • A high burden of measles among infants and adults, the groups at the highest risk of complications. EU/EEA cases have become older over the past ten years, with the median (interquartile range) age of cases increasing from 10 (2–18) years in 2009–10 to 17 (3–31) years in 2018–19. Adults aged 20 years and above represented 35% of reported cases in 2016–19, and nineteen countries have adults as the most affected age group. In 2016–19, the average annual notification rates were highest in infants, up to 44 times higher than the other age groups. Almost half (45%) of all measles deaths were reported in infants.
    • The continued potential of importations, which can worsen existing outbreaks or start new ones in communities where measles is not currently circulating and where immunity gaps persist. In 2016–2019 almost half (43%) of the cases imported into EU/EEA countries acquired their infection in another EU/EEA country, mainly those which were endemic for measles and/or experiencing large outbreaks.
  • Measles is a serious cross-border threat to health in the EU, even though most Member States are deemed to have interrupted endemic transmission. Re-establishment of transmission in these Member States is possible when vaccination coverage is suboptimal and immunity gaps remain.


The full report can be located here