Concern as measles cases doubled in Europe last year

Measles cases in the European region doubled to 127,350 in 2024, reaching the highest level in nearly three decades and leading to 38 deaths, according to data from the World Health Organization (WHO) and UNICEF.

The sharp rise is thought to be directly related to reduced vaccination coverage and comes shortly after two recent deaths in the US – involving an unvaccinated child and adult in Texas and New Mexico, respectively – amid an outbreak of measles in the American southwest.

Measles was considered eliminated as a public health concern in the US in 2000, but the rise of anti-vaccine scepticism means that more and more children are failing to get the routine measles, mumps, and rubella (MMR) immunisation to provide protection. That situation was exacerbated by lockdowns during the COVID-19 pandemic that interrupted immunisation programmes – and at least 95% of the population needs to be vaccinated to generate herd immunity.

Most people get better after contracting measles, but in a small proportion of patients it can lead to health complications like blindness and life-threatening conditions including pneumonia and meningitis. It can also damage the immune system by 'erasing' its memory of how to fight infections, leaving measles survivors vulnerable to other diseases.

According to the latest WHO and UNICEF data, Romania and Kazakhstan were the biggest hot spots in the region last year, with around 30,000 cases apiece, while there were almost 360,000 cases worldwide.

Cases of measles reached a low of 4,440 in 2016, but have been rising steadily since 2018, with spikes during and after the pandemic. However, the big concern is that vaccination rates in many countries have yet to return to pre-pandemic levels, raising the risk of outbreaks.

"Measles is back, and it's a wake-up call. Without high vaccination rates, there is no health security," commented Dr Hans Kluge, WHO Regional Director for Europe.

"As we shape our new regional health strategy for Europe and Central Asia, we cannot afford to lose ground," he added. "Every country must step up efforts to reach under-vaccinated communities. The measles virus never rests - and neither can we."

Worryingly, children under five accounted for more than 40% of the reported cases last year in the European region, which includes 53 countries in Europe and Central Asia, and more than half of the cases required hospitalisation.

"The fall in vaccination rates in the USA and in Europe in recent years is directly responsible for the current outbreaks of measles," commented Professor Sir Andrew Pollard, director of the Oxford Vaccine Group, University of Oxford.

"Just recently, a child died from this infection in Texas and we could expect that as many as 1 in 3,000 unvaccinated children with measles will succumb, and death rates are much higher among children with compromised immune systems and the malnourished," he added.

"Vaccination is able to provide a shield against measles for all of our children - if only we use it."