Declining trend in measles and rubella – good news and a reminder to continue efforts to achieve regional elimination

With far fewer cases reported in the first half of this year (1683) compared to the same period in 2015 (29 726), incidence of measles has dropped dramatically in the WHO European Region. Rubella also continues to fall, with 50% fewer cases so far in 2016 (736), largely due to a decrease in cases in Poland. Epidemiological data on measles and rubella for the first half of the year are now available in the WHO EpiData 2/2016.

Based on monthly reporting by Member States through WHO and the European Centre for Disease Control and Prevention (ECDC), the largest numbers of measles cases in the period January to June 2016 were reported by Italy, Romania and the United Kingdom with 437, 383 and 234 cases respectively. Among those countries with routine surveillance for rubella in place, the highest incidence continues to be in Poland, with 626 cases reported in the first half of the year.

Despite continuous progress, illustrated by interruption of endemic transmission of measles and/or rubella in 34 of the Region’s 53 Member States, the diseases continue to spread in remaining pockets of vulnerability. Considering the small number of reported cases in 2016, the epidemiological situation is promising but stepped up efforts to detect and investigate every suspected case, to stop the current chains of transmission and to reach the un- and underimmunized are required to prevent re-establishment where the viruses have been eliminated.

Measles outbreaks in the Region

In addition to routine monthly measles and rubella surveillance reports, measles outbreaks and clusters of cases were reported by Belgium, Ireland, Romania and Tajikistan in first six months of 2016.

In August 2016, WHO/Europe received a report of an ongoing measles outbreak in Brest city, Belarus. The first case had onset of disease on 10 July 2016, and so far 35 cases with clinical characteristics of measles have been detected, 14 of which have been laboratory confirmed. The measles virus genotype D8 Frankfurt Main was confirmed in some of the specimens. All cases are among the not immunized, and two-thirds are aged 1 to 9 years. In addition, all are citizens of Kyrgyzstan, Russian Federation or Tajikistan, who are temporarily situated in Brest, endeavoring to reach Poland. Active finding of cases and immunization of contacts is ongoing, and the national public health system of Belarus informed relevant counterparts in the cases’ countries of origin about the outbreak. WHO/Europe is in continuous contact with technical counterparts in Belarus, following this event.

The Regional Office is also following up on reported measles cases in asylum seeker centres in Germany. According to Robert Koch-Institut’s Epidemiologisches Bulletin 8. Aug 2016/ Nr. 31, the recent increase in the number of cases coincided with an increased number of asylum seekers arriving from Chechnya, the Russian Federation.

Assessing progress

The European Regional Verification Commission for Measles and Rubella Elimination (RVC) meets every year to assess progress towards the target of eliminating both measles and rubella from the European Region. In October 2015 it determined that 34 of the Region’s Member States have demonstrated interruption of endemic transmission of either or both diseases based on 2014 reporting. The Commission also recommended steps to be taken by those falling behind to also reach this goal. The next RVC meeting will be held in October 2016.

An overview and analysis of epidemiological data on measles and rubella in the WHO European Region is posted regularly in the WHO EpiBrief and WHO EpiData.