Measles and Rubella monthly report

Summary

This report provides an overview of measles and rubella cases reported to ECDC through Epipulse Cases. Measles and rubella cases are reported monthly, and data presented here are for the latest complete months of reporting alongside a historical comparison.

The CDTR (Communicable Disease Threats Report) provides the most recent data on cases and outbreaks based on information made publicly available by the national public health authorities or the media and also includes data for countries outside of the EU/EEA, and complements the Measles and Rubella Monthly Report. Data presented in the two monthly reports may differ.

Measles in August 2025

In August 2025, 27 countries reported measles data. Nine countries reported 96 cases and 18 countries reported zero cases.

Overall, case numbers decreased compared with the previous month, however this may be subject to change in the event of a future retrospective update. The highest case counts were reported by Romania (30), France (27), Poland (11) and Spain (nine).

Measles cases from 1 September 2024 to 31 August 2025

In the most recent 12-month period, from 1 September 2024 to 31 August 2025, 30 EU/EEA Member States reported a total of 10 825 measles cases.

Between 1 September 2024 and 31 August 2025, of the 10 825 cases with known age, 4 448 (41.1%) were in children aged under five years; and 3 461 (32.0%) cases were aged 15 years or above. The highest notification rates were observed in infants under one year of age (364.4 cases per million) and children aged 1-4 years (187.8 cases per million).

Of 10 129 cases (93.6% of all cases) with a known age and vaccination status, 8 403 (83.0%) were unvaccinated, 918 (9.1%) were vaccinated with one dose of a measles-containing vaccine, 676 (6.7%) were vaccinated with two or more doses, and 113 (1.1%) were vaccinated with an unknown number of doses.

During the 12-month period, eight deaths (case fatality rate (CFR): 0.074 %) attributable to measles were reported to ECDC by Romania (five), France (two) and Netherlands (one) (Figure 4).

Rubella in August 2025

Of 29 countries which routinely report rubella data to ECDC, 26 reported rubella data for August 2025.

Overall, case numbers increased compared with the previous month, however this may be subject to change in the event of a future retrospective update. A total of eight cases were reported by three countries (Greece, Poland and Finland) and 23 countries reported zero cases.

From 1 September 2024 to 31 August 2025, 30 EU/EEA Member States reported a total of 100 cases of rubella. During the 12-month period, zero deaths (case fatality rate (CFR) = 0.000%) attributable to rubella were reported to ECDC by any country.

ECDC recommendations

ECDC’s latest advice on measles is available in the Threat Assessment Brief ‘Measles on the rise in the EU/EEA: Considerations for a public health response’, published in February 2024 and the recommendations remain valid. The latest news item on measles was published in March 2025. ECDC recommends that public health authorities take the following action:

  • Close immunity gaps, achieve and maintain high vaccination coverage for measles-containing vaccine (>95% with the second dose). It is vital to ensure first and second dose vaccinations are administered on time, in accordance with national schedules, among children. It is also important to identify and vaccinate eligible individuals (for example, non-immune adolescents and young adults) in immunisation catch-up programmes (as recommended by local and national authorities).
  • Strive towards high-quality surveillance and adequate public health capacity, especially for early detection, diagnosis, response and control of outbreaks.
  • Increase the clinical awareness of health professionals, including reminding them of the importance of checking individuals’ vaccination status, particularly ahead of travel.
  • Healthcare professionals should be fully vaccinated.
  • Promote vaccine acceptance and uptake by employing specific risk communication strategies and identifying drivers of suboptimal measles-mumps-rubella (MMR) vaccine acceptance and uptake to ensure that tailored interventions are implemented in response.
  • Address barriers and engage with populations under-served by healthcare providers. Systemic barriers that impact vaccine uptake in under-served populations who may be isolated and difficult-to-reach need to be monitored and addressed with targeted strategies in order to reduce inequalities in vaccine uptake.

Introduction

Measles is an acute, highly contagious viral disease capable of causing epidemics. It is a serious disease that can lead to complications and even death. Infectivity is close to 100% in susceptible individuals. Immunisation has dramatically reduced the incidence of measles in Europe, but measles cases and outbreaks continue to be reported.

Rubella is also a highly contagious viral disease, generally causing a mild illness with a rash. The rationale for immunising against rubella is due to the high risk of congenital malformations associated with rubella infection during pregnancy. Congenital Rubella Syndrome (CRS) is characterised by a constellation of ophthalmologic, neurologic, cardiac and auditory anomalies. Immunisation against rubella started in Europe in the 1970s and has had a profound impact on the epidemiology of rubella and CRS.

The elimination of measles and rubella as well as the prevention of congenital rubella syndrome, forms part of a global elimination goal [1]. Progress towards elimination is being monitored on an annual basis through a European Regional Verification Commission for Measles and Rubella Elimination (RVC) established in 2011 [1]. Elimination of measles and rubella requires sustained overall immunisation coverage of more than 95% and maintenance of low levels of susceptibility across all subgroups of a population [1].

Data sources and notes

This surveillance report is based on measles and rubella data from Epipulse Cases for the reporting period 1 September 2024 to 31 August 2025. The number of measles and rubella cases reported to ECDC may be subject to retrospective change.

Data are submitted monthly by 30 European Union/European Economic Area (EU/EEA) countries for measles, and 29 EU/EEA countries for rubella (Belgium does not submit rubella data to Epipulse Cases). All countries routinely report case-based data for both measles and rubella, except Belgium which reports aggregated data for measles (and no rubella data) and Poland which reports case-based measles data, but aggregated rubella data.

In this report, possible, probable and confirmed cases are presented together, unless otherwise specified. EU case definitions are available for measles and rubella [2], however the definition used can vary by country. A summary of each country’s surveillance system, including the case definitions used, is available in the Surveillance Systems Overview Table [3]. Cases classified as discarded (see notes) are not included in the report.

Measles and rubella data are also published each month in the ECDC Surveillance Atlas of Infectious Diseases [4], an interactive tool providing access to additional tables and graphs not included in the report.

ECDC also monitors European measles and rubella outbreaks and global measles activity through epidemic intelligence and publishes updates in the Communicable Disease Threats Report (CDTR) on a weekly basis [5]. Where available, links to recent updates published by national public health authorities in the EU/EEA can be found in this report.

In addition, ECDC conducts risk assessments as significant outbreaks or public health events develop. A Threat Assessment Brief (‘Measles on the rise in the EU/EEA – Considerations for public health response’) was published by ECDC in February 2024 [6]. The most recent ECDC Rapid Risk Assessment on the risk of measles transmission in the EU/EEA was published in May 2019 [7].

Measles

Measles in August 2025

In August 2025, 27 countries reported measles data. Nine countries reported a total of 96 cases and 18 countries reported zero cases.

Overall, case numbers decreased compared with the previous month, however this may be subject to change in the event of a future retrospective update. The highest case counts were reported by Romania (30), France (27), Poland (11) and Spain (nine).

Figure 1. Number of measles cases by EU/EEA country, 1 August 2025 to 31 August 2025 (n = 96)

Measles cases from 1 September 2024 to 31 August 2025

In the most recent 12-month period, from 1 September 2024 to 31 August 2025, 30 EU/EEA Member States reported a total of 10 825 cases of measles, 7 738 (71.5%) of which were laboratory confirmed (Table 1). During this 12-month period, two countries (Iceland and Liechtenstein) reported zero cases. The highest number of cases were reported by Romania (7 076), France (897), Italy (595), Netherlands (534) and Spain (403), accounting for 65.4, 8.3, 5.5, 4.9 and 3.7 percent of all cases, respectively (Table 1). Notification rates above the EU/EEA average of 23.8 cases per million population were reported by Romania (371.1), Belgium (33.1), Netherlands (29.8), Ireland (27.5) and Cyprus (23.8) (Figure 3).

Table 1. Number of measles cases by month and notification rate per million population by EU/EEA country, 1 September 2024 to 31 August 2025

Figure 2. Number of measles cases by month and year, EU/EEA, 1 January 2013 to 31 August 2025

Figure 3. Measles notification rate (per million population) by EU/EEA country, 1 September 2024 to 31 August 2025

During the 12-month period, eight deaths (case fatality rate (CFR): 0.074%) attributable to measles were reported to ECDC by Romania (five), France (two) and Netherlands (one) (Figure 4).

Figure 4. Number of measles deaths by month and year, EU/EEA, 1 September 2024 to 31 August 2025

Between 1 September 2024 and 31 August 2025, of the 10 825 measles cases reported by EU/EEA countries, 572 (5.3%) were recorded as being imported, meaning the source of infection (exposure) was outside the reporting country. A further 227 (2.1%) were recorded as import-related – these cases were locally acquired but part of a chain of transmission linked to an imported case. There were 1 999 (18.5%) cases that were locally acquired (not imported) and 8 027 (74.2%) with unknown importation status. Overall, there were 15 countries in which ≥50% of the total reported cases were imported or import-related. Although there is variation in the proportion of imported cases by country, the majority of cases in the EU/EEA acquired measles through local/community transmission within the reporting country.

Of the 10 825 cases with known age, 4 448 (41.1%) were in children under five years; 3 461 (32.0%) cases were aged 15 years or above. The highest notification rates were observed among infants under one year of age (364.4 cases per million) and children aged 1-4 years (187.8 cases per million) (Table 2).

Table 2. Notification rate of measles cases (per million population) by age group, EU/EEA, 1 September 2024 to 31 August 2025

Figure 5. Number of measles cases by time (year and week) and by age group, EU/EEA, reported between 1 September 2024 and 31 August 2025

A total of 1 503 cases (12.9%) had an unknown vaccination status (Figure 6). The proportion of cases with unknown vaccination status was highest in adults above 30 years of age (623 of 1 503 cases; 33.7%). Of 10 129 cases (93.6% of all cases) with a known age and vaccination status, 8 403 (83.0%) were unvaccinated, 918 (9.1%) were vaccinated with one dose of a measles-containing vaccine, 676 (6.7%) were vaccinated with two or more doses, and 113 (1.1%) were vaccinated with an unknown number of doses.

Among 3 351 cases reported in the 1–4 years age group (the target age group of the first, and in certain countries second, dose[7]), 2 680 (80%) were unvaccinated, 383 (11.4%) were vaccinated with one dose of a measles-containing vaccine, 22 (0.7%) were vaccinated with two or more doses and 230 (6.9%) were vaccinated with an unknown number of doses.

Figure 6. Number of measles cases by age group and vaccination status, EU/EEA, 1 September 2024 to 31 August 2025

Figure 7. Proportion of measles cases by vaccination status and age, by EU/EEA country, 1 September 2024 to 31 August 2025

Infants under one year are particularly vulnerable to measles and its complications. They are best protected by a high level of herd immunity as in most EU/EEA countries the first dose of a measles-containing vaccine is given after 12 months of age in most EU/EEA countries [8].

Measles vaccination coverage in many countries remains suboptimal. Sustained coverage of at least 95% for two doses of a measles-containing vaccine at all subnational levels is recommended [1]. However, the latest WHO–UNICEF estimates of national immunisation coverage (for 2024) show that only four EU/EEA countries (Cyprus, Hungary, Iceland, Portugal) reported at least 95% vaccination coverage for both the first [9] and second [10] doses in 2024 (Figure 8; Figure 9; Table 3). If the elimination goal is to be reached, many countries need to make sustained improvements in the coverage of their routine childhood immunisation programmes as well as closing immunity gaps in adolescents and adults who have missed vaccination opportunities in the past [1].

Figure 8. Vaccination coverage for first dose of a measles-containing vaccine, EU/EEA, 2024 (Source: WHO, WUENIC)

Figure 9. Vaccination coverage for second dose of a measles-containing vaccine, EU/EEA, 2024 (Source: WHO, WUENIC)

Table 3. Vaccination coverage by dose, country and year, EU/EEA, 2019 to 2024 (Source: WHO, WUENIC)

Rubella

Rubella in August 2025

Of 29 countries who routinely report rubella data to ECDC, 26 reported rubella data for August 2025.

Overall, case numbers increased compared with the previous month, however this may be subject to change in the event of a future retrospective update. A total of eight cases were reported by three countries (Greece, Poland and Finland) and 23 countries reported zero cases.

Rubella cases from 1 September 2024 to 31 August 2025

From 1 September 2024 to 31 August 2025, 30 EU/EEA Member States reported a total of 100 cases of rubella, 12 (1.0%) of which were laboratory confirmed (Table 4). During this 12-month period, 21 countries (Czechia, Croatia, Denmark, Estonia, Austria, Latvia, Lithuania, Luxembourg, Malta, Ireland, Cyprus, Portugal, Romania, Slovenia, Slovakia, Norway, Iceland, Liechtenstein, Belgium, Hungary and Netherlands) reported zero cases. The highest number of cases were reported by Poland (84), Germany (six) and Sweden (four), accounting for 84.0, 6.0 and 4.0 percent of all cases, respectively (Table 4). Notification rates above the EU/EEA average of 0.2 cases per million population were reported by Poland (2.3) and Sweden (0.4).

Data from Poland should be interpreted with caution, as only three out of 84 cases (3.57%) were laboratory confirmed.

During the 12-month period, zero deaths (case fatality rate (CFR): 0.000%) attributable to rubella were reported to ECDC by any country.

Table 4. Number of rubella cases by month and notification rate (per million population) by country, EU/EEA, 1 September 2024 to 31 August 2025

Figure 10. Rubella notification rate (per million population) by EU/EEA country, 1 September 2024 to 31 August 2025

The latest WHO–UNICEF estimates of national immunisation coverage show that 10 EU/EEA countries reported at least 95% vaccination coverage for the first dose of a rubella-containing vaccine in 2024 [11]. Sustained vaccination coverage of at least 95% for a minimum of one dose of a rubella-containing vaccine at all subnational levels is recommended to achieve elimination [1].

References

  1. World Health Organization Regional Office for Europe (WHO/EURO). Eliminating measles and rubella in the WHO European Region: integrated guidance for surveillance, outbreak response and verification of elimination. Copenhagen: WHO Regional Office for Europe; 2024. Available from: https://www.who.int/europe/publications/i/item/9789289060783

  2. European Centre for Disease Prevention and Control (ECDC). EU case definitions [Internet]. Stockholm: ECDC; 2024 [cited 29 January 2024]. Available from: https://www.ecdc.europa.eu/en/all-topics/eu-case-definitions

  3. European Centre for Disease Prevention and Control (ECDC). Surveillance systems overview for 2022 [Internet]. Stockholm: ECDC; 2024 [cited 29 January 2024]. Available from: https://www.ecdc.europa.eu/en/publications-data/surveillance-systems-overview-2022

  4. European Centre for Disease Prevention and Control (ECDC). Surveillance Atlas of Infectious Diseases – Measles [Internet]. Stockholm: ECDC; 2024 [cited 29 January 2024]. Available from: https://atlas.ecdc.europa.eu/public/index.aspx?Dataset=335

  5. European Centre for Disease Prevention and Control (ECDC). Communicable disease threats reports [internet]. Stockholm: ECDC; 2024 [cited 29 January 2024]. Available from: https://www.ecdc.europa.eu/en/publications-and-data/monitoring/weekly-threats-reports

  6. European Centre for Disease Prevention and Control (ECDC). Threat assessment brief: Measles on the rise in the EU/EEA – Considerations for public health response. Stockholm: ECDC; 2024. Available from: https://www.ecdc.europa.eu/en/publications-data/threat-assessment-brief-measles-rise-eueea-considerations-public-health-response

  7. European Centre for Disease Prevention and Control (ECDC). Risk assessment: Who is at risk for measles in the EU/EEA? Identifying susceptible groups to close immunity gaps towards measles elimination – 28 May 2019. Stockholm: ECDC; 2019. Available from: https://www.ecdc.europa.eu/en/publications-data/risk-assessment-measles-eu-eea-2019

  8. European Centre for Disease Prevention and Control (ECDC). Vaccine Scheduler [Internet]. Stockholm: ECDC; 2024 [cited 29 January 2024]. Available from: http://vaccine-schedule.ecdc.europa.eu

  9. World Health Organization (WHO). WHO-UNICEF estimates of MCV1 coverage [Internet]. Geneva: WHO; 2024 [cited 30 July 2025]. Available from: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/measles-containing-vaccine-first-dose-(mcv1)-immunization-coverage-among-1-year-olds-(-)

  10. World Health Organization (WHO). WHO-UNICEF estimates of MCV2 coverage [Internet]. Geneva: WHO; 2024 [cited 30 July 2025]. Available from: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/measles-containing-vaccine-second-dose-(mcv2)-immunization-coverage-by-the-nationally-recommended-age-(-)

  11. World Health Organization (WHO). WHO-UNICEF estimates of RCV1 coverage [Internet]. Geneva: WHO; 2024 [cited 30 July 2025]. Available from: https://immunizationdata.who.int/pages/coverage/rcv.html?CODE=AUT+BEL+BGR+CYP+HRV+CZE+DEU+DNK+EST+GRC+ESP+FIN+FRA+HUN+IRL+ITA+LVA+LUX+MLT+NLD+NOR+POL+PRT+ROU+SWE+SVK+SVN+ISL+LTU&YEAR=

Notes

The European Surveillance System collects a ‘date used for statistics’, which is a date chosen by the country for reporting purposes. This date may indicate onset of disease, date of diagnosis, date of notification or date of laboratory confirmation, depending on reporting practices in the respective countries. All data presented in this report are based on the ‘date used for statistics’. In addition, when reporting data on measles, rubella and other vaccine-preventable diseases to Epipulse Cases, countries may update previously reported data. This means that the date of retrieval can influence the data presented in this report, as later retrievals of data relating to the same period may result in slightly different numbers. The data for this report were retrieved on 2 October 2025.

In this report and in the ECDC Surveillance Atlas of Infectious Diseases[4], an interactive tool offering the possibility to download data, a Member State will be listed as having not reported data for a particular month if they do not have a reporting period in Epipulse Cases that covers the entire month. As such, if a Member State either reports no data for a month or, in some cases, in a month but with an incomplete reporting period, the entire month is considered to have missing data. Similarly, if no cases occurred in a Member State in a given month, this needs to be reported to Epipulse Cases in order for zero cases to be included in these surveillance outputs.

Cases classified as discarded were suspected cases where subsequent investigation revealed a negative laboratory test, or confirmation of an alternative aetiology, supported by epidemiological and/or virological evidence.