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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, including outside the EU/EEA, and complements the Measles and Rubella Monthly Report. Data presented in the two monthly reports may differ.
Measles in April 2025
In April 2025, 29 countries reported measles data, with 975 cases reported by 18 countries. There were 11 countries that reported zero cases.
Overall, case numbers decreased compared with the previous month, however this is subject to change in the event of a future retrospective update. The highest case counts were reported by Romania (402), France (186), Netherlands (111), Belgium (100) and Spain (52).
Measles cases from 1 May 2024 to 30 April 2025
In the most recent 12-month period, from 1 May 2024 to 30 April 2025, 30 EU/EEA Member States reported a total of 22 481 cases of measles.
Between 1 May 2024 and 30 April 2025, of the 22 481 cases with known age, 9 852 (43.8%) were in children under five years of age; and 6 371 (28.3%) cases were aged 15 years or older. The highest notification rates were observed in infants under one year of age (768.3 cases per million) and children aged 1-4 years (424.4 cases per million).
Of 20 669 cases (100.0% of all cases) with a known age and vaccination status, 17 678 (85.5%) were unvaccinated, 1 851 (9.0%) were vaccinated with one dose of a measles-containing vaccine, 1 067 (5.2%) were vaccinated with two or more doses, and 43 (0.2%) were vaccinated with an unknown number of doses.
Fourteen deaths (case fatality rate (CFR): 0.1) attributable to measles were reported to ECDC during the 12-month period by Romania (12) and France (two) (Figure 4).
Rubella in April 2025
Of 29 countries who routinely report rubella data to ECDC, 27 countries reported rubella data for April 2025.
Overall, case numbers decreased compared with the previous month, however this is subject to change in the event of a future retrospective update. A total of five cases were reported by two countries (Italy and Poland) and 25 countries reported no cases.
From 1 May 2024 to 30 April 2025, 30 EU/EEA Member States reported a total of 136 cases of rubella. Zero deaths (case fatality rate (CFR): 0) attributable to rubella were reported to ECDC during the 12-month period 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 actions:
- Close immunity gaps, achieve and maintain high vaccination coverage for MCV (>95% with the second dose). It is vital to ensure first and second dose vaccinations are administered on time as per 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, including 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 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, isolated and difficult-to-reach populations 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, causing a generally mild illness with 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 May 2024 to 30 April 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 who reports aggregated data for measles (and no rubella data) and Poland who 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.
Additionally, 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 April 2025
In April 2025, 29 countries reported measles data, with 975 cases reported by 18 countries. There were 11 countries that reported zero cases.
Overall, case numbers decreased compared with the previous month, however this is subject to change in the event of a future retrospective update. The highest case counts were reported by Romania (402), France (186), Netherlands (111), Belgium (100) and Spain (52).
Figure 1. Number of measles cases by country, EU/EEA, 1 April 2025 to 30 April 2025 (n = 975)
Measles cases from 1 May 2024 to 30 April 2025
In the most recent 12-month period, from 1 May 2024 to 30 April 2025, 30 EU/EEA Member States reported a total of 22 481 cases of measles, 15 633 (69.5%) of which were laboratory confirmed (Table 1). During this 12-month period, four countries (Latvia, Finland, Iceland and Liechtenstein) reported zero cases. The highest number of cases were reported by Romania (17 815), Italy (887), France (798), Belgium (590) and Germany (557), accounting for 79.2, 3.9, 3.5, 2.6 and 2.5 percent of all cases, respectively (Table 1). Notification rates above the EU/EEA average of 49.4 cases per million population were reported by Romania (934.3) and Belgium (49.9) (Figure 3).
Table 1. Number of measles cases by month and notification rate per million population by country, EU/EEA, 1 May 2024 to 30 April 2025
Figure 2. Number of measles cases by month and year, EU/EEA, 1 January 2013 to 30 April 2025
