Last reviewed: December 2018
Last updated: October  2018
11 Sep 2018

Measles infections hit record high in WHO European Region

The World Health Organization (WHO) has reported that more than 41,000 children and adults in the WHO European Region were infected with measles during the first 6 months of 2018, with reports indicating that at least 37 people died following measles infection during this period.

The WHO had previously reported that measles had rebounded in Europe; following a record low of 5273 measles infections in 2016, there was a fourfold increase in 2017, with 23,927 infections. Between January and June 2018, more than 41,000 infections were reported; this number far exceeds the annual total for every year since 2010.

Seven countries in the WHO European Region have reported over 1000 infections during this 6-month period: France, Georgia, Greece, Italy, the Russian Federation, Serbia, and Ukraine. The highest number of infections has been in Ukraine, with over 23,000 people affected, and the highest number of measles-related deaths has been in Serbia, with 14 deaths reported.

In addition to measures to reach those who have previously missed vaccinations, at least 95% immunisation coverage with 2 doses of measles-containing vaccine is needed every year in every community in order to prevent outbreaks. The WHO has called on all countries to immediately implement "broad, context-appropriate measures to stop further spread of this disease".

Original source of update



History and exam

Key diagnostic factors

  • potential exposure to measles
  • unimmunised or vaccine failure
  • fever
  • cough
  • coryza
  • conjunctivitis
  • Koplik's spots
  • maculopapular rash

Risk factors

  • exposure to measles virus
  • no prior immunisation against measles
  • failure to respond to measles vaccine

Diagnostic investigations

1st investigations to order

  • measles-specific IgM and IgG serology (ELISA)
Full details

Investigations to consider

  • acute and convalescent sera for measles-specific IgG and IgM
  • measles RNA detection by PCR
  • antigen detection by fluorescent antibody or PCR techniques
  • isolation of virus in tissue culture system
Full details

Treatment algorithm



Authors VIEW ALL

Professor of Pediatrics

Boston University School of Medicine

Boston Medical Center




EB has received grant funding to her institution for participation in clinical trials for PaxVax oral cholera vaccine. She has received royalties for writing for UptoDate (evaluation of newly arrived immigrants), AAP (parasitic disease treatment), and Elsevier (Immigrant Medicine). EB has received honoraria for consultancy for HostTherabiomics (travellers' diarrhoea), for speaking for Spire Learning (diarrhea), and for other CME talks (diarrhoea, vaccines).

Peer reviewers VIEW ALL

Associate Professor of Pediatrics

West Virginia University School of Medicine




LN is an author of a reference cited in this topic.

Assistant Professor of Medicine

Associate Residency Program Director

University of Chicago




AS declares that she has no competing interests.

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