The Resurgence of Measles: A Global Health Concern
Measles, a highly contagious viral disease once on the brink of eradication, is staging a concerning comeback across the globe. A recent report from the World Health Organization (WHO) and UNICEF highlights a dramatic surge in measles cases throughout Europe and Central Asia, reaching levels not seen in over two decades. This resurgence underscores the critical importance of vaccination efforts and the potential consequences of declining immunization rates.
The WHO report, released this week, reveals a stark reality: over 120,000 documented cases of measles were recorded in the European region in 2024. This region encompasses 53 countries spanning Europe and Asia, demonstrating the widespread nature of the outbreak. This figure represents a doubling of the cases reported in 2023 and marks the highest total recorded in the area since 1997, a clear indication of the disease’s alarming resurgence.
Measles is caused by a virus and is characterized by its high level of contagiousness. The availability of a safe and effective vaccine since the 1970s, typically administered as the combined measles, mumps, and rubella (MMR) vaccine, has been instrumental in controlling the disease. Ambitious vaccination programs have successfully driven measles to near eradication in numerous regions, including the United States and Europe.
In 2000, the U.S. officially declared the elimination of local measles transmission, a significant public health achievement. Similarly, the European region achieved a record low of 4,440 cases in 2016, demonstrating the power of widespread vaccination. However, measles remains endemic in areas with low vaccination rates and can rapidly resurge in communities where collective immunity, also known as herd immunity, falters. Achieving herd immunity requires approximately 95% of the population to be immunized against measles to prevent widespread transmission.
Since the 2016 low, measles has been steadily regaining ground in Europe. In 2018, the United Kingdom lost its measles-free status only two years after achieving it, a consequence of uncontrolled outbreaks. While the UK eventually regained this status in 2021, the episode highlighted the fragility of measles elimination efforts.
The COVID-19 pandemic further complicated the situation. While social distancing measures implemented to curb the spread of COVID-19 also inadvertently reduced the incidence of other infectious diseases, including measles, the pandemic simultaneously disrupted existing vaccination programs. Lockdowns, healthcare system strain, and vaccine hesitancy all contributed to decreased vaccination rates. As social lives returned to normal, and with vaccination coverage lagging, measles has seized the opportunity to re-establish itself in Europe and other parts of the world.
The 2023 figures served as a warning. Over 60,000 measles cases were reported in the European region in 2023, a number that WHO officials deemed "alarming" at the time. However, the situation has only worsened. In 2024, the region recorded a staggering 127,352 cases of measles, more than double the number reported the previous year. Worryingly, over 40% of these cases affected children under the age of five, who are particularly vulnerable to severe illness. Approximately half of the reported cases required hospitalization, and at least 38 measles-related deaths were recorded in the region during 2024.
These European cases represent a significant proportion of global measles cases, accounting for roughly one-third of the worldwide total. However, the true number of cases is likely even higher, as underreporting is a common issue in disease surveillance. The WHO previously estimated that 10 million people contracted measles in 2023, resulting in around 100,000 deaths. While measles typically presents with a characteristic rash and flu-like symptoms, the infection can sometimes lead to severe complications, such as encephalitis, a dangerous inflammation of the brain, or debilitating conditions like blindness.
"Measles is back, and it’s a wake-up call," stated Hans Henri P. Kluge, WHO Regional Director for Europe, emphasizing the gravity of the situation.
The resurgence of measles is not limited to Europe. The disease has also been re-establishing its presence in the United States, with higher-than-usual case numbers reported since last year. Currently, the virus is actively circulating in parts of Texas, New Mexico, and Oklahoma. Over 200 cases and two deaths have been linked to the same broad outbreak in these states, although the actual number is likely higher due to underreporting. Cases connected to this outbreak have also been reported in Mexico. The outbreak is primarily spreading within rural Mennonite communities, which often have low vaccination rates due to religious or cultural beliefs. At least ten other U.S. states have reported travel-related cases this year, demonstrating the potential for wider spread.
While the overall high vaccination rate in the U.S. reduces the risk of a nationwide measles epidemic, the presence of vulnerable pockets with low vaccination coverage creates the potential for large-scale outbreaks if the virus is introduced into those communities.
The global resurgence of measles highlights the critical importance of maintaining high vaccination rates. Stateside and beyond, the key to curbing this ancient disease is ensuring that people are both able and willing to get vaccinated.
"Without high vaccination rates, there is no health security. As we shape our new regional health strategy for Europe and central Asia, we cannot afford to lose ground. Every country must step up efforts to reach under-vaccinated communities," urged Kluge. "The measles virus never rests – and neither can we."
The fight against measles is an ongoing battle. The recent surge in cases serves as a stark reminder of the importance of sustained investment in vaccination programs, community engagement to address vaccine hesitancy, and robust disease surveillance systems. Only through collective action and a commitment to protecting vulnerable populations can we hope to eradicate this preventable disease and prevent further suffering.
