Around 90,000 cases of measles were reported in Europe in the first half of this year, which is more than the figure recorded for the whole of 2018 (84,462), the World Health Organization (WHO) has warned.

It said that while the WHO European region had been making steady progress towards the elimination of the disease, the number of countries that have achieved or sustained elimination has now declined.

This conclusion was reached by the European Regional Verification Commission for Measles and Rubella Elimination (RVC), which carried out an assessment of measles updates submitted by the 53 member states of the region.

The RVC highlighted the fact that for the first time since the verification process began in the region in 2014, four countries lost their measles elimination status - the UK, Greece, Albania and Czechia.

Measles is a highly contagious disease caused by a viral infection. It causes cold-like symptoms and a rash, but can also lead to more serious complications, such as breathing difficulties, pneumonia and acute encephalitis (inflammation of the brain).

The measles rash is made up of flat red or brown blothches. It usually starts on the forehead and moves downward over the face, neck and body. Other symptoms can include abdominal pain, vomiting and diarrhoea.

"Re-establishment of measles transmission is concerning. If high immunisation coverage is not achieved and sustained in every community, both children and adults will suffer unnecessarily and some will tragically die," commented the RVC's chairperson, Dr Günter Pfaff.

The RVC found that by the end of 2018, 35 countries were considered to have achieved or sustained measles elimination, compared to 37 in 2017. Twelve remained endemic for measles, while four that had previously eliminated it had re-established measles transmission.

The RVC also pointed out that the "surge" in measles cases that began in 2018 "has continued into 2019", with 89,994 cases reported in the first six months of this year. Almost 80% of these were reported in four countries - the Ukraine, Kazakhstan, Georgia and the Russian Federation.

In Ireland, 60 cases had been reported in the first six months of 2019, while 78 cases were reported for the whole of 2018.

Throughout the European region, almost 60% of cases in the first six months of this year occurred in children and teenagers up to 19 years of age, while the remainder were 20 or older.

The vaccination status was known in over 63,000 cases and among these, 62% were not vaccinated.

Meanwhile, over 54,000 people were hospitalised with the disease and there were 37 measles-related deaths reported in 11 countries, including Spain, Italy and Switzerland. Over half of these deaths occurred in children under 10 years of age.

The WHO said that it has classified the ongoing circulation of measles in the European region as a grade 2 emergency.

"Great efforts to control this highly contagious disease have brought us a long way towards regional elimination. However, ongoing measles outbreaks demonstrate that more is needed.

"Through activation of the emergency response, WHO has increased its focus on measles elimination and upgraded its action. This is the time and opportunity to address any underlying health system, social determinants and societal challenges that may have allowed this deadly virus to persist in this region," said the WHO's regional director for Europe, Dr Zsuzsanna Jakab.

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