Measles and rubella monitoring – July 2014

Surveillance report
Publication series: Bi-annual measles and rubella monitoring report
Time period covered: July 2013 - June 2014

Suggested citation: European Centre for Disease Prevention and Control. Measles and rubella monitoring, July 2014 – Reporting on July 2013 – June 2014 surveillance data and epidemic intelligence data to the end of July 2014. 

​Measles and rubella are targeted for elimination in Europe by 2015. ECDC closely monitors progress towards interruption of endemic transmission of both diseases through enhanced surveillance and epidemic intelligence. Measles and rubella vaccinations are routinely delivered as trivalent measles-mumps-rubella (MMR) vaccine in Europe, and the first of the two recommended doses is normally given during the second year of life.

Executive summary


  • During the most recent 12-month period (July 2013 to June 2014) the 30 EU/EEA countries conducting measles surveillance reported 7 116 cases. Twenty-nine of the 30 contributing countries reported consistently for the 12-month period.
  • Germany, Italy and the Netherlands accounted for 77.3% of the cases in this period.
  • In ten countries, the measles notification rate was less than one case per million population during the last 12 months.
  • Of all cases, 51.8% tested positive for measles (serology, virus detection, or isolation). 
  • Of all cases, 93.1% had a known vaccination status and, of these 88.1% were unvaccinated. In the target group for routine childhood MMR vaccination (1–4-year old children), 76.8% of the cases were unvaccinated. 
  • One measles-related death was reported during the period July 2013 to June 2014, and one case was complicated by acute measles encephalitis. 
  • Since the previous bulletin, the outbreak in the Netherlands (The Hague) has been declared over and new outbreaks have been reported in Sweden and Belgium. 
  • Significant nosocomial transmission occurred in the three recent measles outbreaks reported from the Czech Republic, Latvia and Spain, demonstrating the continued presence of susceptible healthcare workers in EU Member States. 
  • Several of the outbreaks both worldwide and in EU Member States have a serological and epidemiological link to the large ongoing outbreak in the Philippines with 47 000 cases. 
  • Outside of the EU, there have been large outbreaks reported, some of them still ongoing, in the former Yugoslav Republic of Macedonia, Russia, Syria, Pakistan, USA, New Zealand, Australia, Japan, Vietnam and the Federated States of Micronesia. Several southern and eastern African countries also report measles outbreaks.


  • Twenty-eight EU/EEA countries reported 9 443 rubella cases during the most recent 12-month period between July 2013 and June 2014. Twenty five countries reported consistently for the 12-month period.
  • Rubella has recently been made a notifiable disease in Germany.
  • Poland accounted for 97.5% of all reported rubella cases in the 12-month period; 63.4% of these cases were either unvaccinated or had an unknown vaccination status.
  • Just over 1% of the cases tested positive for rubella.
  • In 21 countries the rubella notification rate was less than one case per million population during the last 12 months. 
  • No outbreaks have been detected by epidemic intelligence since the last report.