Measles and rubella monitoring report, January - December 2013

Surveillance report
Publication series: Bi-annual measles and rubella monitoring report
Time period covered: 1 January - 31 December 2013

European Centre for Disease Prevention and Control. Measles and rubella monitoring, February 2014 – Reporting on January–December 2013 surveillance data and epidemic intelligence data to the end of February 2014. Stockholm: ECDC; 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 2013 a number of European countries experienced large measles and rubella outbreaks. The number of cases are unacceptably high given that measles and rubella are targeted for elimination in Europe by 2015. EU Member States are urged to accelerate their efforts to eliminate measles and rubella. The report covers surveillance data for the 12-month period to the end of December 2013 and the latest epidemiological information.

From February 2014, ECDC will publish the Measles and Rubella Monitoring Reports to the reports page quarterly, reporting on surveillance data from the previous 12 months and presenting the latest epidemic intelligence data. New to this report is the notification by age group for the five countries reporting most measles cases in Europe. Every month ECDC will update the number of cases in EU/EEA countries and the maps related to measles and rubella on its website.


During the most recent 12-month period, January 2013 to December 2013, 10 271 cases of measles were reported by the 30 EU/EEA countries conducting measles surveillance. The countries which reported most cases were Germany (17%), Italy (22%), the Netherlands (24%), Romania (10%) and the United Kingdom (18%) and together account for 91% of the cases in this period.

Vaccination status was known for 95% of the 10 268 cases reported with known age. Of these 9 708 cases, 88% (8 561 cases) were unvaccinated and 0.1% (7) had received two or more doses.

Over the last 12 months, three measles-related deaths were reported and eight cases were complicated by acute measles encephalitis.

In 2014, two outbreaks were reported in Finland and Austria in anthroposophic schools. The outbreak in the Netherlands, which started in 2013, is still ongoing but showing signs of slowing.

The notification rates by age group showed a very heterogeneous pattern between the countries, with Italy showing the highest incidence among adolescents between 15 and 29 years. Germany, Romania and UK showed the highest incidence in infants below the age of one, and the Netherlands reported the highest incidence in the age group between 5 and 14 years of age.



During the most recent 12-month period, January 2013 to December 2013, 38 847 rubella cases were reported. Poland accounted for 99% of these. A total of 23 572 cases (61%) were unvaccinated and 10 406 (27%) cases had an unknown vaccination status.


No rubella outbreaks have been detected by epidemic intelligence since the previous October report.