epidemiology of measles

In 2018, the WHO estimated that there were around 353,236 cases of measles worldwide.{{Cite web |title=Measles outbreaks continue unabated : Five countries accounted for nearly half of all measles cases in 2018 |url=https://www.unicef.org/press-releases/measles-outbreaks-continue-unabated-five-countries-accounted-nearly-half-all-measles |access-date=2022-11-21 |website=www.unicef.org |language=en}} This has since decreased as in 2020 there were 159,000 approximate cases. Death from measles was reported in approximately 0.2% of the cases in the United States from 1985 through 1992.{{cite web|url=https://www.cdc.gov/vaccines/pubs/pinkbook/meas.html#complications|title=Epidemiology and Prevention of Vaccine-Preventable Diseases:Measles - Complications|date=July 24, 2015|access-date=August 14, 2018|archive-url=https://web.archive.org/web/20150207061223/http://www.cdc.gov/vaccines/pubs/pinkbook/meas.html#complications|archive-date=February 7, 2015|url-status=live|df=mdy-all}} In populations with high levels of malnutrition and a lack of adequate healthcare, mortality can be as high as 10%.[https://www.who.int/mediacentre/factsheets/fs286/en/ Measles] {{Webarchive|url=https://web.archive.org/web/20150203144905/http://www.who.int/mediacentre/factsheets/fs286/en/ |date=2015-02-03 }}, World Health Organization Fact sheet N°286. Retrieved June 28, 2012. Updated February 2014 Increased immunization has led to an estimated 78% drop in measles deaths among UN member states.{{cite web|url=https://www.un.org/millenniumgoals/reports.shtml|title=Millennium Development Goals Reports|publisher=United Nations|access-date=18 March 2013|archive-url=https://web.archive.org/web/20130326043201/http://www.un.org/millenniumgoals/reports.shtml|archive-date=26 March 2013|url-status=live|df=dmy-all}}{{cite web|url=https://www.who.int/mediacentre/factsheets/fs290/en/|title=Millennium Development Goals (MDGs), Fact Sheet N°290|date=May 2014|publisher=WHO|access-date=November 7, 2014|archive-url=https://web.archive.org/web/20141111123701/http://www.who.int/mediacentre/factsheets/fs290/en/|archive-date=November 11, 2014|url-status=live|df=mdy-all}}

Even in countries where vaccination has been introduced, vaccination rates may remain low due to parents choosing not to have their children vaccinated. In Ireland, vaccination was introduced in 1985. There were 99,903 cases that year. Within two years, the number of cases had fallen to 201, but this fall was not sustained. Measles is a leading cause of vaccine-preventable childhood mortality. Worldwide, the fatality rate has been significantly reduced by a vaccination campaign led by partners in the Measles Initiative: the American Red Cross, the United States Centers for Disease Control and Prevention (CDC), the United Nations Foundation, UNICEF and the WHO. Globally, measles fell 60% from an estimated 873,000 deaths in 1999 to 345,000 in 2005.{{Cite web |url=http://www.unicef.org/media/media_38076.html |title=UNICEF Joint Press Release |work=UNICEF |access-date=2015-02-04 |archive-url=https://web.archive.org/web/20150204152400/http://www.unicef.org/media/media_38076.html |archive-date=2015-02-04 |url-status=live }} Estimates for 2008 indicate deaths fell further to 164,000 globally, with 77% of the remaining measles deaths in 2008 occurring within the Southeast Asian region.WHO Weekly Epidemiology Record, 4th December 2009 [https://www.who.int/wer/2009/wer8449/en/index.html WHO.int] {{Webarchive|url=https://web.archive.org/web/20131026035711/http://www.who.int/wer/2009/wer8449/en/index.html |date=2013-10-26 }}

In 2006–07 there were 12,132 cases in 32 European countries: 85% occurred in five countries: Germany, Italy, Romania, Switzerland and the UK. 80% occurred in children and there were 7 deaths.{{cite news|url=https://www.nytimes.com/2009/01/13/health/13glob.html|title=Eradication Goal for Measles Is Unlikely, Report Says|author=McNeil, G.C.|date=January 12, 2009|newspaper=New York Times|access-date=May 3, 2013|archive-url=https://web.archive.org/web/20181125114226/https://www.nytimes.com/2009/01/13/health/13glob.html?_r=0|archive-date=November 25, 2018|url-status=live|df=mdy-all}}

Five out of six WHO regions have set goals to eliminate measles, and at the 63rd World Health Assembly in May 2010, delegates agreed a global target of a 95% reduction in measles mortality by 2015 from the level seen in 2000, as well as to move towards eventual eradication. However, no specific global target date for eradication has yet been agreed to as of May 2010.{{cite web|url=http://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_18-en.pdf|title=Sixty-third World Health Assembly Agenda provisional agenda item 11.15 Global eradication of measles|access-date=2 June 2010|archive-url=https://web.archive.org/web/20100329034005/http://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_18-en.pdf|archive-date=29 March 2010|url-status=live|df=dmy-all}}{{cite web|url=https://www.who.int/mediacentre/events/2010/wha63/journal4/en/index.html|title=Sixty-third World Health Assembly notes from day four|access-date=2 June 2010|archive-url=https://web.archive.org/web/20100526133925/http://www.who.int/mediacentre/events/2010/wha63/journal4/en/index.html|archive-date=26 May 2010|url-status=dead|df=dmy-all}}

On January 22, 2014, the World Health Organization and the Pan American Health Organization declared and certified Colombia free of the measles while becoming the first Latin American country to abolish the infection within its borders.{{Cite web |url=http://www.eltiempo.com/vida-de-hoy/salud/colombia-libre-de-sarampion-y-rubeola_13396295-4 |title=Colombia, libre de sarampión y rubéola - Noticias de Salud, Educación, Turismo, Ciencia, Ecología y Vida de hoy - ELTIEMPO.COM |date=22 January 2014 |access-date=2015-02-04 |archive-url=https://web.archive.org/web/20140202092818/http://www.eltiempo.com/vida-de-hoy/salud/colombia-libre-de-sarampion-y-rubeola_13396295-4 |archive-date=2014-02-02 |url-status=live }}{{Cite web |url=http://www.elespectador.com/noticias/salud/colombia-fue-declarada-libre-de-sarampion-y-rubeola-articulo-470243 |title=Colombia fue declarada libre de sarampión y rubéol {{!}} ELESPECTADOR.COM |access-date=2015-02-04 |archive-url=https://web.archive.org/web/20150523025604/http://www.elespectador.com/noticias/salud/colombia-fue-declarada-libre-de-sarampion-y-rubeola-articulo-470243 |archive-date=2015-05-23 |url-status=live }}

In 2018, The WHO tells us the global annual incidence was about 46 million. During this time, the African Region reported the most cases, about 40%, seen primarily from Nigeria, and Eastern Mediterranean regions. In these specific areas, the incidence was greatly seen in those less than one year old. Studies show that about 95% were immune by 15 years old, making it increasingly common for the incidence of measles to occur in young children.{{Cite journal |last=Minal K Patel, Sebastien Antoni, Yoann Nedelec, Samir Sodha, Lisa Menning, Ikechukwu U Ogbuanu, Marta Gacic Dobo |date=1 October 2020 |title=The Changing Global Epidemiology of Measles |url=https://academic.oup.com/jid/article/222/7/1117/5782424?login=false |journal=The Journal of Infectious Diseases |volume=222 |issue=7 |via=IDSA}}

Cases reported in the first three months of 2019 were 300% higher than in the first three months of 2018, with outbreaks in every region of the world, even in countries with high overall vaccination coverage where it spread among clusters of unvaccinated people.{{cite news |title=New measles surveillance data for 2019 |url=https://www.who.int/immunization/newsroom/measles-data-2019/en/ |access-date=4 June 2019 |publisher=WHO |date=15 April 2019}}

Through the recent improvement of decreasing measles incidence and mortality rates across the world, recently there has been setbacks. Since 2000, the MCV coverage around the world has decreased and the total cases of measles has increased from 132,490 in 2016, to 869,700 in 2019.{{Cite journal |last1=Gastañaduy |first1=Paul A |last2=Goodson |first2=James L |last3=Panagiotakopoulos |first3=Lakshmi |last4=Rota |first4=Paul A |last5=Orenstein |first5=Walt A |last6=Patel |first6=Manisha |date=2021-09-30 |title=Measles in the 21st Century: Progress Toward Achieving and Sustaining Elimination |url=https://academic.oup.com/jid/article/224/Supplement_4/S420/6378081 |journal=The Journal of Infectious Diseases |language=en |volume=224 |issue=Supplement_4 |pages=S420–S428 |doi=10.1093/infdis/jiaa793 |issn=0022-1899 |pmc=8482021 |pmid=34590128}} Though many countries have eliminated measles, several countries have discovered new cases in 2019. Growing concern has been generating in increase cases of measles as incidence in measles have increased in recent years due to anti-vaccination movements due to religion and politics.{{Cite journal |last1=Misin |first1=Andrea |last2=Antonello |first2=Roberta Maria |last3=Di Bella |first3=Stefano |last4=Campisciano |first4=Giuseppina |last5=Zanotta |first5=Nunzia |last6=Giacobbe |first6=Daniele Roberto |last7=Comar |first7=Manola |last8=Luzzati |first8=Roberto |date=2020-02-18 |title=Measles: An Overview of a Re-Emerging Disease in Children and Immunocompromised Patients |journal=Microorganisms |volume=8 |issue=2 |pages=276 |doi=10.3390/microorganisms8020276 |issn=2076-2607 |pmc=7074809 |pmid=32085446|doi-access=free }}

Measles eradication has been challenging for many countries to maintain herd immunity. Due to political unrest, economic challenges, and accessibility to healthcare and proper vaccinations achieving proper vaccination levels in developing countries has halted. Another challenge faced worldwide is vaccination hesitancy. The World Health Organization and Centers for Disease Control and Prevention have listed this is a top ten challenge to global health in reducing the incidence of measles.{{Cite web |title=UNICEF and WHO warn of perfect storm of conditions for measles outbreaks, affecting children |url=https://www.who.int/news/item/27-04-2022-unicef-and-who-warn-of--perfect-storm--of-conditions-for-measles-outbreaks--affecting-children |access-date=2022-11-21 |website=www.who.int |language=en}}

In April 2020, the WHO indicated that many countries had started suspending their measles vaccination programs due to the impact of the COVID-19 pandemic. It is projected that 117 million children will be at risk of infection.{{cite news |url=https://www.spiegel.de/wissenschaft/medizin/unicef-warnt-vor-corona-folgen-117-millionen-kindern-droht-ansteckung-mit-masern-a-31b61755-8e57-4b87-b16d-39360efc3c30| title=117 Millionen Kindern droht Ansteckung mit Masern |newspaper=Der Spiegel| date=14 April 2020 |access-date=April 14, 2020}} Currently all 194 countries have started to routinely vaccinate children with the MCV vaccine, and 122 countries have included the MMR into their routine child immunization schedules.

As measles contagion is high, it can spread rapidly through the population. The incubation period for measles is 10–12 days,{{Cite web |title=Factsheet about measles |url=https://www.ecdc.europa.eu/en/measles/facts |access-date=2022-12-11 |website=European Centre for Disease Prevention and Control |date=24 February 2017 |language=en}} and is characterized by seasonal epidemics, and spreads quickly against non-vaccinated persons. Measles is quite uncommon in populations of highly vaccinated areas, yet when it does occur, it is more commonly seen in adults.

The development of the measles vaccine has been vital in reducing outbreaks. Without a measles vaccine, measles epidemics could happen every 2 to 5 years and last up to 3 to 4 months at a time.

Commonly outbreaks in one country spread to others and this can be traced by close examination of the virus DNA. As of 2020 measles is widespread and there have been over the last decade many outbreaks in areas that were formerly declared measles free. See below for individual countries by continent.

Some examples of measles spreading between countries are:

• As of May 2011, over 17,000 cases of measles had so far been reported from France between January 2008 and April 2011, including 2 deaths in 2010 and 6 deaths in 2011.

{{cite web

|author=Département des maladies infectieuses

|title=Epidémie de rougeole en France. Actualisation des données au 20 mai 2011

|publisher=Institut de veille sanitaire

|url=http://www.invs.sante.fr/surveillance/rougeole/Point_rougeole_200511.pdf

|access-date=2015-02-04

|archive-url=http://webarchive.loc.gov/all/20110810210658/http://www.invs.sante.fr/surveillance/rougeole/Point_rougeole_200511.pdf

|archive-date=2011-08-10

|url-status=dead

}}

Over 7,500 of these cases fell in the first three months of 2011, and Spain, Turkey, Macedonia, and Belgium have been among the other European countries reporting further smaller outbreaks.{{cite report|date=May 2011|title=WHO Epidemiological Brief|url=http://www.euro.who.int/__data/assets/pdf_file/0003/142176/WHO_EPI_Brief__May_2011e.pdf|publisher=World Health Organization (WHO)|access-date=2015-02-04|archive-url=https://web.archive.org/web/20150924013934/http://www.euro.who.int/__data/assets/pdf_file/0003/142176/WHO_EPI_Brief__May_2011e.pdf|archive-date=2015-09-24|url-status=live}} The French outbreak has been specifically linked to a further outbreak in Quebec in 2011, where 327 cases have been reported between January and June 1, 2011,{{cite report|date=March 21, 2012|title=Final report of the provincial outbreak of measles in 2011|url=http://www.msss.gouv.qc.ca/sujets/prob_sante/rougeole/portrait2011.php|publisher=Santé et Services sociaux Québec|access-date=February 4, 2015|archive-url=https://web.archive.org/web/20150102163035/http://www.msss.gouv.qc.ca/sujets/prob_sante/rougeole/portrait2011.php|archive-date=January 2, 2015|url-status=dead|df=mdy-all}} and the European outbreaks in general have also been implicated in further small outbreaks in the US, where 40 separate importations from the European region had been reported between January 1 and May 20.{{cite journal | title = Measles: United States, January–May 20, 2011 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 60 | issue = 20 | pages = 666–8 | date = May 2011 | pmid = 21617634 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6020a7.htm | author1 = Centers for Disease Control Prevention (CDC) | access-date = September 9, 2017 | archive-url = https://web.archive.org/web/20170717190709/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6020a7.htm | archive-date = July 17, 2017 | url-status = live | df = mdy-all }}

• In 2014 many unvaccinated US citizens visiting the Philippines, and other countries, contracted measles, resulting in 288 cases being recorded in the United States in the first five months of 2014, a twenty-year high.{{cite news|title=288 cases of measles reported in US in five months|url=http://www.washingtondcnews.net/index.php/sid/222436243/scat/3a8a80d6f705f8cc/ht/288-cases-of-measles-reported-in-US-in-five-months|archive-url=https://archive.today/20140530111930/http://www.washingtondcnews.net/index.php/sid/222436243/scat/3a8a80d6f705f8cc/ht/288-cases-of-measles-reported-in-US-in-five-months|url-status=dead|archive-date=30 May 2014|access-date=29 May 2014|publisher=Washington DC News.Net}} In Vietnam, in the measles epidemic in the beginning of 2014, as of April 19 there were 8,500 measles cases and 114 fatalities,{{cite web|url=http://www.thanhniennews.com/health/vietnam-minister-calls-for-calm-in-face-of-8500-measles-cases-114-fatalities-25423.html|title=Vietnam minister calls for calm in face of 8,500 measles cases, 114 fatalities | Health | Thanh Nien Daily|date=18 April 2014|publisher=Thanhniennews.com|access-date=2014-04-19|archive-url=https://web.archive.org/web/20140418220953/http://www.thanhniennews.com/health/vietnam-minister-calls-for-calm-in-face-of-8500-measles-cases-114-fatalities-25423.html|archive-date=2014-04-18|url-status=dead}} and as of May 30 there were 21,639 measles cases and 142 fatalities.{{cite web|url=http://tuoitre.vn/Chinh-tri-Xa-hoi/610133/bo-y-te--vn-da-phan-ung-rat-nhanh-doi-voi-dich-soi.html|title=Bộ Y tế: "VN đã phản ứng rất nhanh đối với dịch sởi"|date=30 May 2014 |archive-url=https://web.archive.org/web/20140531233458/http://tuoitre.vn/Chinh-tri-Xa-hoi/610133/bo-y-te--vn-da-phan-ung-rat-nhanh-doi-voi-dich-soi.html|archive-date=2014-05-31}}
• The increase of measles in January and February 2022 sparked concern due to the COVID-19 pandemic and the displacement of millions due to conflict crises. This includes Ukraine, Ethiopia, Somalia, and Afghanistan as this disrupts the routine immunization schedule and the primary focus is the safety of citizens.

It has proven difficult to vaccinate a sufficient number of children in Europe to eradicate the disease, because of opposition on philosophical or religious grounds, or fears of side-effects, or because some minority groups are hard to reach, or simply because parents forget to have their children vaccinated. Vaccination is not mandatory in some countries in Europe, in contrast to the United States and many Latin American countries, where children must be vaccinated before they enter school.{{cite journal | author = Kupferschmidt K | title = Europe's Embarsssing Problem | journal = Science | volume = 336 | issue = 6080 | pages = 406–7 | date = 27 April 2012 | pmid = 22539695 | doi = 10.1126/science.336.6080.406 }}

{{see also|2019–2020 measles outbreak in the Democratic Republic of the Congo}}

In January 2020, the World Health Organization announced that the death toll from the measles outbreak in the Democratic Republic of the Congo had reached 6,000, triple that of Ebola. 310,000 cases have been reported since 2019. US $27.6 million has been spent, but $40 million more is needed.[https://apnews.com/29e06f31c05690b1f5af167c54123050 WHO: Death toll from measles outbreak in Congo hits 6,000] AP, Jan 7, 2020

In 2019, 1,200 had died of measles in an outbreak in Madagascar.{{Cite web|url=https://www.ctvnews.ca/health/measles-parties-are-a-terrible-idea-experts-warn-1.4379487|title='Measles parties' are a 'terrible idea,' experts warn|last=Dehaas|first=Josh|website=ctvnews|date=14 April 2019|language=en|access-date=2019-04-15|archive-url=https://web.archive.org/web/20190415001447/https://www.ctvnews.ca/health/measles-parties-are-a-terrible-idea-experts-warn-1.4379487|archive-date=2019-04-15|url-status=live}}

Beginning in September 2009, Johannesburg, South Africa reported about 48 cases of measles. Soon after the outbreak, the government ordered all children to be vaccinated. Vaccination programs were then initiated in all schools, and parents of young children were advised to have them vaccinated.{{cite web

|url=http://www.news24.com/Content/SouthAfrica/News/1059/42cd42bfbe5545f8bccdfce63c0db184/29-09-2009-11-01/Measles_outbreak_in_Joburg

|title=Measles Outbreak In Joburg

|access-date=2015-02-04

|archive-url=https://web.archive.org/web/20100106174832/http://www.news24.com/Content/SouthAfrica/News/1059/42cd42bfbe5545f8bccdfce63c0db184/29-09-2009-11-01/Measles_outbreak_in_Joburg

|archive-date=2010-01-06

|url-status=dead }} Many people were not willing to have the vaccination done, as it was believed to be unsafe and ineffective. The Health Department assured the public that their program was indeed safe. Speculation arose as to whether or not new needles were being used.{{cite web

|url=http://www.theinternationalonline.com/articles/98-childhood-vaccinations-peak-in-2009-but

|title=Childhood Vaccinations Peak In 2009, But Uneven Distribution Persists

|access-date=2015-02-04

|archive-url=https://web.archive.org/web/20100809104715/http://www.theinternationalonline.com/articles/98-childhood-vaccinations-peak-in-2009-but

|archive-date=2010-08-09

|url-status=dead }} By mid-October, there were at least 940 recorded cases, and four deaths.{{cite web

|url=http://news24.com/Content/SouthAfrica/News/1059/54adfc32c0904c0ba92f92b021d68b3a/21-10-2009-11-27/Measles_vaccinations_safe

|title=Measles Vaccination 'safe'

|access-date=2015-02-04

|archive-url=https://web.archive.org/web/20091027080100/http://www.news24.com/Content/SouthAfrica/News/1059/54adfc32c0904c0ba92f92b021d68b3a/21-10-2009-11-27/Measles_vaccinations_safe

|archive-date=2009-10-27

|url-status=dead}}

By 2020, South Africa eliminated measles outbreaks as there was less than one case per million citizens in the population in 2015, 2016, and 2020.{{Cite journal

|last1=Yousif |first1=Mukhlid

|last2=Hong |first2=Heather

|last3=Malfeld |first3=Susan

|last4=Smit |first4=Sheilagh

|last5=Makhathini |first5=Lillian

|last6=Motsamai |first6=Tshepo

|last7=Tselana |first7=Dipolelo

|last8=Manamela |first8=Morubula

|last9=Kamupira |first9=Mercy

|last10=Maseti |first10=Elizabeth

|last11=Ranchod |first11=Heena

|last12=Otwombe |first12=Kennedy

|last13=McCarthy |first13=Kerrigan

|last14=Suchard |first14=Melinda

|date=2022-08-30

|title=Measles incidence in South Africa: a six-year review, 2015-2020

|journal=BMC Public Health

|volume=22

|issue=1

|pages=1647

|doi=10.1186/s12889-022-14069-w

|issn=1471-2458

|pmc=9427172

|pmid=36042453

|doi-access=free}}

An outbreak started in September 2022,{{Cite web

|url=https://www.nicd.ac.za/measles-outbreak-alert-greater-sekhukhune-district-11-october-2022/

|title=Measles outbreak alert - Greater Sekhukhune District

|date=2022-10-13

|publisher=National Institute for Communicable Diseases

|location=South Africa

|access-date=2023-04-04}} the strain being genotype D8 - similar to the 2022 outbreak strain in Zimbabwe.{{Cite web

|url=https://www.nicd.ac.za/south-african-measles-outbreak-update-2023-31-march/

|title=South African Measles Outbreak Update 2023

|date=2023-03-31

|publisher=National Institute for Communicable Diseases

|location=South Africa

|access-date=2023-04-04}} By October 2023 there were 1199 confirmed positive tests from 7054 serum samples, with most cases in the Limpopo province.{{Cite web

|url=https://www.nicd.ac.za/measles-outbreak-update-02-october/

|title=South African Measles Outbreak Update 2023 (02 October 2023)

|date=2023-10-02

|publisher=National Institute for Communicable Diseases

|location=South Africa

|access-date=2023-10-09}}

In April 2022 cases were reported from the village of Makabvepi near the border with Mozambique, with child deaths from families that belonged to the Johane Marange Apostolic Church whose large Easter service and then a Passover celebration spread measles across the country. The church publicly opposed vaccination and is closely aligned with President Emmerson Mnangagwa who attended the Passover gathering. Vaccine hesitancy was amplified by churches discouraging immunization and urging members to rely on prayer and the intercession of pastors instead. {{As of|2022|09|06}}, there were more than 6500 reported cases and 704 deaths.{{Cite web

|url=https://www.nytimes.com/2022/09/24/health/measles-outbreak-zimbabwe.html

|title=More Than 700 Children Have Died in a Measles Outbreak in Zimbabwe

|last1=Marima |first1=Tendai

|last2=Nolen |first2=Stephanie

|last3=Moyo |first3=Jeffrey

|date=2022-09-24

|publisher=NY Times

|access-date=2023-10-09}}

Indigenous measles was declared to have been eliminated in North, Central, and South America; the last endemic case in the region was reported on November 12, 2002, with only northern Argentina and rural Canada, particularly in Ontario, Quebec, and Alberta, having minor endemic status.[http://www.insidetoronto.ca/News/NorthYork/article/48756 North York: Measles outbreak may bring new strategy]{{dead link|date=December 2016 |bot=InternetArchiveBot |fix-attempted=yes }}, May 2008 Outbreaks are still occurring, however, following importations of measles viruses from other world regions. In June 2006, an outbreak in Boston resulted after a resident became infected in India.{{cite news |url=http://www.boston.com/yourlife/health/diseases/articles/2006/06/10/measles_outbreak_shows_a_global_threat/ |title=Measles outbreak shows a global threat|journal=The Boston Globe |access-date=2007-12-05 |date=2006-06-10 |first1=Stephen |last1=Smith |archive-url=https://web.archive.org/web/20070311193551/http://www.boston.com/yourlife/health/diseases/articles/2006/06/10/measles_outbreak_shows_a_global_threat/ |archive-date=2007-03-11 |url-status=live }}

File:Measles Canada 1924-2018.png

Canadian data since 1924 shows measles outbreaks occurring frequently until the large vaccination campaigns in the 1970s. The 1935 epidemic stands out during this early period, with 83,000 reported cases (770 cases per 100,000 population); the highest number of fatalities occurring in 1926, with 892. Immunization programs became widely spread during the 1970s, with an estimated 85% of the target population receiving one dose of vaccination by the end of the decade. However, the frequent recurrence of significant outbreaks (including 6,178 cases in 1991 alone) showed Canada's 1-dose strategy was lacking, even with provinces requiring immunization for school attendance. Two-dose MMR programs and catch-up campaigns were widely introduced in 1996-1997.{{Cite journal |last1=King |first1=Arlene |last2=Varughese |first2=Paul |last3=De Serres |first3=Gaston |last4=Tipples |first4=Graham A. |last5=Waters |first5=John |date=1 May 2004 |title=Measles Elimination in Canada |url=https://www.jstor.org/stable/30075860 |journal=The Journal of Infectious Diseases |volume=189 |issue=1 |pages=S236–S242 |doi=10.1086/378499 |jstor=30075860|pmid=15106117 }}

The Canadian government defines endemic measles as a situation where a chain of transmission continues uninterrupted for 12 months.[http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/13vol39/acs-dcc-3/assets/pdf/meas-roug-eng.pdf Guidelines for the Prevention and Control of Measles Outbreaks in Canada] {{Webarchive|url=https://web.archive.org/web/20150924090744/http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/13vol39/acs-dcc-3/assets/pdf/meas-roug-eng.pdf |date=2015-09-24 }}, Canada Communicable Disease Report, Endorsed by Chief Medical Officers of Heath, 2 November 2012 By this standard, Canada has been free of endemic measles since 1998, but sporadic imported outbreaks have continued.

Southern regions of the province of Quebec witnessed a measles outbreak affecting 94 persons in the Spring and summer 2007. The outbreak lasted 25 weeks, included more than one strain of the measles virus and had 12-17 generations of spread.

In 2008, Canada had more than 30 confirmed cases in Ontario in 2008, with more than half reported in Toronto.[https://archive.today/20150128182503/http://www.insidetoronto.com/news-story/22019-north-york North York: Measles outbreak may bring new strategy], May 2008

In 2011, Quebec experienced the largest outbreak of measles in the Americas since 2002.{{cite report|author=Ministère de la Santé et des Services sociaux|date=31 August 2012|title=Final report on the provincial outbreak of measles in 2011|url=http://www.msss.gouv.qc.ca/en/sujets/prob_sante/measles/portrait2011.php|access-date=25 May 2013|archive-url=https://web.archive.org/web/20130112045634/http://www.msss.gouv.qc.ca/en/sujets/prob_sante/measles/portrait2011.php|archive-date=12 January 2013|url-status=dead|df=dmy-all}} The outbreak began on 8 January with unvaccinated individuals acquiring the disease whilst traveling to France, a country with high measles incidence, and returning home to Quebec.{{cite news|title=Quebec measles outbreak could spread, warns expert|author=CTV.ca News Staff|url=http://www.ctvnews.ca/quebec-measles-outbreak-could-spread-warns-expert-1.654725|newspaper=CTV News|date=9 June 2011|access-date=25 May 2013|archive-url=https://web.archive.org/web/20140207061611/http://www.ctvnews.ca/quebec-measles-outbreak-could-spread-warns-expert-1.654725|archive-date=7 February 2014|url-status=live|df=dmy-all}} Public health officials responded to the outbreak by launching a mass vaccination campaign,{{cite news|title=Quebec battling major measles outbreak|author=CBC News|url=https://www.cbc.ca/news/canada/montreal/quebec-battling-major-measles-outbreak-1.990990|newspaper=CBC News|date=27 October 2011|access-date=25 May 2013|archive-url=https://web.archive.org/web/20130727074710/http://www.cbc.ca/news/canada/montreal/story/2011/10/27/mtl-measlesoutbreak.html|archive-date=27 July 2013|url-status=live|df=dmy-all}} and on 22 December, the outbreak ended with a total of 776 cases having occurred. 615 cases (79%) had not been vaccinated, including 29 infants too young to receive the vaccine. 11% of cases required hospitalization, and complications occurred in 64 cases (8%), with pneumonia being the most common complication observed (3% of cases). No deaths were reported.

A measles outbreak was declared on 8 March 2014 in regions east of Vancouver in the Fraser Valley area where vaccination rates were known to be low in school and religious groups. A total of 228 cases were confirmed. On March 24, Fraser Health Authority said the outbreak have been contained and confined to the original community.{{cite news|title=Measles outbreak mostly contained at 228 cases: Fraser Health|url=http://www.cbc.ca/news/canada/british-columbia/measles-outbreak-mostly-contained-at-228-cases-fraser-health-1.2584866|newspaper=CBCNEWS|date=24 March 2014|access-date=27 March 2014|archive-url=https://web.archive.org/web/20140327023919/http://www.cbc.ca/news/canada/british-columbia/measles-outbreak-mostly-contained-at-228-cases-fraser-health-1.2584866|archive-date=27 March 2014|url-status=live|df=dmy-all}}

In May 2024, a child under the age of five in Ontario died of measles, the first case in the province in over a decade. The child was reportedly not vaccinated against the virus, and required hospitalization before his death.{{cite web|title=Ontario's first measles death in decades offers grim reminder that unvaccinated kids are at risk|url=https://www.cbc.ca/news/health/measles-vaccination-rates-1.7207834}}

Twenty-five cases of measles were reported in Mexico City on March 18, 2020. The outbreak began in the Reclusario Norte (Northern penitentiary) the previous week. 8,000 vaccines were applied at the penitentiary and 10,000 doses were applied at the other penitentiaries in the city. Eleven children and five adults in the nearby Gustavo A. Madero borough were among the 25 infected.[https://www.mediotiempo.com/otros-mundos/sarampion-cdmx-suben-25-casos-confirmados-pandemia-covid-19 Coronavirus increases and so does measles! There are already 25 cases in CDMX] {{in lang|es}} Mediotiempo, 18 March 2020[https://www.mediotiempo.com/otros-mundos/detectan-caso-sarampion-cdmx-nina-8-anos Measles case detected in CDMX in 8-year-old girl] {{in lang|es}} Mediotiempo, 18 March 2020

{{see also|Measles resurgence in the United States}}

file:Measles US 1938-2019.png

Indigenous measles has been declared eliminated in North, Central, and South America; the last endemic case in the region was reported on November 12, 2002.{{cite web |url=http://www.paho.org/english/ad/fch/im/Measles.htm |title=paho.org |access-date=2007-12-05 |archive-url=https://web.archive.org/web/20071121003508/http://www.paho.org/english/ad/fch/im/measles.htm |archive-date=2007-11-21 |url-status=live }} Though measles is considered "eliminated," outbreaks are still occurring following importations of measles viruses from other world regions. In June 2006, an outbreak in Boston resulted after a resident became infected in India,{{cite news |url=http://www.boston.com/yourlife/health/diseases/articles/2006/06/10/measles_outbreak_shows_a_global_threat/ |title=Measles outbreak shows a global threat – The Boston Globe |access-date=2007-12-05 |date=2006-06-10 |first1=Stephen |last1=Smith |archive-url=https://web.archive.org/web/20070311193551/http://www.boston.com/yourlife/health/diseases/articles/2006/06/10/measles_outbreak_shows_a_global_threat/ |archive-date=2007-03-11 |url-status=live }} and in October 2007, a Michigan girl who had been vaccinated contracted the disease overseas.{{cite news |first=David |last=Jesse |title=Measles outbreak may have spread |url=http://blog.mlive.com/study_hall/2007/10/measles_outbreak_may_have_spre.html |publisher=The Ann Arbor News |date=October 4, 2007 |access-date=2008-07-10 |archive-url=https://web.archive.org/web/20071019005736/http://blog.mlive.com/study_hall/2007/10/measles_outbreak_may_have_spre.html |archive-date=October 19, 2007 |url-status=live |df=mdy-all }}

In 1991 in the Philadelphia region, thousands of children were sick with measles. The center of this outbreak was traced to the Faith Tabernacle Congregation, a Faith Healing church that actively discouraged parishioners from vaccinating their children. A judge issued a Court Order to forcibly treat children whose parents refused to seek medical care, and nine children were forcibly vaccinated. Nine children eventually died as a result of this outbreak.{{cite web |url=https://www.npr.org/blogs/health/2015/02/19/386040745/why-a-court-once-ordered-kids-vaccinated-against-their-parents-will |title=NPR Why A Court Once Ordered Kids Vaccinated Against Their Parents' Will |website=NPR.org |access-date=2015-02-19 |archive-url=https://web.archive.org/web/20150219201412/http://www.npr.org/blogs/health/2015/02/19/386040745/why-a-court-once-ordered-kids-vaccinated-against-their-parents-will |archive-date=2015-02-19 |url-status=live }}

File:US Measles Cases 2010-2018.png

Between January 1 and April 25, 2008, a total of 64 confirmed measles cases were preliminarily reported in the United States to the Centers for Disease Control and Prevention,{{cite web|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e501a1.htm?s_cid=mm57e501a1_e|title=Measles – United States, January 1 – April 25, 2008|publisher=Centers for Disease Control|access-date=2008-05-02|archive-url=https://web.archive.org/web/20081014162036/http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e501a1.htm?s_cid=mm57e501a1_e|archive-date=October 14, 2008|url-status=live|df=mdy-all}}{{cite web|url=http://www.jsonline.com/story/index.aspx?id=738120|title=Measles outbreak brewing, city health officials say|author=Susanne Rust|work=jsonline.com|access-date=7 February 2015|archive-url=https://web.archive.org/web/20081007000651/http://www.jsonline.com/story/index.aspx?id=738120|archive-date=7 October 2008|url-status=live|df=dmy-all}} the most reported by this date since 2001, and the highest total number in six years.[http://www.foxnews.com/story/0,2933,354013,00.html U.S. On Verge of Measles Outbreak?] {{Webarchive|url=https://web.archive.org/web/20121020051721/http://www.foxnews.com/story/0,2933,354013,00.html |date=2012-10-20 }}, foxnews.com, May 2008 Of the 64 cases, 54 were associated with importation of measles from other countries into the United States, and 63 of the 64 patients were unvaccinated or had unknown or undocumented vaccination status.{{cite web |url=https://www.cdc.gov/Features/MeaslesUpdate/ |title=cdc.gov MeaslesUpdate |access-date=2008-05-02 |archive-url=https://web.archive.org/web/20080503091324/http://www.cdc.gov/Features/MeaslesUpdate/ |archive-date=2008-05-03 |url-status=live }} By July 9, 2008, a total of 127 cases were reported in 15 states, making it the largest US outbreak since 1997 (when 138 cases were reported).{{cite news |first=Will |last=Dunham |editor=Julie Steenhuysen |editor2=Peter Cooney |title=Measles outbreak hits 127 people in 15 states |url=https://www.reuters.com/article/newsOne/idUSN0943743120080709 |publisher=Reuters |date=July 9, 2008 |access-date=2008-07-10 |archive-url=https://web.archive.org/web/20090109200934/http://www.reuters.com/article/newsOne/idUSN0943743120080709 |archive-date=January 9, 2009 |url-status=live |df=mdy-all }} Most of the cases were acquired outside of the United States and affected individuals who had not been vaccinated.

In early 2008 there was an outbreak of measles in San Diego, California. The outbreak is traced to an unvaccinated 7-year-old child who went on a family trip to Europe.{{cite web|url=https://www.cdc.gov/mmwR/preview/mmwrhtml/mm57e222a1.htm|title=Outbreak of Measles – San Diego, California, January–February 2008|work=cdc.gov|access-date=7 February 2015|archive-url=https://web.archive.org/web/20150209031439/http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e222a1.htm|archive-date=9 February 2015|url-status=live|df=dmy-all}}{{cite web|url=http://www.californiareport.org/archive/R802291630/b|title=Measles Outbreak in San Diego|work=The California Report|access-date=7 February 2015|archive-url=https://web.archive.org/web/20120225073532/http://www.californiareport.org/archive/R802291630/b|archive-date=25 February 2012|url-status=live|df=dmy-all}} The CDC refers to this as an "import-associated outbreak". The final diagnosis included 11 additional cases of measles in unvaccinated children in San Diego. All of the confirmed patients were not vaccinated because they were younger than 1, the minimum age for measles inoculation, or because their parents declined to have them vaccinated.[http://www.signonsandiego.com/news/health/20080305-9999-1m5measles.html County measles outbreak close to ending officially] {{Webarchive|url=https://web.archive.org/web/20080802181146/http://www.signonsandiego.com/news/health/20080305-9999-1m5measles.html |date=2008-08-02 }}, San Diego Union Tribune The typical vaccine would be the MMR vaccine. The incident drew attention to the controversy over MMR vaccination. This was San Diego County's first measles outbreak since 1991.

In February 2008 there was an outbreak of measles in Pima County, Arizona. There were 13 laboratory confirmed and 4 probable measles cases, though 22 cases were previously reported.{{cite web|url=http://www.pimahealth.org/about/PressReleases/measles_press_release_7-21-08.pdf|title=Pima Health|access-date=7 February 2015|archive-url=https://web.archive.org/web/20120227012801/http://www.pimahealth.org/about/PressReleases/measles_press_release_7-21-08.pdf|archive-date=27 February 2012|url-status=live|df=dmy-all}} The outbreak started with a visitor from Switzerland and resulted in a public health emergency declaration by Pima County. The last confirmed Pima County case occurred in 1994, and the last outbreak occurred in 1991.[https://archive.today/20120906140024/http://www.kold.com/Global/story.asp?S=8400321&nav=14RT Health Officials: Measles Outbreak Fading], KOLD News 13, May 2008

By July 9, 2008, a total of 127 cases were reported in 15 states (including 22 in Arizona),{{cite news |first=Arthur |last=Rotstein |title=Response curtailed measles outbreak |url=http://www.tucsoncitizen.com/daily/local/90471.php |agency=Associated Press |date=July 9, 2008 |access-date=2008-07-10 |archive-url=https://web.archive.org/web/20090731114640/http://www.tucsoncitizen.com/daily/local/90471.php |archive-date=July 31, 2009 |url-status=live |df=mdy-all }} making it the largest U.S. outbreak since 1997 (when 138 cases were reported). Most of the cases were acquired outside of the United States and affected individuals who had not been vaccinated. By July 30, 2008, the number of cases had grown to 131. Of these, about half involved children whose parents rejected vaccination. The 131 cases occurred in seven different outbreaks. There were no deaths, and 15 hospitalizations. Children who were unvaccinated or whose vaccination status was unknown accounted for 122 cases. Some of these were under the age when vaccination is recommended, but in 63 cases, the vaccinations had been refused for religious or philosophical reasons.

On May 24, 2011, the Centers for Disease Control and Prevention reported that the United States has had 118 measles cases so far this year. The 118 cases were reported by 23 states and New York City between Jan 1 and May 20. Of the 118 cases, 105 (89%) were associated with cases abroad and 105 (89%) of the 118 patients had not been vaccinated.{{cite news|last=Roos|first=Robert|title=US measles surge this year is biggest since 1996|url=http://www.cidrap.umn.edu/cidrap/content/other/news/may2411measles.html|newspaper=CIDRAP News|date=May 24, 2011|access-date=July 2, 2015|archive-url=https://web.archive.org/web/20130506201616/http://www.cidrap.umn.edu/cidrap/content/other/news/may2411measles.html|archive-date=May 6, 2013|url-status=live|df=mdy-all}}

In 2013, at least 20 members of the Eagle Mountain International Church in Newark, Texas were diagnosed with measles after a few members of the congregation traveled abroad on a mission trip and contracted the disease. The church has sponsored several vaccination drives.{{cite web |url=https://www.nbcnews.com/health/measles-outbreak-tied-texas-megachurch-sickens-21-8C11009315 |title=Measles outbreak tied to Texas megachurch sickens 21 |first=JoNel |last=Aleccia |date=August 27, 2013 |website=NBC News |access-date=January 4, 2014 |archive-url=https://web.archive.org/web/20140104203856/https://www.nbcnews.com/health/measles-outbreak-tied-texas-megachurch-sickens-21-8C11009315 |archive-date=January 4, 2014 |url-status=live |df=mdy-all }} Senior Pastor Terri Pearsons, who had previously expressed concerns about potential links between the measles vaccine and autism, was encouraging parishioners to get vaccinated. However, she said she still has some concerns about vaccines, particularly for young children with a family history of autism, and where several immunizations are given at the same time. Professor William Schaffner, professor at the Vanderbilt University School of Medicine, described the pastor as "misinformed" and said that young children are among the most vulnerable to measles.{{cite news |last=Szabo |first=Liz |date=August 25, 2013 |title=Texas measles outbreak linked to church |url=https://www.usatoday.com/story/news/nation/2013/08/23/texas-measles-outbreak/2693945/ |newspaper=USA Today |access-date=January 4, 2014 |archive-url=https://web.archive.org/web/20131226033218/http://www.usatoday.com/story/news/nation/2013/08/23/texas-measles-outbreak/2693945/ |archive-date=December 26, 2013 |url-status=live |df=mdy-all }}

In February and March 2014, 20 confirmed cases appeared in New York City.{{cite news | url=https://www.nytimes.com/2014/03/19/nyregion/measles-outbreak-in-new-york-may-have-spread-in-medical-facilities.html | work=The New York Times | first=Anemona | last=Hartocollis | title=Measles Outbreak May Have Spread in Medical Facilities, a New York City Official Says | date=18 March 2014 | access-date=24 February 2017 | archive-url=https://web.archive.org/web/20161221042058/https://www.nytimes.com/2014/03/19/nyregion/measles-outbreak-in-new-york-may-have-spread-in-medical-facilities.html | archive-date=21 December 2016 | url-status=live | df=dmy-all }}

{{Anchor|Disneyland 2014}}

In December 2014, a measles outbreak began at Disneyland in Southern California. At least 173 people have become infected with measles in 21 states, as of May 2015. Health officials say 39 cases have been traced to direct exposure at the park, with 117 infections linked by primary or secondary exposure. Among the 110 California patients, 49 (45%) were unvaccinated; five (5%) had 1 dose of measles-containing vaccine, seven (6%) had 2 doses, one (1%) had 3 doses, 47 (43%) had unknown or undocumented vaccination status, and one (1%) had immunoglobulin G seropositivity documented, which indicates prior vaccination or measles infection at an undetermined time. 12 of the unvaccinated patients were infants too young to be vaccinated.{{cite news | url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm?s_cid=mm6406a5_w | work=CDC | title=Measles Outbreak – California, December 2014–February 2015 | date=February 20, 2015 | access-date=September 9, 2017 | archive-url=https://web.archive.org/web/20170826034042/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm?s_cid=mm6406a5_w | archive-date=August 26, 2017 | url-status=live | df=mdy-all }}{{cite news | url=https://www.npr.org/blogs/health/2015/01/29/382436262/rise-in-measles-cases-marks-a-wake-up-call-for-u-s | work=NPR | first1=Scott | last1=Hensley | first2=Meredith | last2=Rizzo | first3=Alyson | last3=Hurt | title=Rise In Measles Cases Marks A 'Wake-Up Call' For U.S. | date=29 January 2015 | access-date=4 April 2018 | archive-url=https://web.archive.org/web/20150428182013/http://www.npr.org/blogs/health/2015/01/29/382436262/rise-in-measles-cases-marks-a-wake-up-call-for-u-s | archive-date=28 April 2015 | url-status=live | df=dmy-all }}

Medical professionals, such as David Gorski, have criticized physicians and pediatricians in the area who do not adhere to the CDC's recommended vaccination schedule or discourage vaccination, among them Bob Sears and Jay Gordon for reducing vaccination rates and thus weakening herd immunity, and creating a situation in which an outbreak was more likely.{{cite web|last1=Gorski|first1=David|author-link=David Gorski|title=Say it ain't so, Mickey! A holiday measles outbreak makes the happiest place in the world sad|url=http://www.sciencebasedmedicine.org/say-it-aint-so-mickey-a-holiday-measles-outbreak-makes-the-happiest-place-in-the-world-sad|website=Science-Based Medicine|date=12 January 2015|access-date=24 January 2015|archive-url=https://web.archive.org/web/20150124021312/http://www.sciencebasedmedicine.org/say-it-aint-so-mickey-a-holiday-measles-outbreak-makes-the-happiest-place-in-the-world-sad/|archive-date=24 January 2015|url-status= live}} California passed a mandatory vaccination law in June 2015.[https://www.cnn.com/2015/06/30/health/california-vaccine-bill/index.html California governor signs vaccine bill that bans personal, religious exemptions] {{Webarchive|url=https://web.archive.org/web/20181209124531/https://www.cnn.com/2015/06/30/health/california-vaccine-bill/index.html |date=2018-12-09 }}, Michael Martinez and Amanda Watts, CNN, June 30, 2015

In January 2015, it was reported that over 70 people who had visited Disneyland or Disney California Adventure between Dec. 15 and Dec. 20 fell ill with measles, with 62 of them residing in California. The total number of cases included five people who had been fully vaccinated against the disease.{{cite web |url=http://www.latimes.com/local/california/la-me-measles-spread-20150122-story.html |title=Disneyland measles outbreak: Cases not limited to the unvaccinated |website=Los Angeles Times |date=21 January 2015 |access-date=21 July 2017 |archive-url=https://web.archive.org/web/20170813122526/http://www.latimes.com/local/california/la-me-measles-spread-20150122-story.html |archive-date=13 August 2017 |url-status=live |df=dmy-all }} Between the dates of January 1 and 28, 2015, most of the 84 people who were diagnosed with measles were either infected during their visit to Disneyland or by someone who visited the theme park.{{Cite web |url=https://www.usatoday.com/story/news/2015/01/29/measles-outbreak-dangerousness/22521529/ |title=Measles has infected 84 people in 14 states this year |website=USA Today |access-date=2017-08-27 |archive-url=https://web.archive.org/web/20180108151457/https://www.usatoday.com/story/news/2015/01/29/measles-outbreak-dangerousness/22521529/ |archive-date=2018-01-08 |url-status=live }}

In Spring 2015, the death of an immune-suppressed woman in Washington State caused by measles was diagnosed after autopsy. This was the first U.S. measles death since 2012.[https://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_09.pdf] {{Webarchive|url=https://web.archive.org/web/20150611120420/http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_09.pdf|date=2015-06-11}} National Vital Statistics Reports – Deaths: Final Data for 2012, CDC, August 31, 2015

In spring 2017, a measles outbreak occurred in Minnesota. As of June 16, 78 cases of measles had been confirmed in the state, 71 were unvaccinated and 65 were Somali-Americans.{{Cite web |url=http://www.health.state.mn.us/divs/idepc/diseases/measles/ |title=Measles – Minnesota Dept. Of Health |access-date=2017-06-08 |archive-url=https://web.archive.org/web/20170610014848/http://www.health.state.mn.us/divs/idepc/diseases/measles/ |archive-date=2017-06-10 |url-status=dead }}{{Cite news |url=https://www.washingtonpost.com/national/health-science/imams-in-us-take-on-the-anti-vaccine-movement-during-ramadan/2017/05/26/8660edc6-41ad-11e7-8c25-44d09ff5a4a8_story.html |title=Measles outbreak in Minnesota surpasses last year's total for the entire country – the Washington Post |newspaper=The Washington Post |access-date=2017-06-02 |archive-url=https://web.archive.org/web/20170602152306/https://www.washingtonpost.com/national/health-science/imams-in-us-take-on-the-anti-vaccine-movement-during-ramadan/2017/05/26/8660edc6-41ad-11e7-8c25-44d09ff5a4a8_story.html |archive-date=2017-06-02 |url-status=live }}{{Cite web|url=http://www.cnn.com/2017/05/08/health/measles-minnesota-somali-anti-vaccine-bn/index.html|title=Anti-vaccine groups blamed in Minnesota measles outbreak|author=Jacqueline Howard|website=CNN|date=8 May 2017|access-date=2017-05-26|archive-url=https://web.archive.org/web/20170525055903/http://www.cnn.com/2017/05/08/health/measles-minnesota-somali-anti-vaccine-bn/index.html|archive-date=2017-05-25|url-status=live}}{{Cite news|url=https://www.newscientist.com/article/mg23431253-200-minnesota-measles-outbreak-follows-antivaccination-campaign/|title=Minnesota measles outbreak follows anti-vaccination campaign|work=New Scientist|access-date=2017-05-26|language=en-US|archive-url=https://web.archive.org/web/20170510193554/https://www.newscientist.com/article/mg23431253-200-minnesota-measles-outbreak-follows-antivaccination-campaign/|archive-date=2017-05-10|url-status=live}}{{Cite news|url=https://www.npr.org/sections/health-shots/2017/05/03/526723028/autism-fears-fueling-minnesotas-measles-outbreak|title=Unfounded Autism Fears Are Fueling Minnesota's Measles Outbreak|work=NPR.org|access-date=2017-05-26|language=en|archive-url=https://web.archive.org/web/20170525004652/http://www.npr.org/sections/health-shots/2017/05/03/526723028/autism-fears-fueling-minnesotas-measles-outbreak|archive-date=2017-05-25|url-status=live}}{{Citation|last=Healthcare Triage|title=A Measles Outbreak in Minnesota. Nice Work, Anti-vaxxers|date=2017-05-26|url=https://www.youtube.com/watch?v=EyBiTIfPpOM|access-date=2017-05-26}} The outbreak has been attributed to low vaccination rates among Somali-American children, which can be traced back to 2008, when Somali parents expressed concerns about disproportionately high numbers of Somali preschoolers in special education classes who were receiving services for autism spectrum disorder. Around this time, Andrew Wakefield visited Minneapolis, teaming up with vaccine-skeptical groups to raise concerns about the MMR vaccine.{{Cite web |url=https://www.npr.org/sections/health-shots/2017/05/03/526595475/understanding-the-history-behind-communities-vaccine-fears |title=Understanding the History Behind Communities' Vaccine Fears |website=NPR |date=3 May 2017 |access-date=2018-04-04 |archive-url=https://web.archive.org/web/20180221072444/https://www.npr.org/sections/health-shots/2017/05/03/526595475/understanding-the-history-behind-communities-vaccine-fears |archive-date=2018-02-21 |url-status=live |last1=Sohn |first1=Emily }} Multiple studies have shown no connection between the MMR vaccine and autism.{{Cite journal |title=Vaccines and Autism: A Tale of Shifting Hypotheses |journal=Clinical Infectious Diseases |date=15 February 2009 |volume=48 |issue=4 |pages=456–461 |doi=10.1086/596476 |last1=Plotkin |first1=Stanley |last2=Gerber |first2=Jeffrey S. |last3=Offit |first3=Paul A. |pmid=19128068 |pmc=2908388 }}

In January 2019, Washington's Clark County Public Health officials declared a public health emergency due to a measles outbreak. As of February 28, 2019, 65 cases were identified.{{Cite web |url=https://www.clark.wa.gov/public-health/measles-investigation |title=Measles investigation |access-date=2019-01-24 |archive-url=https://web.archive.org/web/20190124063928/https://www.clark.wa.gov/public-health/measles-investigation |archive-date=2019-01-24 |url-status=live }}

In March 2019, a disaster was declared by county authorities and the county health department in Rockland County, New York, over a growing measles outbreak there.{{Cite web |url=https://www.cbsnews.com/news/measles-outbreak-rockland-county-new-york-state-of-emergency/ |title=Measles outbreak: Rockland County, New York, declares state of emergency |website=CBS News |date=26 March 2019 |access-date=2019-04-02 |archive-url=https://web.archive.org/web/20190402043006/https://www.cbsnews.com/news/measles-outbreak-rockland-county-new-york-state-of-emergency/ |archive-date=2019-04-02 |url-status=live }} Additionally there has been 259 confirmed cases of measles in Brooklyn and Queens, most of which are affecting the Orthodox Jewish community.{{Cite web |url=https://www1.nyc.gov/site/doh/health/health-topics/measles.page |title=Measles – NYC Health |access-date=2019-04-06 |archive-url=https://web.archive.org/web/20190321003955/https://www1.nyc.gov/site/doh/health/health-topics/measles.page |archive-date=2019-03-21 |url-status=live }}

In 2019, 1,274 reported measles cases drew concern as this was the largest reported number of cases in the United States since 1992. Cases were mostly unvaccinated individuals. In 2021, cases went down to only 49 reported cases in the United States.{{Cite web |last=CDC |date=2022-11-18 |title=Measles Cases and Outbreaks |url=https://www.cdc.gov/measles/cases-outbreaks.html |access-date=2022-11-21 |website=Centers for Disease Control and Prevention |language=en-us}} In 2022, cases jumped to 121 reported cases. In 2023, cases decreased to 58 reported cases, but the CDC has remarked that they have already had more cases reported in 2024 than the previous year, again citing unvaccinated individuals.{{Cite news |last=Mandavilli |first=Apoorva |date=March 20, 2024 |title=Following Measles Outbreaks, Officials Grow Wary of Renewed Threat |url=https://www.nytimes.com/2024/03/20/health/measles-children-travel.html |work=The New York Times}}

In 2018, Venezuela had 5,525 cases of measles reported, which was 68% of the total cases in the Americas at the time.{{Cite journal |last1=Paniz-Mondolfi |first1=Alberto E. |last2=Tami |first2=Adriana |last3=Grillet |first3=Maria E. |last4=Márquez |first4=Marilianna |last5=Hernández-Villena |first5=Juan |last6=Escalona-Rodríguez |first6=María A. |last7=Blohm |first7=Gabriela M. |last8=Mejías |first8=Isis |last9=Urbina-Medina |first9=Huníades |last10=Rísquez |first10=Alejandro |last11=Castro |first11=Julio |last12=Carvajal |first12=Ana |last13=Walter |first13=Carlos |last14=López |first14=María G. |last15=Schwabl |first15=Philipp |date=April 2019 |title=Resurgence of Vaccine-Preventable Diseases in Venezuela as a Regional Public Health Threat in the Americas |journal=Emerging Infectious Diseases |volume=25 |issue=4 |pages=625–632 |doi=10.3201/eid2504.181305 |issn=1080-6040 |pmc=6433037 |pmid=30698523 }} As of 2020, the Pan America Health Organization reported that the measles outbreak is under control, and have increased vaccination rates in over 9 million children.{{Cite web |last=Mitchell |first=Cristina |date=2020-01-30 |title=PAHO/WHO {{!}} Measles outbreak in Venezuela is under control |url=https://www3.paho.org/hq/index.php?option=com_content&view=article&id=15705:measles-outbreak-in-venezuela-is-under-control&Itemid=0&lang=en#gsc.tab=0 |access-date=21 November 2022 |website=Pan American Health Organization / World Health Organization |language=en-us}}

Approximately 100 cases of the disease were reported in Israel between August 2007 and May 2008 (in sharp contrast to just some dozen cases the year before).{{Cite journal|last1=Stein-Zamir|first1=C.|last2=Abramson|first2=N.|last3=Shoob|first3=H.|last4=Zentner|first4=G.|date=2008-02-21|title=An outbreak of measles in an ultra-orthodox Jewish community in Jerusalem, Israel, 2007--an in-depth report|journal=Euro Surveillance |volume=13|issue=8|pages=8045|doi=10.2807/ese.13.08.08045-en|issn=1560-7917|pmid=18445412|doi-access=free}} Many children in ultra-Orthodox Jewish communities were affected due to low vaccination coverage.{{cite journal |last=Stein-Zamir |first=C. |author2=G. Zentner |author3=N. Abramson |author4=H. Shoob |author5=Y. Aboudy |author6=L. Shulman |author7=E. Mendelson |date=February 2008 |title=Measles outbreaks affecting children in Jewish ultra-orthodox communities in Jerusalem. |journal=Epidemiology and Infection |volume=136 |issue=2 |pages=207–214 |pmid=17433131 |doi=10.1017/S095026880700845X |pmc=2870804 }}{{cite news |first=Tamar |last=Rotem |title=Current measles outbreak hit ultra-Orthodox the hardest |url=http://www.haaretz.com/hasen/spages/921836.html |publisher=Haaretz |date=August 11, 2007 |access-date=2008-07-10 |archive-url=https://web.archive.org/web/20081007050347/http://www.haaretz.com/hasen/spages/921836.html |archive-date=October 7, 2008 |url-status=live |df=mdy-all }}

In 2018 and 2019, Israel suffered a measles outbreak affecting 4,300 citizens.{{Cite journal |last1=Stein-Zamir |first1=Chen |last2=Levine |first2=Hagai |title=The measles outbreak in Israel in 2018-19: lessons for COVID-19 pandemic |journal=Human Vaccines & Immunotherapeutics |year=2021 |volume=17 |issue=7 |pages=2085–2089 |doi=10.1080/21645515.2020.1866918 |issn=2164-5515 |pmc=8189060 |pmid=33481632}}

In 2007, a large measles outbreak in Japan caused a number of universities and other institutions to close in an attempt to contain the disease.{{cite web |url=http://www.phac-aspc.gc.ca/tmp-pmv/2007/measjap070601_e.html|title=The Public Health Agency of Canada Travel Advisory |access-date=2008-05-02}}{{cite news |first=Justin |last=Norrie |title=Japanese measles epidemic brings campuses to standstill |url=http://www.smh.com.au/news/world/japanese-measles-epidemic-brings-campuses-to-standstill/2007/05/27/1180205052602.html |publisher=The Sydney Morning Herald |date=May 27, 2007 |access-date=2008-07-10 |archive-url=https://web.archive.org/web/20090601063947/http://www.smh.com.au/news/world/japanese-measles-epidemic-brings-campuses-to-standstill/2007/05/27/1180205052602.html |archive-date=June 1, 2009 |url-status=live |df=mdy-all }}

In early 2010, there was a serious outbreak of measles in the Philippines with 742 cases, leaving four unvaccinated children dead in the capital city of Manila.{{cite news|title=Measles can be serious|author=Chua, P.S.|url=http://globalnation.inquirer.net/cebudailynews/opinion/view/20100329-261437/Measles-can-be-serious|newspaper=Inquirer Global Nation|date=March 29, 2010|access-date=February 4, 2015|archive-url=https://web.archive.org/web/20150204153915/http://globalnation.inquirer.net/cebudailynews/opinion/view/20100329-261437/Measles-can-be-serious|archive-date=February 4, 2015|url-status=dead|df=mdy-all}}

In late 2013, it was reported in the Philippines that 6,497 measles cases occurred which resulted in 23 deaths.{{cite news

| author = Sheila Crisostomo

| title = DOH to vaccinate 2 M kids against measles

| publisher = The Philippine Star

| page = 17

| date = January 22, 2014

}}

In 2014 the Philippines experienced a large measles outbreak. According to the World Health Organization there were 57,564 suspected cases of measles, including 21,403 confirmed cases, and 110 measles deaths reported in the Philippines from January 1 through December 20, 2014. Most of the cases were among unvaccinated people. A major outbreak was declared on February 6, 2019, with 70 recorded deaths of children, this outbreak was attributed to the "Dengvaxia scare".{{cite news |last1=Dancel |first1=Raul |title=Philippines hit by deadly measles outbreak after controversy over dengue vaccinations |url=https://www.straitstimes.com/asia/se-asia/22-dead-in-measles-outbreak-in-several-regions-in-the-philippines |access-date=7 February 2019 |work=The Straits Times |archive-url=https://web.archive.org/web/20190208033359/https://www.straitstimes.com/asia/se-asia/22-dead-in-measles-outbreak-in-several-regions-in-the-philippines |archive-date=8 February 2019 |url-status=live |df=dmy-all }}

{{see also|Measles resurgence in Europe}}

{{image frame|caption=Measles cases in the WHO European region{{cite web |title=WHO EpiData |url=http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/surveillance-and-data/who-epidata |language=en |date=15 February 2019 |access-date=15 February 2019 |archive-url=https://web.archive.org/web/20190413182520/http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/surveillance-and-data/who-epidata |archive-date=13 April 2019 |url-status=live |df=dmy-all }}|content={{Graph:Chart|width=300|height=200|type=line|x=2009,2010,2011,2012,2013,2014,2015,2016,2017,2018|y=7884,30604,33254,26788,32857,18869,28413,5273,25863,82596}}}}

Despite the highest ever vaccination rate of 90% achieved in 2017 in the European region, number of measles cases tripled the next year reaching 82,596 with 72 of them resulting in death.{{cite web |title=Measles in Europe: record number of both sick and immunized |url=http://www.euro.who.int/en/media-centre/sections/press-releases/2019/measles-in-europe-record-number-of-both-sick-and-immunized |website=WHO Regional Office for Europe |access-date=17 February 2019 |language=en |date=7 February 2019 |archive-url=https://web.archive.org/web/20190210022729/http://www.euro.who.int/en/media-centre/sections/press-releases/2019/measles-in-europe-record-number-of-both-sick-and-immunized |archive-date=10 February 2019 |url-status=live |df=dmy-all }} Almost two thirds of them were registered in Ukraine,{{cite web |title=У 2018 році на кір захворіли понад 54 тисячі українців. Зупинити поширення хвороби може лише вакцинація |url=http://moz.gov.ua/article/news/u-2018-roci-na-kir-zahvorili-ponad-54-tisjachi-ukrainciv--zupiniti-poshirennja-hvorobi-mozhe-lishe-vakcinacija |website=Ministry of Health of Ukraine |access-date=17 February 2019 |language=uk |archive-url=https://web.archive.org/web/20190218021313/http://moz.gov.ua/article/news/u-2018-roci-na-kir-zahvorili-ponad-54-tisjachi-ukrainciv--zupiniti-poshirennja-hvorobi-mozhe-lishe-vakcinacija |archive-date=18 February 2019 |url-status=live |df=dmy-all }} where vaccination rates dropped to 31% in 2016.{{cite journal |last1=Wadman |first1=Meredith |title=Measles cases have tripled in Europe, fueled by Ukrainian outbreak |journal=Science |date=12 February 2019 |doi=10.1126/science.aaw9903 |s2cid=134362877 |url=https://www.science.org/content/article/measles-cases-have-tripled-europe-fueled-ukrainian-outbreak |access-date=17 February 2019 |archive-url=https://web.archive.org/web/20190218021350/https://www.sciencemag.org/news/2019/02/measles-cases-have-tripled-europe-fueled-ukrainian-outbreak |archive-date=18 February 2019 |url-status=live |df=dmy-all}}

Ukraine has had a multiple large outbreaks of measles. In 2001–2002, there were around 25,000 cases and 14 deaths reported.[http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2918 Measles outbreak in the Ukraine, 2005-2006] {{Webarchive|url=https://web.archive.org/web/20150910153300/http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2918 |date=2015-09-10 }}, Eurosurveillance, Volume 11, Issue 10, 09 March 2006 In 2006 with 44,534 reported cases with at least 2 deaths.[http://ecdc.europa.eu/en/publications/Publications/20120314_RA_Measles_Ukraine.pdf Outbreak of measles in Ukraine and potential for spread in the EU, 2012] {{Webarchive|url=https://web.archive.org/web/20140811011545/http://ecdc.europa.eu/en/publications/Publications/20120314_RA_Measles_Ukraine.pdf |date=2014-08-11 }}, European Center for Disease Prevention and Control, 13 March 2012 13,517 cases were reported in 2012.[https://www.who.int/immunization/diseases/MRI_2012_Annual_Report.pdf Annual Report 2012] {{Webarchive|url=https://web.archive.org/web/20141019011155/http://www.who.int/immunization/diseases/MRI_2012_Annual_Report.pdf |date=2014-10-19 }}, Measles and Rubella Initiative In 2019 Ukraine reported over 57,000 cases, over half the total reports in the WHO European Region.{{cite web |url=http://www.euro.who.int/en/countries/ukraine/news/news/2020/01/strengthening-response-to-measles-outbreak-in-ukraine |title=Strengthening response to measles outbreak in Ukraine |publisher=WHO |date=22 January 2020 |access-date=20 February 2020 |archive-date=20 February 2020 |archive-url=https://web.archive.org/web/20200220114249/http://www.euro.who.int/en/countries/ukraine/news/news/2020/01/strengthening-response-to-measles-outbreak-in-ukraine |url-status=dead }}

Ukraine has one of the world's worst measles epidemics with more than 100,000 cases from 2017 to June 2019, with 16 deaths in 2018. In 2016 only 31% of the population had been immunised with the MMR vaccine. Various reasons are given for the low rate of vaccination including: a distrust of the state in the 1990s, a failure to keep vaccine supplies reliably refrigerated leading to ineffectiveness, a poorly informed medical profession and a high level of vaccine distrust in the wider population. Children are required to be vaccinated before entering the school system, but UNICEF estimates that as many as 30% of vaccination certificates are falsified.{{cite news |url=https://www.bbc.co.uk/news/stories-48668841 |title=The medical student who died of measles |author1=Tim Whewell |author2=Kateryna Shipko |author3=Diana Kuryshko |work=BBC News |date=22 June 2019 |access-date=23 June 2019}}

Germany has faced repeated outbreaks in the 21st century. 6,037 cases were reported in 2001 with at least two deaths.{{cite journal | year = 2009 | title = Further efforts needed to achieve measles elimination in Germany: results of an outbreak investigation | url =https://www.who.int/bulletin/volumes/87/2/07-050187/en/ | journal = Bulletin of the World Health Organization | volume = 87 | issue = 2 | pages = 108–115 | doi = 10.2471/BLT.07.050187 | pmid = 19274362 | pmc = 2636188 | last1 = Wichmann | first1 = O | last2 = Siedler | first2 = A | last3 = Sagebiel | first3 = D | last4 = Hellenbrand | first4 = W | last5 = Santibanez | first5 = S | last6 = Mankertz | first6 = A | last7 = Vogt | first7 = G | last8 = Van Treeck | first8 = U | last9 = Krause | first9 = G | access-date = 2015-07-31 | archive-url = https://web.archive.org/web/20150710040024/http://www.who.int/bulletin/volumes/87/2/07-050187/en/ | archive-date = 2015-07-10 | url-status = dead }} More than 1,500 cases were reported in 2006.{{cite journal | year = 2014 | title = Measles incidence and reporting trends in Germany, 2007–2011 | url =https://www.who.int/bulletin/volumes/92/10/13-135145/en/ | journal = Bulletin of the World Health Organization | volume = 92 | issue = 10 | pages = 742–749 | doi = 10.2471/BLT.13.135145 | pmid = 25378728 | pmc = 4208482 | last1 = Takla | first1 = A | last2 = Wichmann | first2 = O | last3 = Rieck | first3 = T | last4 = Matysiak-Klose | first4 = D | access-date = 2015-07-31 | archive-url = https://web.archive.org/web/20150722045612/http://www.who.int/bulletin/volumes/92/10/13-135145/en/ | archive-date = 2015-07-22 | url-status = dead }} 1,600 cases were reported in an outbreak in 2013. An outbreak in 2015 had more than 1,700 cases had been reported by May 11 with one death.[http://wwwnc.cdc.gov/travel/notices/watch/measles-germany Measles in Germany] {{Webarchive|url=https://web.archive.org/web/20150905083456/http://wwwnc.cdc.gov/travel/notices/watch/measles-germany |date=2015-09-05 }}, Centers for Disease Control and Prevention, June 03, 2015

In September 2008 an outbreak occurred among anthroposophists' children in the cities of The Hague and Utrecht. Some 90 infections of unvaccinated children were recorded by the Dutch National Institute for Public Health and the Environment (RIVM) by September 29. It was expected the outbreak would spread to the region of the Veluwe, locally known as a bijbelgordel ("Bible Belt") with a large population of unvaccinated children on religious grounds.{{cite journal|journal=Nederlands Dagblad |date=2008-09-29 |title=Mazelen onder antroposofen zet door (Dutch) |url=http://www.nd.nl/document.aspx?document=nd_artikel&vorigDocument=&id=122193 }}{{dead link|date=March 2016|bot=medic}}{{cbignore|bot=medic}}

In June 2013, another outbreak occurred in the Bible Belt in The Netherlands. According to newspaper Algemeen Dagblad, there were 161 infections, of which 5 infected people were hospitalized critically ill. Two of the hospitalized cases had meningitis, two others had pneumonia and from one of them, the complications are still{{when|date=July 2022}} unknown.{{cite web|url=http://www.ad.nl/ad/nl/4560/Gezond/article/detail/3467491/2013/06/29/Vijf-kinderen-met-mazelen-in-het-ziekenhuis.dhtml|title=Vijf kinderen met mazelen in het ziekenhuis|work=AD|access-date=7 February 2015|archive-url=https://web.archive.org/web/20150207153639/http://www.ad.nl/ad/nl/4560/Gezond/article/detail/3467491/2013/06/29/Vijf-kinderen-met-mazelen-in-het-ziekenhuis.dhtml|archive-date=7 February 2015|url-status=live|df=dmy-all}}

As of 2019, the Netherlands reported over 80 measles cases.{{Cite web |title=Measles in the Netherlands {{!}} RIVM |url=https://www.rivm.nl/en/en/measles/measles-in-the-netherlands |access-date=2022-11-21 |website=www.rivm.nl}}

File:Measles incidence and vaccination England & Wales 1991-2007.png (lower curve) and vaccination rates (upper curve) in England and Wales, 1991–2007.]]

After the MMR vaccine controversy began, the MMR vaccination compliance dropped sharply in the United Kingdom, from 92% in 1996 to 84% in 2002. In some parts of London, it was as low as 61% in 2003, far below the rate needed to avoid an epidemic of measles.{{cite journal |journal= Lancet |year=2003 |volume=362 |issue=9394 |pages=1498–9 |title= Separating inflammation from speculation in autism |author= Murch S |doi=10.1016/S0140-6736(03)14699-5 |pmid=14602448|s2cid=40071957 }} By 2006 coverage for MMR in the UK at 24 months was 85%, lower than the about 94% coverage for other vaccines.{{cite journal |vauthors=McIntyre P, Leask J |title= Improving uptake of MMR vaccine |journal=BMJ |volume=336 |issue=7647 |pages=729–30 |year=2008 |pmid=18309963 |pmc= 2287215 |doi=10.1136/bmj.39503.508484.80}}

After vaccination rates dropped, the incidence of two of the three diseases increased greatly in the UK. In 1998 there were 56 confirmed cases of measles in the UK; in 2006 there were 449 in the first five months of the year, with the first death since 1992.{{cite journal |journal=BMJ |year=2006 |volume=333 |issue=7574 |pages=890–5 |title=Measles in the United Kingdom: can we eradicate it by 2010? |vauthors=Asaria P, MacMahon E |doi=10.1136/bmj.38989.445845.7C |pmid=17068034 |pmc=1626346 }} Cases occurred in inadequately vaccinated children. The age group affected was too old to have received the routine MMR immunizations around the time the paper by Wakefield et al. was published, and too young to have contracted the natural disease as a child, and thus to achieve a herd immunity effect.{{cite news |url=http://www.nzherald.co.nz/index.cfm?c_id=2&ObjectID=10125382 |title=England and Wales in grip of mumps epidemic - 13 May 2005 - NZ Herald: World / International News |work=The New Zealand Herald |access-date=2008-07-10 |date=13 May 2005 |archive-date=10 April 2005 |archive-url=https://web.archive.org/web/20050410142531/http://www.nzherald.co.nz/index.cfm?c_id=2 |url-status=dead }}{{cite web |url=http://www.hpa.org.uk/infections/topics_az/mumps/gen_info.htm |title=HPA — Mumps |access-date=2008-07-10 |url-status=dead |archive-url=https://web.archive.org/web/20070502002924/http://www.hpa.org.uk/infections/topics_az/mumps/gen_info.htm |archive-date=2007-05-02 }}

With the decline in infection that followed the introduction of the MMR vaccine, these individuals had not been exposed to the disease, but still had no immunity, either natural or vaccine induced. Therefore, as immunization rates declined following the controversy and the disease re-emerged, they were susceptible to infection.{{cite news |url=http://www.nzherald.co.nz/index.cfm?c_id=2&ObjectID=10125382 |title=England and Wales in grip of mumps epidemic - 13 May 2005 - NZ Herald: World / International News |work=The New Zealand Herald |access-date=2008-07-10 |date=13 May 2005 |archive-date=10 April 2005 |archive-url=https://web.archive.org/web/20050410142531/http://www.nzherald.co.nz/index.cfm?c_id=2 |url-status=dead }} Measles cases continued in 2006, at incidence rates 13 times greater than 1998 levels.{{cite web |title= Confirmed cases of measles, mumps & rubella |publisher= Health Protection Agency |date= 2007-03-22 |url= http://www.hpa.org.uk/infections/topics_az/measles/data_mmr_confirmed.htm |access-date= 2007-09-05 |archive-url= https://web.archive.org/web/20070726080700/http://www.hpa.org.uk/infections/topics_az/measles/data_mmr_confirmed.htm |archive-date= 2007-07-26 |url-status= live }} Two children were severely and permanently injured by measles encephalitis despite undergoing kidney transplantation in London. Disease outbreaks also caused casualties in nearby countries including Ireland.

In 2008, for the first time in 14 years, measles was declared endemic in the UK, meaning that the disease was sustained within the population. This was caused by the preceding decade's low MMR vaccination rates, which created a population of susceptible children who could spread the disease. In May 2008, a British 17-year-old with an underlying immunodeficiency died of measles.Smith, Rebecca (20 June 2008) [https://www.telegraph.co.uk/news/uknews/2164002/Teenager-dies-of-measles-as-cases-of-disease-rise.html Teenager dies of measles as cases of disease rise] {{Webarchive|url=https://web.archive.org/web/20180914211705/https://www.telegraph.co.uk/news/uknews/2164002/Teenager-dies-of-measles-as-cases-of-disease-rise.html |date=2018-09-14 }} The Telegraph, Retrieved 21 April 2013

An outbreak centered on the Swansea area of Wales started in November 2012; as of 22 April there have been 886 cases.[http://www.wales.nhs.uk/sitesplus/888/page/66389 Public Health Wales: Measles Outbreak: Data] {{Webarchive|url=https://web.archive.org/web/20150419181618/http://www.wales.nhs.uk/sitesplus/888/page/66389 |date=2015-04-19 }} (accessed 24 April 2013)

In March 2013, an epidemic was declared in Swansea, Wales, UK with 1,219 cases and 88 hospitalizations to date.{{cite news|title=Measles outbreak: number of cases passes 1,000 in Swansea area|author=Press Association|url=https://www.theguardian.com/society/2013/apr/30/measles-outbreak-number-cases-swansea|newspaper=The Guardian|date=April 30, 2013|access-date=May 1, 2013|archive-url=https://web.archive.org/web/20130927123926/http://www.theguardian.com/society/2013/apr/30/measles-outbreak-number-cases-swansea|archive-date=September 27, 2013|url-status=live|df=mdy-all}} A 25-year-old male had measles at the time of death and died from giant cell pneumonia caused by the disease.{{cite news|title=Measles sufferer Gareth Colfer-Williams died from pneumonia|author=BBC News|url=https://www.bbc.co.uk/news/uk-wales-23135464|work=BBC News|date=July 1, 2013|access-date=July 2, 2013|archive-url=https://web.archive.org/web/20130702014505/http://www.bbc.co.uk/news/uk-wales-23135464|archive-date=July 2, 2013|url-status=live|df=mdy-all}} There have been growing concerns that the epidemic could spread to London and infect many more people due to poor MMR uptake,{{cite news|title='Very large outbreak' of measles could hit London|author=Legge, J.|url=https://www.independent.co.uk/news/uk/home-news/very-large-outbreak-of-measles-could-hit-london-8591561.html|work=The Independent|date=April 28, 2013|access-date=April 28, 2013|archive-url=https://web.archive.org/web/20130429071625/http://www.independent.co.uk/news/uk/home-news/very-large-outbreak-of-measles-could-hit-london-8591561.html|archive-date=April 29, 2013|url-status=live|df=mdy-all}} prompting the Department of Health to set up a mass vaccination campaign targeted at one million school children throughout England.{{cite news|title=Measles vaccination plan in England targets 1m children|author=Gallagher, J.|url=https://www.bbc.co.uk/news/health-22276975|work=BBC News|date=April 25, 2013|access-date=April 28, 2013|archive-url=https://web.archive.org/web/20130428030852/http://www.bbc.co.uk/news/health-22276975|archive-date=April 28, 2013|url-status=live|df=mdy-all}}

In April 2019 a senior epidemiologist at Public Health England said that confidence in the immunization program was high and that timing, availability and location of appointments were the main barriers to vaccination.{{cite news |title=Appointment availability is behind huge number of missed measles vaccinations, PHE expert says |url=https://www.pharmaceutical-journal.com/20206471.article |access-date=9 June 2019 |publisher=Pharmaceutical Journal |date=26 April 2019 }}{{dead link|date=July 2023|bot=medic}}{{cbignore|bot=medic}}

In 2021, the United Kingdom reported 2 total measles cases in the country.{{Cite web |title=Confirmed cases of measles, mumps and rubella in England and Wales: 1996 to 2021 |url=https://www.gov.uk/government/publications/measles-confirmed-cases/confirmed-cases-of-measles-mumps-and-rubella-in-england-and-wales-2012-to-2013 |access-date=2022-11-21 |website=GOV.UK |language=en}}

1,500 cases and three deaths were reported in the Irish outbreak of 2000, which occurred as a direct result of decreased vaccination rates following the MMR scare.{{cite journal |journal=Clin Med |year=2007 |volume=7 |issue=6 |pages=562–78 |title= Science and serendipity |author= Pepys MB |pmid=18193704 |pmc=4954362 |doi=10.7861/clinmedicine.7-6-562}}

In 2017, there were 4,991 cases and four deaths, representing almost six-times the number of cases in 2016.{{Cite news|url=https://www.dddmag.com/news/2018/01/italy-reports-4991-measles-cases-amid-politicized-debate|title=Italy Reports 4,991 Measles Cases Amid Politicized Debate|last=|date=26 January 2018|work=Drug Discovery & Development Magazine|access-date=26 January 2018|agency=Associated Press|archive-url=https://web.archive.org/web/20180127001004/https://www.dddmag.com/news/2018/01/italy-reports-4991-measles-cases-amid-politicized-debate|archive-date=27 January 2018|url-status=live|df=dmy-all}} The number of cases for 2013 through 2016 were 2211, 1674, 251 and 844.

In 2020 and 2021, Italy reported 4 confirmed cases of measles.{{Cite journal |last1=Bianchi |first1=Silvia |last2=Gori |first2=Maria |last3=Fappani |first3=Clara |last4=Ciceri |first4=Giulia |last5=Canuti |first5=Marta |last6=Colzani |first6=Daniela |last7=Dura |first7=Marco |last8=Terraneo |first8=Mara |last9=Lamberti |first9=Anna |last10=Baggieri |first10=Melissa |last11=Senatore |first11=Sabrina |last12=Faccini |first12=Marino |last13=Magurano |first13=Fabio |last14=Tanzi |first14=Elisabetta |last15=Amendola |first15=Antonella |date=May 2022 |title=Characterization of Vaccine Breakthrough Cases during Measles Outbreaks in Milan and Surrounding Areas, Italy, 2017–2021 |journal=Viruses |language=en |volume=14 |issue=5 |pages=1068 |doi=10.3390/v14051068 |pmid=35632809 |pmc=9147195 |issn=1999-4915|doi-access=free }}

Beginning in April 2009 there was a large outbreak of measles in Bulgaria, with 23,791 cases, including 24 deaths, reported up to 28 July 2010.{{Cite web | title=Measles outbreak in Bulgaria: update as of week 29, 2010 | url=http://euvac.net/graphics/euvac/outbreak/bulgaria29.html | access-date=2010-08-26 | archive-url=https://archive.today/20130222021630/http://euvac.net/graphics/euvac/outbreak/bulgaria29.html | archive-date=2013-02-22 | url-status=dead }} From Bulgaria, the strain was carried to Germany, Turkey, Greece, Macedonia, and other European countries.{{Cite journal | last1 = Kupferschmidt | first1 = K. | title = Europe's Embarrassing Problem | doi = 10.1126/science.336.6080.406 | journal = Science | volume = 336 | issue = 6080 | pages = 406–407 | year = 2012 | pmid = 22539695| bibcode = 2012Sci...336..406K }}

Between January 2008 and May 2012, 22,000 measles cases were reported in France. 5,000 patients were hospitalised including 1,023 with severe pneumonia, 27 with encephalitis and/or myelitis, and 10 died.{{cite journal |pmid=23171908 | doi=10.1051/medsci/20122811023 | volume=28 | issue=11 | title=[Measles in France] | year=2012 | journal=Med Sci (Paris) | pages=1003–7 |vauthors=Antona D, Baudon C, Freymuth F, Lamy M, Maine C, Parent du Chatelet I, Lévy-Bruhl D | doi-access=free }} An awareness campaign about MMR vaccination was launched.{{cite news | url = https://www.bbc.co.uk/news/health-15999492 | title = WHO issues Europe measles warning | work = BBC News | date = 2 December 2011 | access-date = 3 December 2011 | archive-url = https://web.archive.org/web/20111203030802/http://www.bbc.co.uk/news/health-15999492 | archive-date = 3 December 2011 | url-status = live | df = dmy-all }}

Most recent reported cases of measles in Portugal are originally imported from other European countries (United Kingdom, France and Romania), Africa (Angola, South African and Ethiopia) and Asia (China).

Descrição dos surtos e casos isolados registados em Portugal, 2004-2012

. Direcao Geral de Saude 2013. Available online:http://www.dgs.pt/ficheiros-de-upload-2013/sarampo-descricao-dos-casos-pdf.aspx {{Webarchive|url=https://web.archive.org/web/20160303171245/http://www.dgs.pt/ficheiros-de-upload-2013/sarampo-descricao-dos-casos-pdf.aspx |date=2016-03-03 }}

Since 2004, Portugal reported 22 confirmed cases of measles. Virus isolates from 2005 and 2008 outbreaks belong the genotype D4.{{cite journal |pmid=18926113 |url=http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19010 |year=2008 |last1=Gíria |first1=M |title=Report on the measles situation in Portugal |journal=Euro Surveillance |volume=13 |issue=42 |last2=Rebelo-De-Andrade |first2=H |last3=Fernandes |first3=T |last4=Pedro |first4=S |last5=Freitas |first5=G |access-date=2015-09-22 |archive-url=https://web.archive.org/web/20150925144153/http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19010 |archive-date=2015-09-25 |url-status=live }} Vaccination coverage in Portugal is ≥95% (since 2006) but pockets of reduced immunization coverage (85-94%) still persist in the population.Programa Nacional de Eliminacao do Sarampo. Direcao Geral de Saude (2013). Available online:https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0062013-de-02042013-jpg.aspx {{Webarchive|url=https://web.archive.org/web/20160303170213/https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0062013-de-02042013-jpg.aspx |date=2016-03-03 }}

In 2021-22 Portugal has reported 0 cases of measles.{{Cite web |title=Reported measles cases for the period February 2021—January 2022 (data as of 10 March 2022) |url=https://www.who.int/europe/publications/m/item/reported-measles-cases-for-the-period-february-2021-january-2022-(data-as-of-10-march-2022) |access-date=2022-11-21 |website=www.who.int |language=en}}

On December 5, 2023, the Romanian Ministry of Health announced in a press communique that there is a measles epidemic in Romania with over 2,000 cases registered.{{Cite web|url=https://www.ms.ro/ro/centrul-de-presa/ministerul-s%C4%83n%C4%83t%C4%83%C8%9Bii-a-declarat-epidemie-de-rujeol%C4%83-la-nivel-na%C8%9Bional/|title=Ministerul Sănătății a declarat epidemie de rujeolă la nivel național|access-date=6 December 2023|publisher=Ministerul Sănătății (Centrul de presă)|author=Government of Romania (press release)|date=5 December 2023}} Anti-measles vaccination in Romania is continuing a descending trend, with 72% of the eligible population having received the first dose and 62% the second dose.{{Cite web|url=https://www.digi24.ro/stiri/actualitate/sanatate/ministerul-sanatatii-declara-epidemie-de-rujeola-in-romania-2604987|title=Ministerul Sănătății declară epidemie de rujeolă în România|publisher=Digi24.ro|date=5 December 2023}}

Fourteen cases have been reported in multiple Australian and New Zealand cities including Melbourne and Auckland in the period between December 7, 2013, and January 3, 2014. The outbreak is believed to have begun at the 2013 World Supremacy Battlegrounds dance festival held in Sydney, Australia.{{cite news|title=Measles outbreak linked to Sydney dance festival|url=http://www.smh.com.au/national/measles-outbreak-linked-to-sydney-dance-festival-20140103-30a1e.html|access-date=4 January 2014|newspaper=The Sydney Morning Herald|date=January 4, 2014|archive-url=https://web.archive.org/web/20140104051511/http://www.smh.com.au/national/measles-outbreak-linked-to-sydney-dance-festival-20140103-30a1e.html|archive-date=4 January 2014|url-status=live|df=dmy-all}}

Ten cases were reported in Christchurch in July 2009.{{cite web |url=http://nz.news.yahoo.com/a/-/latest/5703674/more-cases-confirmed-in-christchurch-measles-outbreak/ |title=More cases confirmed in Christchurch measles outbreak — YahooXtra News |access-date=2009-09-20 |archive-url=https://web.archive.org/web/20090801173716/http://nz.news.yahoo.com/a/-/latest/5703674/more-cases-confirmed-in-christchurch-measles-outbreak/ |archive-date=2009-08-01 |url-status=dead }}

An outbreak between 25 May 2011 and 24 July 2012 in the Auckland region had 489 confirmed or probable cases of measles, 82 of which required hospitalisation.{{cite web |url=http://www.arphs.govt.nz/health-information/communicable-disease/measles |title=Measles |access-date=2013-10-04 |archive-url=https://web.archive.org/web/20121011013404/http://www.arphs.govt.nz/health-information/communicable-disease/measles |archive-date=2012-10-11 |url-status=live }} The outbreak was started with an unimmunised child becoming infected on a family trip to England, then developing measles back in Auckland.

In June and July 2014, 124 confirmed cases of measles were reported in Hamilton. Eighty percent of persons infected were aged between 10 and 20, and all but four were not immunised. Most of those infected were linked with Fraser High School in the city's west, resulting in the school cancelling all school trips and cultural and sporting events.{{cite news |first= Rebecca |last= Quilliam |date= 29 June 2014 |title= School events cancelled due to measles outbreak |url= http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11284120 |publisher= The New Zealand Herald |access-date= 21 January 2015 |archive-url= https://web.archive.org/web/20150121121356/http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11284120 |archive-date= 21 January 2015 |url-status= live |df= dmy-all }}{{cite news |title= Waikato measles outbreak nearing 130 |url= http://tvnz.co.nz/national-news/waikato-measles-outbreak-nearing-130-6048371 |date= 6 August 2014 |publisher= Television New Zealand |access-date= 21 January 2015 |archive-url= https://web.archive.org/web/20150121120055/http://tvnz.co.nz/national-news/waikato-measles-outbreak-nearing-130-6048371 |archive-date= 21 January 2015 |url-status= live |df= dmy-all }}

In 2019, New Zealand saw its worst outbreak in two decades. As of 5 September 2019, there had been 1,051 reported cases, mainly in Auckland which has seen 877 cases.{{cite news |title=New Zealand measles cases top 1000 mark as push to get vaccinations continues |url=https://www.tvnz.co.nz/one-news/new-zealand/new-zealand-measles-cases-top-1000-mark-push-get-vaccinations-continues |access-date=5 September 2019 |publisher=1News |date=5 September 2019}}{{cite news |title=New Zealand measles outbreak rises above 1,000 cases |url=https://www.bbc.com/news/world-asia-49589620 |access-date=5 September 2019 |publisher=BBC News |date=5 September 2019}} There were also reported cases in the South Island's Canterbury region, Otago and Southland regions.{{cite news |title=Measles outbreak: 759 cases now confirmed in Auckland |url=https://www.rnz.co.nz/news/national/397792/measles-outbreak-759-cases-now-confirmed-in-auckland |access-date=1 September 2019 |publisher=Radio New Zealand |date=30 August 2019}} In response to the epidemic, the Government established a National Health Coordination Centre in Auckland.{{cite news |title=National crisis centre set up to combat measles - government |url=https://www.rnz.co.nz/news/national/397811/national-crisis-centre-set-up-to-combat-measles-government |access-date=1 September 2019 |publisher=Radio New Zealand |date=30 August 2019}} On 5 September, the United States Department of State and the Center for Disease Control issued a health travel advisory for US citizens traveling to New Zealand.{{cite news |title=Message for American Citizens regarding the Measles |url=https://nz.usembassy.gov/message-for-american-citizens-regarding-the-measles/ |access-date=5 September 2019 |publisher=U.S. Embassy & Consulate |date=5 September 2019 |archive-date=12 April 2021 |archive-url=https://web.archive.org/web/20210412233249/https://nz.usembassy.gov/message-for-american-citizens-regarding-the-measles/ |url-status=dead }}{{cite news |title=NZ measles outbreak: US State Department, Centre for Disease Control share travel warning to US citizens |url=https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12265074 |access-date=5 September 2019 |publisher=New Zealand Herald |date=5 September 2019}} By 17 September, the number of measles cases had reached 1,327, with 1,108 reported in Auckland. Over 54,000 doses of vaccination had been distributed that month with 52,000 more doses arriving from Belgium on that date.{{cite news |title=Thousands of measles vaccines arrive as Auckland outbreak tops 1100 cases |url=https://www.tvnz.co.nz/one-news/new-zealand/thousands-measles-vaccines-arrive-auckland-outbreak-tops-1100-cases |access-date=17 September 2019 |publisher=1News |date=17 September 2019}}

{{main|2019 Samoa measles outbreak}}

An outbreak in November 2019 resulted in the deaths of 24 children and one adult from over 2,200 cases as of November 25, 2019. The Health Ministry estimates two-thirds of its 200,000 residents are vaccinated, while UNICEF puts the vaccination rate even lower at 28-40 per cent.{{cite news| title = Samoa measles outbreak claims lives of 15 children - sources |url = https://www.rnz.co.nz/international/pacific-news/403586/samoa-measles-outbreak-claims-lives-of-15-children-report| access-date=19 November 2019}}{{cite news| title = Death toll in Samoa measles crisis rises to 22| url = https://www.stuff.co.nz/world/south-pacific/117659220/death-toll-in-samoa-measles-crisis-rises-to-22 | access-date = 23 November 2019}}{{cite news| title = Samoan measles outbreak kills 24 children, with 140 more cases in last day identified| url = https://www.sbs.com.au/news/samoan-measles-outbreak-kills-24-children-with-140-more-cases-in-last-day-identified | access-date = 25 November 2019}} The death toll had increased to 39 by November 28, 2019.{{cite news| title = Samoa measles vaccinations compared to 'Nazi Germany' by social media influencer | url = https://www.abc.net.au/news/2019-11-28/australian-samoan-influencer-measles-crisis-nazi-germany/11737938 | access-date = 28 November 2019}} The death toll reached 53 on December 2. The government had declared a state of emergency on November 15, when schools were closed and children were banned from public gatherings.[https://abcnews.go.com/International/death-toll-samoa-measles-outbreak-rises-53-young/story?id=67431315&cid=clicksource_3029898_null_dp_hed Death toll from Samoa measles outbreak rises to 53, mostly young children] MORGAN WINSOR, ABC News, Dec 2, 2019

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Category:Measles

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