European Immunisation Week 2017

1. Trends for ECDC measles and
rubella monitoring, 2013-2016
European Centre for Disease Prevention and Control
European Immunisation Week, 24−30 April 2017

2. Measles
European Centre for Disease Prevention and Control
European Immunisation Week, 24−30 April 2017

3. Measles surveillance in EU/EEA
30 EU/EEA Member States report measles surveillance data to
ECDC on a monthly basis
Measles cases are reported and presented according to the
2012 EU case definition:
possible, probable, confirmed cases
Notification rates were calculated using the most recent
population estimates available from Eurostat (2016)

4. Number of measles cases by month and
notification rate, 2016, EU/EEA countries
Liechtenstein does not report. NR: Not reported
In the table, countries with a notification rate of ≥1 per million population are highlighted in green. All cases (endemic, imported, import-related) are included in
the calculation of the notification rate. Also included are all confirmed, probable, possible or unknown cases, as defined by the EU 2012 case definition.
Country
2016
Total cases
Cases per
million
Total
lab-positive
casesJan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Austria 0 0 0 2 1 1 8 3 4 3 1 4 27 3.2 25
Belgium 4 8 19 13 17 9 1 0 2 2 2 3 80 7.1 61
Bulgaria 0 1 0 0 0 0 0 0 0 0 0 0 1 0.1 1
Croatia 0 0 0 2 0 0 1 0 1 0 0 0 4 1.0 4
Cyprus 0 0 0 0 0 0 0 0 0 0 0 NR 0 0.0 0
Czech Republic 0 0 1 0 4 0 0 0 1 0 1 0 7 0.7 7
Denmark 0 0 0 1 0 0 0 1 0 0 0 1 3 0.5 3
Estonia 1 0 0 1 0 0 0 0 0 0 0 0 2 1.5 2
Finland 1 0 0 0 0 0 0 0 0 0 0 3 4 0.7 4
France 18 14 12 3 0 7 6 4 7 2 2 4 79 1.2 50
Germany 6 4 16 28 45 72 38 27 30 11 25 21 323 4.0 270
Greece 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Hungary 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Iceland 0 0 0 0 0 0 0 1 0 0 0 NR 1 3.0 1
Ireland 0 1 0 0 19 14 3 5 1 0 1 0 44 9.5 43
Italy 77 85 74 76 84 85 45 34 55 75 84 69 843 13.9 596
Latvia 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Lithuania 0 0 0 10 10 2 0 0 0 0 0 0 22 7.5 22
Luxembourg 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Malta 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Netherlands 0 0 0 0 0 0 0 2 0 0 0 4 6 0.4 5
Norway 0 0 0 0 0 0 0 0 0 0 0 1 1 0.2 1
Poland 0 0 2 0 2 3 5 39 39 24 13 4 131 3.5 80
Portugal 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Romania 6 40 63 67 78 100 112 185 219 417 129 160 1576 79.3 814
Slovakia 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Slovenia 0 0 0 0 1 0 0 0 0 0 0 0 1 0.5 1
Spain 0 0 9 9 0 2 3 2 3 2 6 2 38 0.8 25
Sweden 0 0 0 1 0 0 0 2 0 0 0 0 3 0.3 3
United Kingdom 4 22 44 56 48 76 132 108 29 37 14 1 571 8.8 571
Total 117 175 240 269 309 371 354 413 391 573 278 277 3767 7.3 2589
Source: The European Surveillance System TESSy as of 26 January 2017

5. Number of measles cases by month,
2008-16 (n=114 191), EU/EEA countries
0
1000
2000
3000
4000
5000
6000
7000
2008 2009 2010 2011 2012 2013 2014 2015 2016
Numberofcases
Years
Source: The European Surveillance System (TESSy). Note: From 2008 – 2011, 29 EU/EEA countries reported measles data to ECDC. From 2012 onwards, when
Croatia joined the European Union, 30 EU/EEA countries have been reporting measles data to ECDC.

6. Source: The European Surveillance System TESSy as of 26 January 2017
Measles notification rate per million population by
country, 2016, EU/EEA countries (n=3 767)

7. Source: The European Surveillance System TESSy as of 27 February 2017
Measles notification rate per million population by
country, 2015, EU/EEA countries (n= 4 003)

8. Source: The European Surveillance System TESSy as of 27 February 2017
Measles notification rate per million population by
country, 2014, EU/EEA countries (n=3 656)

9. Source: The European Surveillance System TESSy as of 27 February 2017
Measles notification rate per million population by
country, 2013, EU/EEA countries (n=10 551)

10. Age distribution of measles cases
In 2016
42% of cases were < 5 years
28% of cases were >20 years
In 2015
24% of cases were < 5 years
38% of cases were >20 years
In 2014
21% of cases were < 5 years
53% of cases were >20 years
Measles affects all age groups.
10

11. Age distribution among measles cases by age
group and year, 2006 – 2016, EU/EEA countries
Source: The European Surveillance System TESSy as of 26 January 2017
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
<1 year 1-4 years 5-9 years 10-14 years 15-19 years ≥20 years

12. Percentage distribution of vaccination status
among measles cases by age group, 2016, EU/EEA
countries (n=3 761*)
Source: The European Surveillance System TESSy as of 26 January 2017
* For 6 cases reported in 2016 the age was unknown
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
<1 1-4 5-9 10-14 15-19 20-24 25-29 >=30
Age group (years)
Unvaccinated Vaccination: one dose
Vaccination: ≥ two doses Vaccination with unknown number of doses
Unknown vaccination status
95% measles cases with a known vaccination status were either unvaccinated or
had received an inadequate or unknown number of doses to ensure full protection

13. Measles vaccine coverage, first dose
Vaccine coverage figures are retrieved from the WHO Global Database. When 2015 official country coverage estimates were unavailable,
estimates from 2014 were used.

14. Measles vaccine coverage, second dose
Vaccine coverage figures are retrieved from the WHO Global Database. When 2015 country estimates were unavailable, estimates from
2014 were used.

15. Rubella
European Centre for Disease Prevention and Control
European Immunisation Week, 24−30 April 2017

16. Rubella surveillance in EU/EEA
28 EU/EEA Member States report rubella surveillance data to
ECDC on a monthly basis
Rubella cases are reported and presented according to the
2012 EU case definition:
possible, probable, confirmed cases
Notification rates were calculated using the most recent
population estimates available from Eurostat (2016)

17. Number of rubella cases by month and notification
rate (cases per million) by country, 1 January – 31
December 2016, EU/EEA countries
Country
2016
Total cases
Cases per
million
Total
lab-positive
casesJan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Austria 0 1 1 0 0 0 0 1 0 0 0 0 3 0.4 1
Bulgaria 0 0 0 0 0 0 1 0 0 0 1 0 2 0.3 0
Croatia 0 0 0 0 2 0 0 0 0 0 0 0 2 0.5 2
Cyprus 0 0 0 0 0 0 0 0 0 0 0 NR 0 0.0 0
Czech Republic 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Denmark* 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Estonia 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Finland 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Germany 3 7 5 16 11 15 14 3 5 3 7 5 94 1.2 21
Greece 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Hungary 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Iceland 0 0 0 0 0 0 0 0 0 0 0 NR 0 0.0 0
Ireland 0 0 1 0 0 0 1 1 0 0 0 1 4 0.9 0
Italy 1 4 3 2 7 7 2 1 1 2 4 1 35 0.6 11
Latvia 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Lithuania 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Luxembourg 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Malta 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Netherlands 0 0 0 0 0 0 0 0 0 0 0 NR 0 0.0 0
Norway 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Poland 142 138 111 151 110 116 54 53 48 81 64 76 1144 30.1 19
Portugal 2 1 1 0 1 2 0 0 0 0 1 0 8 0.8 0
Romania 0 0 1 1 2 0 1 1 2 0 1 2 11 0.6 10
Slovakia 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Slovenia 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
Spain 0 0 1 1 0 0 0 0 0 0 0 0 2 0.0 2
Sweden 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0
United Kingdom 0 0 1 0 0 0 0 0 0 0 1 0 2 0.0 2
Total 148 151 125 171 133 140 73 60 56 86 79 85 1307 ** 68
Liechtenstein, Belgium and France do not report. NR: Not reported
In the table, countries with a notification rate of ≥ 1 per million population are highlighted in green. All cases (endemic, imported, import-related)
are included for the calculation of the notification rate. Also included are all confirmed, probable, possible or unknown cases, as defined by the EU
2012 case definition.
* The national surveillance system for rubella in Denmark currently only captures rubella infections during pregnancy; therefore the true incidence
of rubella in the Danish population is underestimated.
Source: The European Surveillance System TESSy

18. Rubella notification rate per million population by
country, 1 January – 31 December 2016, EU/EEA
countries (n=1 307)
Source: The European Surveillance System TESSy as of 26 January 2017