Where in Europe are cases of measles on the rise?
One of the world's most contagious diseases is spreading in Europe.
Measles has been on the rise for months. Last year was the worst for measles in Europe and Central Asia since 1997, with more than 120,000 cases reported across the region.
Health authorities have warned that cases are likely to rise in the coming months.
So far in 2025, about 5,500 measles cases have been reported across the European Union, according to the European Centre for Disease Prevention and Control (ECDC).
Over the past year, many cases have been among unvaccinated children under the age of five, the agency says.
Measles is usually a mild or moderately severe illness, but in some cases it can lead to deadly complications. It's extremely contagious, but vaccination is effective at keeping people from getting sick.
Here's where cases are highest in 2025, according to ECDC data through the end of April.
The vast majority of the EU's measles cases are in Romania, which has reported 3,605 infections as of late April. Three people have died.
The country's years-long outbreak has been driven by anti-vaccine sentiment, conflicting health guidance, and a medical system struggling to keep up.
In 2023, just 62 per cent of the population was fully vaccinated against measles, far below the 95 per cent threshold needed to prevent outbreaks.
There have been 526 measles cases so far this year in France, spurred in part by a "notable increase" in the number of measles cases brought into the country this year, the ECDC said.
At least 41 infections have been linked to someone who brought the virus in from Morocco, compared to 26 cases in 2024.
In 2023, 93 per cent of people in France were fully vaccinated. But if there are pockets of unvaccinated people in a community, measles can easily take hold.
The Netherlands reported 371 measles infections in the first four months of 2025. More than two dozen cases were among people who contracted measles in Morocco or Romania and then came into the Netherlands.
Dutch health authorities said there are "clusters" of measles infections, for example, at primary schools or childcare facilities, with most cases among children under the age of 10.
But they stressed there is no national measles outbreak.
At 81 per cent, the Netherlands has one of the lowest measles vaccination rates in the EU. Only Romania and Cyprus (80 per cent) had lower coverage levels.
In Italy, 268 measles infections have been recorded so far in 2025. Overall, in the year ending in late January, it's had more cases than anywhere in the EU except Romania.
The country's measles vaccination rate was 85 per cent in 2023, too low to stave off outbreaks.
Spain is experiencing outbreaks in several parts of the country, resulting in 251 measles infections this year. Several cases were also imported from outside of Spain, the ECDC said.
Notably, 92 per cent of people in Spain were fully vaccinated against measles in 2023, landing the country near herd immunity.
In May, the Spanish Ministry of Health encouraged people to check their vaccination status amid the uptick in measles cases both worldwide and within Spain.
"The resumption of mobility after the pandemic has increased the risk of imported cases," the ministry said.
Health officials in the United States have changed their advice to international travellers about measles, saying people should be vaccinated against the virus no matter where they're going.
US residents are recommended to get measles-mumps-rubella shots, anyway. But the US Centers for Disease Control and Prevention (CDC) previously emphasised the importance of vaccination for travellers going to countries with outbreaks.
Last week, the CDC updated its guidance to call for vaccinations for travellers going to all other countries.
Ashley Darcy-Mahoney, a researcher at George Washington University's nursing school in the US, called the update significant.
A Colorado outbreak last month stemmed from an international flight that landed in Denver, she noted. The CDC travel notice change reflects a recognition that people are not just being exposed to measles in countries where it's spreading, but also in airplanes and during travel, she added.
"We're seeing a shift from localised outbreaks to transmission in transit," and the CDC seems to be responding to that, Darcy-Mahoney said.
In line with recommendations in the European Union, the CDC's travel notice advises two doses for all Americans ages 1 and older, and an early dose for travelling infants ages 6 months to 11 months.
Meanwhile, the European Centre for Disease Prevention and Control (ECDC) recommends that travellers ensure they are up-to-date on their vaccinations before going abroad.
So far this year, the US has seen more than 1,000 measles cases, and the EU has reported more than 5,500 cases.
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