Italy tops EU/EEA measles case count with 653 infections in 12 months

ECDC count

The European Centre for Disease Prevention and Control counted 2,335 measles cases across 30 EU/EEA states in the 12 months to 31 August 2026. Of these, 2,040 were laboratory confirmed. Italy's 653 cases gave an incidence of 11.1 per million, against a European average of 5.1 per million. Bulgaria followed with 564 cases, Romania 255, Spain 230 and France 146. Bulgaria had the highest rate relative to population, at 87.6 per million. Only five countries recorded no cases in the period.

Second-dose coverage

At the end of September Italy's health ministry told regions to step up surveillance, vaccination and catch-up campaigns. Its circular cited second-dose coverage of 84.45%, against 94.77% for the first dose. The first-dose figure is just under the 95% level the WHO says is needed to stop sustained spread. Regional second-dose coverage is uneven: Bolzano 73.69%, Campania 71.89%, Sicily 67.88%. The Italian Paediatric Society described Italy's case count as worrying, Il Sole 24 ORE reported.

Most cases unvaccinated

Across the EU/EEA, 2,068 cases had known age and vaccination status. Of these, 1,487 (71.9%) were unvaccinated, 342 (16.5%) had one dose, 193 (9.3%) had two or more, and 45 (2.2%) had an unknown number of doses. Of the 2,335 cases with known age, children under five accounted for 636 (27.2%). People aged 15 and over accounted for 1,203 (51.5%). Notification rates were highest among infants under one, at 54.8 per million, followed by children aged one to four at 27.5 per million.

August cases

In August 2026, 28 countries reported measles data. Ten countries reported 143 cases and 18 reported none. Bulgaria (62), Sweden (41), Italy (18), Spain (nine) and Germany (six) logged the most. Case numbers rose against the previous month, although the ECDC said retrospective updates may change that. The agency received no reports of deaths attributable to measles over the 12 months.

Surveillance

The ECDC's complementary surveillance check on 9 October 2026 found no new or ongoing outbreaks in the EU/EEA, only sporadic cases and clusters. In 13 countries in the WHO European region, including France, Germany and Italy, measles is considered endemic, according to Gavi, the Vaccine Alliance.

Global context

Europe averages around 94% coverage for one dose and 88% for two, below the WHO threshold. In low- and middle-income countries, only around 80% of young children receive at least one dose, falling to around 70% for two doses. About 11 million measles cases are expected worldwide in 2026, mostly in Africa and Asia, the World Health Organization estimates. Measles is one of the most contagious infections; one case can infect 17 others. It has no specific treatment. Two doses of MMR give about 97% protection, and one dose gives 93%.