Abstract
BACKGROUND
Following substantial progress towards measles elimination after the COVID-19 pandemic, Italy experienced a marked increase in measles cases in 2024.
AIM
Our aim was to describe measles epidemiology in Italy, October 2023–March 2025, and assess vaccination coverage, surveillance performance at national and regional levels, and temporal patterns of transmission.
METHODS
Numbers of measles cases and outbreaks were reviewed. Vaccination coverage and surveillance indicators were described at national and regional levels. Measles variants were classified by genotype and Distinct Sequence Identifier (DSId). Temporal transmission patterns of measles variants were assessed nationally and regionally to identify sustained transmission chains (≥ 12 consecutive months).
RESULTS
In total, 1,311 measles cases were reported, with 178 outbreaks. Cases’ median age was 30.9 years (IQR: 15.6–39.8); 601 were female (45.8%) and 710 male (54.2%). Only 3.1% (38/1,230) were fully vaccinated. In 2024, the first-dose vaccination coverage increased to 94.77% (95% CI: 94.70–94.84%) nationally, while second-dose coverage declined to 84.45% (95% CI: 84.35–84.55%). Among all cases, 12.1% (n = 158) were imported/importation-related, 64.1% (n = 841) were of unknown origin and 52.8% had DSId data available (n = 692), with high regional heterogeneity. Twenty-five measles variants were identified. One variant (D8–5963) showed sustained national transmission for over 12 months, meeting criteria for re-established endemic transmission, although no single region showed uninterrupted ≥ 12-month circulation.
CONCLUSION
Measles resurgence in Italy was marked by persistent immunity gaps, heterogeneous surveillance performance, and sustained national circulation of a D8 variant, indicating loss of near-elimination status. Strengthening vaccination strategies and enhancing molecular surveillance is urgently needed to restore progress towards measles elimination.
Source: Eurosurveillance Journal, https://doi.org/10.2807/1560-7917.ES.2026.31.45.2600090
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