Measles cases in Europe and Central Asia doubled last year compared to 2023, the World Health Organisation (WHO) and UNICEF have warned in what is being called a “wake-up call”.
There were 127,350 reported infections in the region in 2024, which is the highest number since 1997.
It is around a third of last year’s total worldwide cases of 359,521.
More than 40% of the European cases were children under five, as the two global bodies appealed for urgent action to increase vaccination levels.
In 2023, half a million children across the region missed the first dose of the vaccine (MCV1) that should be given through routine immunisation services, said the organisations.
Two doses of the measles vaccine are believed to be 97% effective in preventing the disease, which typically affects the respiratory system and leads to symptoms such as fever, cough, runny nose and a rash.
Measles is one of the most contagious viruses for humans. In serious cases, infections can cause complications including pneumonia, encephalitis, dehydration and blindness.
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More than half of the European region cases had to be treated in hospital, and 38 people died.
‘Measles is back’
WHO’s Europe director Dr Hans Kluge said: “Measles is back, and it’s a wake-up call.” He added: “Without high vaccination rates, there is no health security… The measles virus never rests – and neither can we.”
The nation with the most infections last year was Romania which had 30,692, followed by Kazakhstan with 28,147.
Fewer than 80% of eligible children in Bosnia and Herzegovina, Montenegro, North Macedonia and Romania were vaccinated with MCV1 in 2023 – which is well below the 95% coverage rate needed to prevent an outbreak.
In Montenegro, fewer than 50% of children have been vaccinated against measles for at least the past five years. In Bosnia and Herzegovina, the figure was less than 70%.
UK officials said last month there have been more than 200 reported cases in the country and that many more were expected.
Vaccination rates not back to pre-pandemic levels
Measles cases in the region have generally been declining since 1997, when 216,000 were reported, reaching a low of 4,440 cases in 2016, according to the WHO and UNICEF.
Image: File pic: iStock
However, a resurgence was seen in 2018 and 2019 with 89,000 and 106,000 cases reported for those years respectively.
After a drop in immunisation coverage during the COVID pandemic, cases rose significantly again in 2023 and 2024.
Vaccination rates in many countries are yet to return to pre-pandemic levels, increasing the risk of outbreaks.
Measles is spread when an infected person breathes, coughs or sneezes.
A rash usually appears a few days after the cold-like symptoms. The rash starts on the face and behind the ears before spreading to the rest of the body.
A person is infectious from when they first have symptoms (around four days before the rash appears) until four days after they get the rash.
There are things people can do to reduce the risk of spreading or catching measles.
Do:
Wash hands often with soap and warm water.
Use tissues when coughing or sneezing.
Throw used tissues in the bin.
Don’t:
Do not share cutlery, cups, towels, clothes, or bedding.
Information from NHS website
‘Never too late to be vaccinated’
Concerns about the safety of the measles vaccine have lingered for decades, after British physician Dr Andrew Wakefield and colleagues published a paper in 1998 – which has long since been retracted – linking the measles, mumps and rubella (MMR) vaccine to autism.
No evidence for any causal link has ever been found and Wakefield had his licence to practise medicine in the UK revoked.
“It’s never too late to get vaccinated,” said Dr Ben Kasstan-Dabush, from the London School of Hygiene and Tropical Medicine, who warned that misinformation can unfortunately travel rapidly. “Even a small decline in vaccine uptake can have devastating consequences.”
In the US, an outbreak in Texas and New Mexico, which led to the country’s first measles deaths in a decade, has seen 28 more infections this week, taking the total to 256.
It is the first major challenge for new health secretary and long-time vaccine sceptic Robert F Kennedy Jr.
Vladimir Putin made demands to take control of key regions of Ukraine during his talks with Donald Trump, it has been widely reported, as a condition for ending the war.
During their summit in Alaska, the Russian leader is said to have told the US president he wants the eastern Donetsk and Luhansk regions – and would give up other Ukrainian territories held by his troops in exchange.
The plans were reported by several news outlets, citing sources close to the matter, as Mr Trump scheduled a further meeting with Ukrainian president Volodymyr Zelenskyy in Washington DC for Monday. He has said this could potentially pave the way for a three-way meeting with Mr Putin.
Mr Trump reportedly backs the plans, according to some outlets – but Mr Zelenskyy has previously ruled out formally handing any territory to Moscow. Russia already controls a fifth of Ukraine, including about three-quarters of Donetsk province, which it first entered in 2014.
Details of the plans emerged after little was revealed during the high-profile summit between the US and Russian leaders on Friday.
Despite threats by the US president beforehand, of sanctions for Russia should there be no agreement on a ceasefire, a short news briefing after the talks ended with no mention of a suspension of fighting, no announced agreement on how to end the war, and little clarity about the next steps.
On Saturday, Mr Trump appeared to change his stance on what he hopes to achieve in Ukraine, indicating he wants a permanent peace settlement rather than a ceasefire.
“It was determined by all that the best way to end the horrific war between Russia and Ukraine is to go directly to a Peace Agreement, which would end the war, and not a mere Ceasefire Agreement, which often times do not hold up,” he said in a post on his social network site, Truth Social.
Image: Pic: Sergei Bobylev/ Sputnik/ Kremlin pool via AP
Trump: ‘Russia is a big power – they’re not’
In an interview with Fox News following the summit, Mr Trump signalled he and Putin had discussed land transfers and security guarantees for Ukraine, and had “largely agreed”. He said Ukraine has to made a deal, as “Russia is a very big power, and they’re not”.
Monday’s meeting at the White House will be the Ukrainian president’s second this year. His last descended into a fiery spat with Mr Trump and his vice president JD Vance, which saw him leave early.
After the fresh meeting was announced, Mr Zelenskyy in a post on X that he was grateful for the invitation.
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5:55
Trump and Putin’s body language analysed
“It is important that everyone agrees there needs to be a conversation at the level of leaders to clarify all the details and determine which steps are necessary and will work,” he said.
However, he said Russia had rebuffed “numerous calls for a ceasefire and has not yet determined when it will stop the killing”, which “complicates the situation”.
Mr Zelenskyy continued: “If they lack the will to carry out a simple order to stop the strikes, it may take a lot of effort to get Russia to have the will to implement far greater – peaceful coexistence with its neighbours for decades.
“But together we are working for peace and security. Stopping the killing is a key element of stopping the war.”
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23:24
Trump and Putin in Alaska – The Debrief
Putin releases statement on summit
In a statement on the summit, Mr Putin described the talks as “timely and quite useful” – but said the “removal” of what he calls the “root causes” of the crisis “must underlie the settlement”.
He continued: “We definitely respect the US administration’s position which wants the hostilities to stop as soon as possible. So do we, and we would like to move forward with settling all issues by peaceful means.
“The conversation was very frank and substantive, which, in my view, moves us closer towards making necessary decisions.”
Image: Keir Starmer welcomed Volodymyr Zelenskyy to Downing Street earlier this week. Pic: AP/ Kirsty Wigglesworth
European leaders who make up the “coalition of the willing” are set to hold a conference call today ahead of the crunch talks between Mr Trump and Mr Zelenskyy.
Prime Minister Keir Starmer, French President Emmanuel Macron and German Chancellor Friedrich Merz will host the video conference.
In a statement on Saturday,Sir Keir said Mr Trump’s efforts had “brought us closer than ever before to ending Russia’s illegal war in Ukraine” and that his leadership “in pursuit of an end to the killing should be commended”.
He said he supported the next phase of talks, but added: “In the meantime, until (Putin) stops his barbaric assault, we will keep tightening the screws on his war machine with even more sanctions.”
Meanwhile, Ukraine’s military has reported an advance of up to 2km on the Sumy front in the country’s northeast.
“Zones of continuous enemy fire damage are being maintained,” the Ukrainian General Staff said on Telegram. “Ukrainian troops are repelling Russian forces”.
In the early hours of Sunday, a regional governor in Russia said a railway employee had been injured and a power line damaged by a Ukrainian drone attack.
The incident happened in the Voronezh region, Alexander Gusev said on Telegram.
European leaders who make up the ‘coalition of the willing’ are set to hold a conference call on Sunday – ahead of crunch talks between Donald Trump and Ukraine’s Volodymyr Zelenskyy next week.
The coalition – co-chaired by Sir Keir Starmer, France’s President Emmanuel Macron and Germany’s Chancellor Friedrich Merz – has the aim of bringing countries together to protect a peace deal in Ukraine.
Top of the agenda at Sunday’s meeting will be securing a concrete commitment from Mr Trump on a security guarantee that would act as a powerful backstop in any Russia-Ukraine peacekeeping arrangement.
European leaders seemed buoyed by the US president’s most recent hints on the subject, in the knowledge that US military might is likely to deter Vladimir Putin from advancing in the future.
They will also discuss how to bring Mr Zelenskyy into talks after Mr Trump and Mr Putin’s Alaska meeting saw him left out in the cold.
Image: The Russian and US presidents met in Alaska on Friday. Pic: AP
Image: Volodymyr Zelenskyy. Pc: Reuters
In coordinated statements, European leaders said Mr Zelenskyy must play a greater role in future talks, and that peace cannot be achieved without him.
The hard bit will be to persuade the unpredictable US administration to change its approach, something that has proved almost impossible in the past.
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5:55
Trump and Putin’s body language analysed
When Mr Trump re-entered the White House and made it clear the US would no longer provide a blank cheque to protect peace in Europe, others decided they had to step up, and the ‘coalition of the willing’ was thrown together in March.
Since then, information about the allied peacekeeping effort has been patchy, but we know it includes over 30 countries, which have been asked to pledge whatever military support they can, including troops.
No deal has been reached to end the war in Ukraine – but Donald Trump has said there are “many points” he and Vladimir Putin agreed on during their highly anticipated summit.
Following the meeting in Alaska, which lasted more than two-and-a-half hours, the two leaders gave a short media conference giving little detail about what had been discussed, and without taking questions.
Mr Trump described the meeting as “very productive” and said there were “many points that we agreed on… I would say a couple of big ones”.
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2:20
Key moments from Trump-Putin news conference
But there are a few left, he added. “Some are not that significant. One is probably the most significant, but we have a very good chance of getting there…
“We haven’t quite got there, we’ve made some headway. There’s no deal until there’s a deal.”
Mr Putin described the negotiations as “thorough and constructive” and said Russiawas “seriously interested in putting an end” to the war in Ukraine. He also warned Europe not to “torpedo nascent progress”.
Image: Donald Trump greets Vladimir Putin at Joint Base Elmendorf-Richardson, Alaska. Pic: AP/ Julia Demaree Nikhinson
After much build-up to the summit – with the US president threatening “severe” consequences for Russia should it not go well – it was ultimately not clear whether the talks had produced meaningful steps towards a ceasefire in what has been the deadliest conflict in Europe in 80 years.
Mr Trump said he intended to speak with Ukrainian President Volodymyr Zelenskyy and other European leaders, who were excluded from the discussions, to brief them.
Despite not reaching any major breakthrough, the US leader ended his remarks with a thank you, and said he would probably see Mr Putin again “very soon”.
When the Russian president suggested that “next time” would be Moscow, he responded by saying he might face criticism, but “I could see it possibly happening”.
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2:10
Trump applauds Putin and shares ride in ‘The Beast’
The red carpet treatment
The news conference came after a grand arrival at the Elmendorf-Richardson military base in Anchorage, where the US president stepped down from Air Force One and later greeted his Russian counterpart with a handshake and smiles on a red carpet.
Mr Putin even travelled alongside Mr Trump in the presidential limousine, nicknamed “The Beast”.
It was the kind of reception typically reserved for close US allies, belying the bloodshed and the suffering in the war.
Before the talks, the two presidents ignored frantically-shouted questions from journalists – and Mr Putin appeared to frown when asked by one reporter if he would stop “killing civilians” in Ukraine, putting his hand to his ear as though to indicate he could not hear.
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3:22
‘Fury, anger and disgust’ in Ukraine
Our US correspondent Martha Kelner, on the ground in Alaska, said he was shouting “let’s go” – apparently in reference to getting the reporters out of the room.
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3:02
What we learned from Trump-Putin news conference
A ’10/10′ meeting
During his first day back in the White House in January, Mr Trump had pledged confidently to bring about an end to the war in Ukraine.
But seven months later, after infamously berating Mr Zelenskyy during a meeting at the Oval Office in February, and then stanching the flow of some US military assistance to Kyiv, he still does not appear to have brought a pause to the conflict.
In an interview with Fox News before leaving Alaska, Mr Trump described the meeting with Mr Putin as “warm” and gave it a “10/10”, but declined to give details about what they discussed.
He also insisted that the onus going forward could be on Mr Zelenskyy “to get it done”, but said there would also be some involvement from European nations.
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7:06
Trump’s body language was ‘disappointed’
What happens next?
Mr Trump is expected to speak to Mr Zelenskyy, Sir Keir Starmer and European leaders about the talks.
A meeting of ambassadors from European countries has been scheduled for 8.30am UK time, EU presidency sources have told Sky News.
European heads of state and Mr Trump are also likely to have a virtual meeting later in the day.
Despite the US president’s efforts to bring about a ceasefire, Russian attacks on Ukraine have only intensified in the past few months.