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.
Donald Trump has said that his 28-point peace plan for Ukraine is “by far” not the “final offer”, ahead of crisis talks in Geneva.
Meeting on the sidelines of a G20 summit in South Africa, European and other Western leaders scrambled to respond to the US president’s demand for Ukraine to accept the plan drawn up by the Trump administration and the Kremlin.
In a joint statement on Saturday, they said the plan announced on Friday could serve as a basis for talks to end Russia’s war in Ukraine but required “additional work”.
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As a result, a meeting has been hastily convened in Geneva, Switzerland, on Sunday, where national security advisers from the E3 – France, Britain and Germany – will meet EU, US and Ukrainian officials for further discussions.
Ahead of the talks, Volodymyr Zelenskyy said in a video address to his nation that Ukrainian representatives at the talks “know how to protect Ukrainian national interests and exactly what is needed to prevent Russia from carrying out” another invasion.
“Real peace is always based on security and justice,” the Ukrainian leader added.
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3:08
PM: ‘More to do’ on US Ukraine peace plan
The 28-point peace plan closely resembles the list of demands repeatedly stated by the Kremlin since it launched its full-scale invasion of Ukraine nearly four years ago and if adopted, would see Ukraine cede territory to Russia – and cut the size of its military.
Mr Trump has said he wants a response from Ukraine by Thursday, while suggesting an extension could be possible.
On Saturday, Mr Trump told reporters outside the White House that the plan was not the “final offer” when asked.
He said: “We’d like to get the peace, it should’ve happened a long time ago. The Ukraine war with Russia should’ve never happened. If I was president, it would have never happened. We’re trying to get it ended. One way or another, we have to get it ended.”
His secretary of state Marco Rubio insisted that the peace proposal was authored by the US, despite what a handful of senators have alleged.
“It is based on input from the Russian side. But it is also based on previous and ongoing input from Ukraine,” he said.
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3:42
The 28-point peace plan explained
Leaders have sought to balance praise for President Trump’s attempt to end the war with recognition that some terms in his proposal are unpalatable for Kyiv.
“There are many things that cannot simply be an American proposal, which requires broader consultation,” French President Emmanuel Macron said on the sidelines of the G20, adding that an agreement had to allow for peace for Ukrainians and “security for all Europeans”.
German Chancellor Friedrich Merz underlined the importance to Europe of supporting Ukraine.
“If Ukraine loses this war and possibly collapses, it will have an impact on European politics as a whole, on the entire European continent. And that is why we are so committed to this issue,” he said.
“There is currently an opportunity to end this war, but we are still quite a long way from a good outcome for everyone.”
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0:48
Keir Starmer calls for growth plan at G20
Prime Minister Sir Keir Starmer told reporters in Johannesburg: “We are concerned about [caps on military], because it’s fundamental that Ukraine has to be able to defend itself if there’s a ceasefire.”
He said the proposal “requires additional work”, adding: “And that’s why there’s been the agreement that in Geneva tomorrow [Sunday], you’ll have senior US personnel, you’ll have European NSAs [national security advisers], including the UK NSA, and obviously Ukrainians there to work further on the draft.”
Sir Keir also spoke to Mr Trump, relaying discussions held at G20 to the US leader, according to a Downing Street spokesperson, who added that the two leaders would speak again on Sunday.
“The G20 has worked together before to fix fundamental problems in the global economy. We need to find ways to play a constructive role again today in the face of the world challenges,” he said.
“I’d like to see us come together around a five-point plan for growth that leaves no one behind.”
Image: Sir Keir Starmer, Emmanuel Macron and Friedrich Merz at the G20 summit. Pic: PA
The US, however, is boycotting the talks.
The Trump administration made its opposition to South Africa’s G20 agenda clear earlier this year when the country started holding meetings ahead of the summit. South Africa gets to set the agenda as the country holding the rotating G20 presidency.
G20 leaders broke with tradition and adopted a declaration at the start of their summit – despite opposition from the US.
Vincent Magwenya, spokesman for South African president Cyril Ramaphosa, said a leaders’ declaration was adopted unanimously in Johannesburg.
The White House later accused South Africa of refusing to facilitate a smooth transition of the G20 presidency.
The G20 bloc was formed in 1999 as a bridge between rich and poor nations to confront global financial crises.
While it often operates in the shadow of the powerful Group of Seven nations, G20 members represent around 85% of the world’s economy, 75% of international trade and more than half the global population.
Countries attending COP30, the biggest climate meeting of the year, have agreed steps to help speed up climate action, according to a draft deal.
The meeting of leaders in the Brazilian city of Belem also saw them agree to reviewing related trade barriers and triple the money given to developing countries to help them withstand extreme weather events, according to the draft.
However, the summit’s president Correa do Lago said “roadmaps” on fossil fuels and forests would be published as there was no consensus on these issues.
The annual United Nations conference brings together world leaders, scientists, campaigners, and negotiators from across the globe, who agree on collective next steps for tackling climate change.
The two-week conference in the Amazon city of Belem was due to end at 6pm local time (9pm UK time) on Friday, but it dragged into overtime.
The standoff was between the EU, which pressed for language on transitioning away from fossil fuels, and the Arab Group of nations, including major oil exporter Saudi Arabia, which opposed it.
The impasse was resolved following all-night negotiations led by Brazil, negotiators said.
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The European Union’s climate commissioner, Wopke Hoekstra, said on Saturday that the proposed accord was acceptable, even though the bloc would have liked more.
“We should support it because at least it is going in the right direction,” he said.
The Brazilian presidency scheduled a closing plenary session.
Brazil’s President Luiz Inacio Lula da Silva and about 80 countries, including the UK and coal-rich Colombia, had been pushing for a plan on how to “transition away from fossil fuels”.
This is a pledge all countries agreed to two years ago at COP28 – then did very little about since.
But scores of countries – including major oil and gas producers like Saudi Arabia and Russia – see this push as too prescriptive or a threat to their economies.
This breaking news story is being updated and more details will be published shortly.
Israel says it has begun striking Hamas targets in Gaza, reportedly killing at least nine people, after what it called a “blatant violation of the ceasefire agreement”.
Local health authorities in Gaza said there had been three separate airstrikes, one hit a car in the densely populated Rimal neighbourhood, killing five people and wounding several others.
Shortly after the attack on the car, the Israeli air force hit two more targets in the central Gaza Strip, medics said.
They said at least four people died when two houses were struck in Deir Al-Balah city and Nuseirat camp.
The Israeli military said there had been a “blatant violation of the ceasefire agreement”.
It claimed a gunman had crossed into Israeli-held territory after exploiting “the humanitarian road in the area through which humanitarian aid enters southern Gaza”.
A Hamas official rejected the Israeli military’s allegations as baseless, calling them an “excuse to kill”, adding the Palestinian group was committed to the ceasefire agreement.
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The Israeli airstrikes are a further test of a fragile ceasefire with Hamas, which has held since 10 October following the two-year Gaza war.
Israel pulled back its troops, and the flow of aid into the territory has increased. But violence has not completely halted.
Palestinian health authorities say Israeli forces have killed 316 people in strikes on Gaza since the truce.
Meanwhile, Israel says three of its soldiers have been killed since the ceasefire began and it has attacked scores of militants.
This breaking news story is being updated and more details will be published shortly.