Epidemiological situation of measles in Romania, Italy, and Hungary: On what threats should we focus nowadays?

Although the prevalence of wild-type measles virus infection has decreased by >90% in Europe, the disease is still not eliminated and has even reemerged with recurrent outbreaks in different countries, including Romania and Italy. Minor outbreaks of Romanian origin were reported from Hungary as well. In Romania, an outbreak has been ongoing since February 2016. As of October 2017, 9,670 measles cases and 35 deaths were registered in the country. The three most affected counties are located next to the Hungarian border. In Italy, until the end of August 2017, 4,477 cases were reported to the surveillance system. The outbreak affected most of the Italian administrative regions. Until October 2017, three minor measles outbreaks were also detected in Hungary. All of these outbreaks were derived from Romanian cases. Although in these countries, there are vaccination programs running, the spread of the disease raises the possibility of secondary vaccine failure.