Measles resurgence in Italy: analysis of temporal patterns of viral transmission, surveillance performance, and vaccination coverage at national and regional levels, October 2023 to March 2025
- 1Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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.
Related
- Spatio-temporal dynamics, transmission hotspots, and vaccination gaps driving measles persistence in Nigeria, 2006–2025
- Chikungunya resurgence highlights gaps in Aedes surveillance and control in South America
- Global resurgence of norovirus GII.17[P17] accompanies shifting phylogeographic connectivity patterns: surveillance in Jiangsu, 2023–2025
- Three-year longitudinal safety surveillance following COVID-19 vaccination in individuals with underlying medical conditions
- Boosting vaccination uptake using wastewater surveillance: a county-randomized controlled trial
BibTeX
@article{marzuillo2026measles,
title = {{Measles resurgence in Italy: analysis of temporal patterns of viral transmission, surveillance performance, and vaccination coverage at national and regional levels, October 2023 to March 2025}},
author = {Carolina Marzuillo},
journal = {Eurosurveillance},
year = {2026},
month = nov,
doi = {10.2807/1560-7917.es.2026.31.45.2600090},
url = {https://doi.org/10.2807/1560-7917.es.2026.31.45.2600090},
note = {CC BY},
}
RIS
TY - JOUR
TI - Measles resurgence in Italy: analysis of temporal patterns of viral transmission, surveillance performance, and vaccination coverage at national and regional levels, October 2023 to March 2025
AU - Carolina Marzuillo
PY - 2026
DA - 2026/11/13
JO - Eurosurveillance
DO - 10.2807/1560-7917.es.2026.31.45.2600090
UR - https://doi.org/10.2807/1560-7917.es.2026.31.45.2600090
AB - 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.
SN - 1560-7917
ER -