Measles in Romania 2026: we are the European epicenter of a disease that could have been eradicated
With over 35,000 cases between 2023 and 2025, 30 deaths, and a vaccination rate half that of the WHO target, Romania has gone through its most severe measles epidemic episode in recent decades. Although the number of cases dropped significantly in 2025, the accumulated immunity gaps keep the risk at a worrying level. What every citizen and every healthcare professional needs to know.
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35,736 confirmed cases in Romania (Jan. 2023 – Dec. 2025) |
85% of total EU cases originate from Romania (Feb. 2024 – Jan. 2025) |
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30 deaths recorded in the same period, mostly children |
47.4% MMR vaccination rate (first dose) compared to the 95% target |
Current Context — April 2026
Preliminary data for 2025 indicate a reduction of approximately 75% in the number of cases compared to the peak recorded in 2024 — a positive development, partially reflecting the effect of catch-up vaccination campaigns and outbreak control measures. However, public health specialists warn that a decrease in incidence does not equate to the elimination of the epidemic risk.
The main concern at present is immunity gaps — cohorts of children who remained unvaccinated or incompletely vaccinated in previous years, due to disruptions during the COVID-19 pandemic, misinformation, and difficult access to medical services in rural areas. These children, now older, form a susceptible mass large enough to sustain a new epidemic wave if viral transmission intensifies.
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A reduction in cases does not mean we are safe — it means we have a window of opportunity. The immediate priority is catching up on outstanding vaccinations, before the accumulation of susceptible individuals creates the conditions for a new epidemic episode. |
What is measles and why is it so dangerous
Measles is an acute viral disease caused by the measles virus from the Paramyxoviridae family. Although it is often perceived as a trivial childhood disease, current epidemiological data demonstrate that this perception is profoundly wrong and, in some cases, fatal.
Basic reproduction number (R₀)
Measles is one of the most contagious diseases known: each infected person can transmit the virus to 12–18 unvaccinated people (compared to 2–3 for seasonal flu or 1.5–3.5 for the original COVID-19 variant). The herd immunity threshold requires a vaccination coverage of at least 95%.
Severe complications
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Clinically documented complications – Pneumonia: The most common cause of death in children under 5 years old. Occurs in 1–6% of cases. – Acute encephalitis: Cerebral inflammation, with a risk of permanent neurological sequelae. Incidence: ~1/1,000 cases. – Subacute sclerosing panencephalitis (SSPE): A rare but invariably fatal complication that occurs years or decades after infection. Risk of 1–2/10,000 cases, higher in children infected under 2 years old. – Post-measles immunosuppression: The measles virus destroys part of the previously acquired immunological memory (a phenomenon called 'immune amnesia'), increasing vulnerability to other infections for 2–3 years. – Keratitis and blindness: A frequent complication in countries with vitamin A deficiency. – Preterm birth and spontaneous abortion in infected pregnant women. |
Epidemiology of measles in Romania (2023–2025)
Between February 2024 and January 2025, Romania reported 27,568 measles cases — representing 85% of the total recorded in the entire European Union. Italy ranked second, far behind, with 1,097 cases. In 2024, the WHO and UNICEF reported 127,350 measles cases in the European Region — the highest number since 1997 — and Romania contributed 30,692 of these.
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According to the findings of the Regional Verification Commission for Measles Elimination (WHO, September 2025), Romania is among the 13 European countries with endemic transmission of measles — meaning that the disease circulates continuously in the population, without interruption. |
Argeș County records the lowest vaccination coverage in the country: 23.7%. Other counties with alarming figures include Arad (31%), Satu Mare (40%), Suceava, and Neamț (44–46%). The 30 deaths recorded between 2023 and 2025 affected children in Bucharest, Brașov, Giurgiu, Argeș, Iași, Suceava, Satu Mare, and other counties.
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MMR vaccination coverage data (first dose) — source: INSP, 31.12.2025 – National average: 47.4% (vs. the WHO target of 95%) – Lowest-performing county — Argeș: 23.7% – Best-performing county — Bihor: 73.8% (still below the WHO threshold) – No county in Romania has reached the 95% herd immunity target |
How the measles virus is transmitted
Understanding the mode of transmission is essential both for the public and for professionals managing collective spaces.
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Modes of transmission and survival in the environment – Airborne (primary): The virus spreads through respiratory droplets expelled when coughing, sneezing, or speaking. It is airborne — direct contact with an infected person is not required. – Survival in the air: The virus remains active in the air of a room for up to 2 hours after the infected person has left. An unventilated classroom can remain contaminated for hours. – Indirect contact with surfaces: Infected droplets settle on surfaces (desks, handles, toys, teaching materials), where they can remain active for several hours. – Contagion period: A person is contagious for 4 days before and 4 days after the rash appears — often before the disease is diagnosed. |
The role of hygiene and disinfection in prevention
It is important to be clear: vaccination remains the only truly effective method for preventing measles. Disinfection does not replace the vaccine and does not protect against airborne transmission — the primary path of spread. However, hygiene and surface disinfection are essential components of a complete prevention protocol in group settings, especially during active outbreaks.
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HYGIENE in group settings (schools, kindergartens, medical offices) – Ventilation: Frequent airing of spaces is the first and most important decontamination measure for airborne diseases, in accordance with Ministry of Health regulations (Order 185/2003). – Disinfection of frequently touched surfaces: Desks, door handles, light switches, railings, knobs — at least twice a day with approved virucidal spectrum products. – Hand hygiene: Washing hands with soap and water for at least 20 seconds and using disinfectants after contact with common surfaces. – Isolation of cases: Children or adults with compatible symptoms must not attend the collective until 4 days after the disappearance of the rash. – Materials and toys: In nurseries and kindergartens, shared toys and materials must be disinfected daily with approved products compatible with the material they are made of. |
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For professionals: Disinfectants used must be approved by the Ministry of Health and have demonstrated virucidal activity against enveloped viruses (such as those in the Paramyxoviridae family). |
Vaccination — the only real solution
The MMR (Measles-Mumps-Rubella) vaccine is included in the National Vaccination Program and is administered free of charge by the family doctor. The standard schedule provides for the first dose at 12 months of age and the booster at 5 years. The efficacy of the vaccine after the complete schedule (two doses) is approximately 99%.
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High-risk categories – Unvaccinated or incompletely vaccinated children – Infants under 12 months (not yet eligible) – Unvaccinated pregnant women – Young adults without immunity – Immunocompromised individuals |
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Causes of declining vaccination – Disinformation on social media – Excessive bureaucracy in the medical system – Lack of access in rural areas – Elimination of school-based vaccination – Post-pandemic decline |
Romania once achieved a vaccination rate of 98% — at the beginning of the 2000s. Returning to these levels is possible, but requires a coordinated effort: simplifying access to vaccination, reintroducing school-based campaigns, proper medical education, and actively combating disinformation.
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Message for parents: If you are not sure whether you or your child are fully vaccinated against measles, contact your family doctor. A single consultation can prevent a disease with serious and, in rare cases, fatal complications. The MMR vaccine is safe, effective, and free of charge. |
This article was developed for the purpose of informing the general public and professionals in the field. The information regarding disinfection is general in nature — for protocols specific to your facility, consult the Ministry of Health regulations and the specifications of the manufacturers of authorized products.
Sources:
INSP — Measles situation in Romania (31.12.2025)
ECDC — Measles surveillance data 2024–2025
WHO & UNICEF — European Region measles report 2024
Save the Children Romania — Vaccination coverage report 2025
Ministry of Health Order no. 185/2003 — Technical standards for disinfection in healthcare units
Photo source:
Freepik
AI (Gemini)
