Current: Measles Outbreak, a Global Situation

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: 31 May 2026 | Viewed by 5501

Special Issue Editor


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Guest Editor
1. School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7BL, UK
2. Virology, Veterinary Sciences Division, Agri-Food and Biosciences Institute, Belfast BT4 3SD, UK
Interests: pathogenic mechanisms of RNA viruses (morbilliviruses, respiratory syncytial virus, coronavirus); recombinant vaccine design; genetic markers of virus susceptibility and assessment in small/large animal models; paramyxoviruses; pathogenic mechanisms of measles virus; morbilliviruses; respiratory syncytial virus; coronavirus; vaccine design; vaccination
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Dear Colleagues,

Measles is one of the most infectious diseases known, with 1 individual able to infect up to 15 others. The virus can cause severe complications including pneumonia, ear infections, diarrhea, and post-measles encephalitis (brain inflammation), as well as rare but fatal complications such as subacute sclerosing panencephalitis (SSPE) and inclusion body encephalitis. The disease is preventable due to a highly effective vaccine with 90-95 % coverage required to give herd immunity and the possibility of eventual elimination.  Measles outbreaks are currently happening in most regions of the world. The COVID-19 pandemic led to the suspension of immunization services and hence decline in vaccination rates as well as surveillance in critical areas. Vaccination programmes in war zones are now also severely impacted. Africa, Asia and some South American countries have the highest number of cases with incidence rising in many European countries and the USA. Measles was declared eliminated in the USA in 2000, but outbreaks continue due to unvaccinated international travellers bringing the disease into the country and in some areas, lower vaccine uptake. Similarly, most European countries have rising case numbers, particularly in Romania.  According to the World health organisation in 2023, there were an estimated 107 500 measles deaths globally. Overall, millions of children are left vulnerable to measles and approaches are necessary to regain progress and achieve regional measles elimination targets.

Prof. Dr. S. Louise Cosby
Guest Editor

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Keywords

  • measles
  • vaccination
  • surveillance
  • complications
  • outbreaks

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Published Papers (3 papers)

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Research

25 pages, 4311 KB  
Article
Social Determinants and Outbreak Dynamics of the 2025 Measles Epidemic in Mexico: A Nationwide Analysis of Linked Surveillance Data
by Judith Carolina De Arcos-Jiménez, Pedro Martínez-Ayala, Oscar Francisco Fernández-Diaz, Sergio Sánchez-Enríquez, Patricia Noemi Vargas-Becerra, Ana María López-Yáñez, Roberto Damian-Negrete, Sofía Gutierrez-Perez and Jaime Briseno-Ramírez
Viruses 2026, 18(2), 219; https://doi.org/10.3390/v18020219 - 8 Feb 2026
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Abstract
Measles resurgence threatens elimination achievements in the Americas. We conducted a nationwide analysis of Mexico’s 2025–2026 measles outbreak, integrating individual-level surveillance data from the Special Surveillance System for Febrile Exanthematous Diseases with municipal-level social determinants from eight national databases, complemented by molecular surveillance [...] Read more.
Measles resurgence threatens elimination achievements in the Americas. We conducted a nationwide analysis of Mexico’s 2025–2026 measles outbreak, integrating individual-level surveillance data from the Special Surveillance System for Febrile Exanthematous Diseases with municipal-level social determinants from eight national databases, complemented by molecular surveillance data. We analyzed 6892 confirmed cases using spatial autocorrelation (Moran’s I and LISA), effective reproduction number estimation, logistic regression models for municipal case presence, and multivariable logistic regression for risk factors for complications. Cases concentrated in Chihuahua (65.2%), with 47 LISA hot-spot municipalities containing 64.4% of cases. Molecular surveillance confirmed two independent introductions: D8/MVs/Ontario.CAN/47.24 (98.1%), linked to the North American outbreak, and B3 (1.9%) in Oaxaca. Transmission followed a three-stage pattern: introduction through seasonal agricultural worker networks, amplification in undervaccinated communities, and diffusion to marginalized indigenous populations. A dual-model analysis revealed that school non-attendance among children aged 6–14 years may have mediated the effect of very high marginalization on municipal case presence (OR 1.26; p < 0.001), identifying a potentially actionable vaccination pathway. Vaccine effectiveness was 98.1%, confirming susceptible accumulation rather than vaccine failure. Wave-stratified analysis showed late outbreak phase as an independent risk factor for complications (aOR 1.68, 95% CI: 1.42–2.00), converging with an age of <1 year (aOR 3.36), indigenous status (aOR 1.89), and unvaccinated status (aOR 1.96) in the most marginalized communities. Indigenous individuals comprised 29.1% of cases but 76% of the 25 deaths. This outbreak demonstrates that national vaccination thresholds are insufficient when municipal pockets of susceptibility remain systematically underserved. Full article
(This article belongs to the Special Issue Current: Measles Outbreak, a Global Situation)
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14 pages, 1579 KB  
Article
Measles Virus Genotypes Causing Outbreaks in Tanzania, 2022–2024
by Fausta S. Michael, Maria E. Kelly, Lawrence A. Mapunda, Monica F. Francis, Naimi H. Mbogo, Azizi H. Ituka, Kelvin A. Tenga, Ambele E. Mwafulango, Mariam M. Mirambo, Stephen E. Mshana and Gerald Misinzo
Viruses 2026, 18(2), 182; https://doi.org/10.3390/v18020182 - 29 Jan 2026
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Abstract
Globally, 24 measles virus genotypes have been detected, and these genotypes have been classified into eight clades based on 450 nucleotides of the C-terminal region of the nucleoprotein gene. Genotype B3 is predominant in Africa, but there are limited data from Tanzania since [...] Read more.
Globally, 24 measles virus genotypes have been detected, and these genotypes have been classified into eight clades based on 450 nucleotides of the C-terminal region of the nucleoprotein gene. Genotype B3 is predominant in Africa, but there are limited data from Tanzania since the introduction of the second dose of measles-containing vaccine in 2014. A total of 129 nasopharyngeal samples and corresponding sera were collected during measles outbreaks between 2022 and 2024. Viral RNA was extracted from nasopharyngeal swabs prior to RT-qPCR and sequencing of a 450-nucleotide segment of the nucleoprotein (N) gene. Out of 129 nasopharyngeal samples, 73 (56%) were successfully amplified and identified as endemic measles virus genotype B3. Nine distinct sequence identifiers were detected, with seven reported for the first time in the MeaNS database. All the Tanzanian B3 sequences were closely related and clustered with genotype B3, similar to those reported from Kenya, Ethiopia, Rwanda, Uganda, Burundi, and South Africa. On multivariate analysis, only inpatient admission status (p = 0.014) and positive measles IgM (p = 0.003) were found to be associated with positive measles RT-qPCR. Our results indicate that genotype B3 remains endemic in Tanzania and is closely related to other genotype B3 reported globally, indicating its high stability and transmissibility. Full article
(This article belongs to the Special Issue Current: Measles Outbreak, a Global Situation)
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11 pages, 1019 KB  
Article
Paediatric Measles in Romania: A Comparative Clinical and Epidemiological Analysis of the 2017–2019 and 2023–2024 Epidemic Waves at a Tertiary Care Centre in Bucharest
by Gheorghiță Jugulete, Mădălina Maria Merișescu, Bianca Borcos, Alexandra Nicoleta Totoianu and Anca Oana Dragomirescu
Viruses 2025, 17(6), 755; https://doi.org/10.3390/v17060755 - 26 May 2025
Cited by 2 | Viewed by 2092
Abstract
Measles remains a major public health issue, particularly among paediatric populations who are unvaccinated or lack of maternal antibody transfer. Although the majority of cases manifest with moderate clinical forms, certain patient categories are at risk for severe disease progression. This study aims [...] Read more.
Measles remains a major public health issue, particularly among paediatric populations who are unvaccinated or lack of maternal antibody transfer. Although the majority of cases manifest with moderate clinical forms, certain patient categories are at risk for severe disease progression. This study aims to describe the clinical and epidemiological characteristics of paediatric measles cases hospitalized in the Paediatric Departments of the “Prof. Dr. Matei Balș” National Institute of Infectious Diseases, Bucharest, Romania during two distinct epidemic waves: 2017–2019 and 2023–2024. A retrospective analysis evaluated mortality rates, distribution by age and sex, as well as clinical disease patterns. The 2023–2024 measles epidemic was marked by a higher number of paediatric cases (3.114 vs. 1.068), a lower mortality rate (0.32% vs. 3.74%), a shift towards older age groups, and a greater frequency of complications—particularly gastrointestinal, haematological, and ophthalmological—compared to the 2017–2019 wave. The findings underscore the urgent need for strengthened vaccination programs and targeted public health interventions, particularly among vulnerable groups and patients at risk of developing severe forms of the disease. Owing to a sustained decline in measles vaccination coverage among the paediatric population, Romania has experienced two major measles outbreaks within the past decade, interrupted by the COVID-19 pandemic. This study draws attention to the increasing incidence of measles in older children, suggesting a cumulative effect of reduced immunization rates over time. Full article
(This article belongs to the Special Issue Current: Measles Outbreak, a Global Situation)
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