Peer-reviewed article

Measles - retrospective study of cases reported in a national notification system, Czech Republic, 2018-2024.

Monika Liptáková, Marek Malý, Michaela Špačková, Radomíra Limberková, Lada Svobodová et al. · 25 Mar 2026

Abstract

BACKGROUND: In response to the recent increase in measles cases and outbreaks across Europe, Czech surveillance data were analysed. The aim was also to evaluate the effect of vaccination on measles complications. METHODS: Cases of measles reported to the national surveillance system according to the EU case definition (2018) between 2018–2024, were analysed. Demographic characteristics were assessed using descriptive analysis (counts and proportions). Logistic regression with an odds ratio (OR) supplemented with the 95% confidence interval (95% CI) was calculated to measure the association between vaccination status and the occurrence of complications. RESULTS: A total of 791 measles cases were reported during the study period, of which 762 (96%) were laboratory confirmed, 29 (4%) were probable and 416 (53%) were male. Most cases (546; 69%) occurred in 2019. Half of the cases (n = 395, 50%) were outbreak related. The median age of cases was 33 years (range: 0–54). In total, 109 (14%) measles cases were imported (62 from Ukraine and smaller numbers from 25 other countries; 57 of the imported cases were unvaccinated) and 523 cases (70%) were hospitalised. In total, 330 (42%) of all cases were known to have been vaccinated, of which 205 (62%) with two or three doses and 75 (23%) with only one dose. Of 88 complications (11% of all cases) was pneumonia most frequent (n = 19; 2%). The highest proportion of complications occurred in infants (< 1 year [too young to be vaccinated]; 28%) and in children aged 1–4 years (20%). Compared to unvaccinated cases, two and more vaccine doses significantly reduced odds of any complications (OR = 0.44, 95% CI: 0.24–0.81, p = 0.008). CONCLUSIONS: Within analysed 7-year period most cases were detected pre-pandemic in 2018 and 2019. It is likely that restrictive measures limited further epidemic potential. Isolation of measles case is mandatory in Czech Republic; therefore, this criterion does not reflect the clinical severity of cases. Having this limitation in mind, the effect of vaccination against measles complications only was demonstrated. To prevent further cases, increased awareness and promotion of measles vaccination is recommended for all individuals, including travellers, as a substantial proportion of cases were unvaccinated.