In the period from 20.07-25.07.2019,, a total of 5 cases of measles were reported. From the total number of newly reported cases, 4 cases are from Skopje, while the 1 is from Kumanovo.

During this week, 2 cases are children under the age of 1, 1 case in children from 1-4 years, 1 case from 15-19 years and 1 case from over 30 years.

According to the vaccine status, 4 cases are unvaccinated, incomplete vaccinated or with unknown vaccine status and 1 is vaccinated with 2 doses.

In total, since the onset of the epidemic in December 2018 as of July 25, 2019, 1870 cases of measles have been registered in the Republic of North Macedonia with a disease rate of 90.4 per 100,000 inhabitants.

Due to the epidemiological criteria, a measles epidemic is ongoing on the entire territory of the Republic of North Macedonia.

According to the place of permanent living, measles cases are registered in 24 towns, of which 979 cases are from Skopje, Kumanovo – 231, Tetovo – 194, Struga – 112, Kicevo – 59, Veles – 53, Gostivar – 69, Ohrid-35, Gevgelija -19, Debar -22, Prilep-11, Stip-40, and in other cities less than 10 cases were registered (Chart 1). The highest incidence is registered in Skopje (158.5/100 000, Struga (165.1/100 000, Kumanovo 161.9/100 000) Chart 1.

Chart 1. Geographic distribution of measles in N. Macedonia, December 2018 – July 2019

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The largest number of cases are from the age group over 30 years -838 (44.9%), and the overall disease rate in this age group is 65.8 per 100,000 inhabitants. 320 (17.1%) children under the age of one year were registered and a disease rate of 1369.1 per 100,000 inhabitants. Children aged 1-4 years are registered with 279 cases (14.9%) and the second highest incidence of 300.6 per 100,000 inhabitants (Chart 2).

Chart 2. Distribution of measles patients in N.Macedonia by age, December 2018-July 2019 (n=1.870)

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According to the vaccine status, 1501 or 80.3% of diseased people are unvaccinated, incompletely vaccinated or with unknown vaccine status. From the non-vaccinated persons, 320 (21.3%) are under the age of 12 months and are not subject to vaccination, according to the Immunization Calendar.

Out of 279 children aged 1-4 years, 86.7% were unvaccinated or with unknown vaccine status, and from 838 patients over 30 years of age, 72.2% were unvaccinated, incomplete vaccinated or with unknown vaccine status.

From the reported cases, 88428 or 45.1% were hospitalized, and 296 (15.8%) had complications. Of these, the highest number of complications – 134 or 45.3% were in children from 0-4 –   77 (26%) under the age of one year and 57 (19.3%) in children aged 1-4 years, suggesting that this age group is the most affected and susceptible to complications.

According to the results obtained from the samples sent to Luxembourg’s reference measles laboratory, the B3 Dublin genotype circulates in the country, which circulating also in the neighboring countries.

In Skopje from the beginning of the epidemic, a total of 16333 children were vaccinated to 14 years of age.

In the rest of the country, a total of 17396 children were vaccinated up to 14 years.

The total number of immunized people aged 14 years with MRP vaccine since the start of the epidemic in the republic is 33729.

From the beginning of the epidemic to present date, in the Centers for Public Health, a total of 6032 people have been vaccinated, of which more than 60% are health workers, students and pupils in secondary medical schools, the rest are persons over 14 years of age.