In the period from 26.04.02.04.2019, a total of 110 cases of measles were reported. From the total number of newly reported cases, 46 cases are from Skopje, while the remaining 64 are from 8 other cities in N. Macedonia – Struga(10), Tetovo (9), Kumanovo (25), Veles (1), Gostivar 8), Valandovo (1), Kratovo-1, Kicevo-8, Kriva Palanka-1. During this week, the highest number of cases (73) are over the age of 20,

According to the vaccine status, 84 or 76.4% of the registered cases are unvaccinated, incomplete vaccinated or with unknown vaccine status.

In total, since the onset of the epidemic in December 2018 as of May 2, 2019, 1285 cases of measles have been registered in the Republic of North Macedonia with a disease rate of 62.1 per 100,000 inhabitants, the highest number of registered cases in the last 10 years. Due to the epidemiological criteria, a measles epidemic has been declared on the entire territory of the Republic of North Macedonia.

According to the place of permanent living, measles cases are registered in 21 towns, of which 797 cases are from Skopje, Kumanovo – 134, Tetovo – 108, Struga – 71, Kicevo – 38, Veles – 26, Gostivar – 35, Gevgelija -18, Debar -17, and in other cities less than 10 cases were registered (Chart 1). The highest incinedce is registered in Skopje (129/100 000, Struga (104.6/100 000, Kumanovo 93,9/100 000)

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

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The largest number of cases are from the age group over 30 years -555, and the overall disease rate in this age group is 43.6 per 100,000 inhabitants. 217 children under the age of one year were registered and a disease rate of 928.4 per 100,000 inhabitants. Children aged 1-4 years are registered with 211 cases and the second highest incidence of 227.3 per 100,000 inhabitants (Chart 2).

Chart 2. Distribution of measles patients in N.Macedonia by age, December 2018-April 2019 (n = 1285)

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According to the vaccine status, 895 or 76.1% of diseased people are unvaccinated, incompletely vaccinated or with unknown vaccine status. From the non-vaccinated persons, 217 (16.9%) are under the age of 12 months and are not subject to vaccination, according to the Immunization Calendar.

Out of 211 children aged 1-4 years, 88.2% were unvaccinated or with unknown vaccine status, and from 747 patients over 20 years of age, 65.9% were unvaccinated, incomplete vaccinated or with unknown vaccine status.

From the reported cases, 546 or 42.5% were hospitalized, and 215 (17.4%) had complications. Of these, the highest number of complications – 56 or 26% were in children under the age of one year and 43 (20%) in children aged 1-4 years, suggesting that this age group is the most affected and susceptible to complications.

In Skopje from the beginning of the epidemic, a total of 13375 children were vaccinated to 14 years of age.

In the rest of the country, a total of 9555 children under the age of 14 were vaccinated with a first or second dose.

The total number of immunized people aged 14 years with MRP vaccine since the start of the epidemic in the republic is 22930.