In the period from 10-16.05.2019, a total of 134 cases of measles were reported. From the total number of newly reported cases, 48 cases are from Skopje, while the remaining 86 are from 10 other cities in N. Macedonia – Struga(25), Tetovo (11), Kumanovo (26), Ohrid (8), Veles (6), Prilep (1), Gostivar (5), Valandovo (5), Debar (1), Kriva Palanka-1,. During this week, the highest number of cases (82) are over the age of 20,

According to the vaccine status, 94 or 70.1% 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 16, 2019, 1524 cases of measles have been registered in the Republic of North Macedonia with a disease rate of 73.7 per 100,000 inhabitants. 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 22 towns, of which 882 cases are from Skopje, Kumanovo – 183, Tetovo – 129, Struga – 106, Kicevo – 39, Veles – 36, Gostivar – 41, Ohrid-24, Gevgelija -19, Debar -19, Prilep-10,  and in other cities less than 10 cases were registered (Chart 1). The highest incinedce is registered in Skopje (142.8/100 000, Struga (156.2/100 000, Kumanovo 128.3/100 000)

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

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The largest number of cases are from the age group over 30 years -673, and the overall disease rate in this age group is 52.9 per 100,000 inhabitants. 261 children under the age of one year were registered and a disease rate of 1016.7 per 100,000 inhabitants. Children aged 1-4 years are registered with 229 cases and the second highest incidence of 246.7 per 100,000 inhabitants (Chart 2).

Chart 2. Distribution of measles patients in N.Macedonia by age, December 2018-May 2019 (n = 1524)

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According to the vaccine status, 1136 or 74.5% of diseased people are unvaccinated, incompletely vaccinated or with unknown vaccine status. From the non-vaccinated persons, 261 (17.1%) are under the age of 12 months and are not subject to vaccination, according to the Immunization Calendar.

Out of 229 children aged 1-4 years, 87.8% were unvaccinated or with unknown vaccine status, and from 898 patients over 20 years of age, 64.7% were unvaccinated, incomplete vaccinated or with unknown vaccine status.

From the reported cases, 643 or 42.2% were hospitalized, and 238 (16.2%) had complications. Of these, the highest number of complications – 107 or 45% were in children from 0-4 –   62 (26,1%) under the age of one year and 45 (18,9%) 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 14103 children were vaccinated to 14 years of age.

In the rest of the country, a total of 11705 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 25808.

From the beginning of the epidemic to present date, in the Centers for Public Health, a total of 1780 people have been vaccinated, of which more than 65% are health workers, students and pupils in secondary medical schools, the rest are contacts and persons over 14 years of age.