In the period from 17-23.05.2019, a total of 105 cases of measles were reported. From the total number of newly reported cases, 46 cases are from Skopje, while the remaining 59 are from 9 other cities in N. Macedonia – Kicevo (17), Struga(25), Tetovo (8), Kumanovo (7), Stip (7), Struga (6), Ohrid (1), Veles (4), Negotino-(1),. During this week, the highest number of cases (56) are over the age of 30,

According to the vaccine status, 81 or 77.1% 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 23, 2019, 1625 cases of measles have been registered in the Republic of North Macedonia with a disease rate of 78.5 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 23 towns, of which 925 cases are from Skopje, Kumanovo – 189, Tetovo – 136, Struga – 112, Kicevo – 56, Veles – 40, Gostivar – 42, Ohrid-25, Gevgelija -19, Debar -27, Prilep-10, Stip-11, Prilep-10  and in other cities less than 10 cases were registered (Chart 1). The highest incinedce is registered in Skopje (149.8/100 000, Struga (165.1/100 000, Kumanovo 132.5/100 000) Chart 1.

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 -727, and the overall disease rate in this age group is 57.1 per 100,000 inhabitants. 261 children under the age of one year were registered and a disease rate of 1189.4 per 100,000 inhabitants. Children aged 1-4 years are registered with 233 cases (14.3%) and the second highest incidence of 251.0 per 100,000 inhabitants (Chart 2).

Chart 2. Distribution of measles patients in N.Macedonia by age, December 2018-May 2019 (n = 1625)

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According to the vaccine status, 1213 or 74.6% of diseased people are unvaccinated, incompletely vaccinated or with unknown vaccine status. From the non-vaccinated persons, 278 (22,9%) are under the age of 12 months and are not subject to vaccination, according to the Immunization Calendar.

Out of 233 children aged 1-4 years, 87.1% were unvaccinated or with unknown vaccine status, and from 970 patients over 20 years of age, 65,4% were unvaccinated, incomplete vaccinated or with unknown vaccine status.

From the reported cases, 689 or 42.5% were hospitalized, and 253 (15,6%) had complications. Of these, the highest number of complications – 115 or 45,5% were in children from 0-4 –   69 (27,3%) under the age of one year and 46 (18,2%) 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 14541 children were vaccinated to 14 years of age.

In the rest of the country, a total of 12707 children

The total number of immunized people aged 14 years with MRP vaccine since the start of the epidemic in the republic is27248.

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 2439 contacts and persons over 14 years of age.