Measles cases doubled in Europe in 2024 to a 25-year high, the World Health Organization said on Thursday, stressing the importance of vaccinations to curb the illness’ spread.

Last year, 127,350 cases of measles and 38 deaths were registered in the WHO’s European region, which counts 53 countries and includes central Asia.

Romania and Kazakhstan were the countries most affected, reporting 30,692 and 28,147 cases respectively.

Half of the European cases required hospitalisation, the WHO said, noting that 40 percent of cases involved children under the age of five.

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“Measles is back, and it’s a wake-up call. Without high vaccination rates, there is no health security,” WHO Europe director Hans Kluge said in a statement.

He urged authorities to intensify their immunisation efforts to protect under- and unvaccinated communities.

In 2023, 500,000 children in the region did not receive their first dose of the vaccine.

“Without high vaccination rates, there is no health security,” Kluge said.

Measles is highly contagious, spreading through respiratory droplets and lingering in the air for up to two hours after an infected person leaves an area.

The disease causes fever, respiratory symptoms, and a rash — but can also lead to severe complications, including pneumonia, brain inflammation, and death.

Europe accounted for a third of the world’s measles cases in 2024.

After 216,000 cases were reported in 1997, measles sharply declined in Europe, reaching a low of 4,440 cases in 2016.

But the illness resurged in 2018 and 2019 and has exploded since 2023, after a backsliding of vaccinations during the Covid-19 pandemic.