Laboratory confirmed cases of measles, mumps and rubella in England: October to December 2024
Updated 27 March 2025
Applies to England
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Introduction
Measles, mumps and rubella are notifiable diseases; healthcare professionals are legally required to inform their local health protection team (HPT) of any suspected case. National enhanced surveillance including oral fluid (OF) testing of all suspected cases is provided through the Virus Reference Department (VRD) at Colindale to support and monitor progress towards World Health Organization (WHO) measles and rubella elimination targets (1).
Two WHO indicators are of prime importance for measuring the performance of national measles and rubella surveillance systems. These are:
- The rate of laboratory investigations (at least 80% of suspected cases).
- The annual rate of discarded cases (at least 2 per 100,000 population).
In order to achieve these targets, the focus of the UK Health Security Agency (UKHSA) is to ensure that all suspected cases are appropriately tested. Immunoglobulin M (IgM) serology testing and oral fluid testing are the only two tests considered adequate by WHO for confirming or discarding a suspected measles or rubella case. Recent infection is confirmed by measuring the presence of IgM antibodies or detecting viral RNA (by PCR) in these samples.
Samples that have been confirmed positive for measles or rubella in a proficient laboratory (this includes local laboratories as well as the National Reference Laboratory) are included in this report. Samples that are referred to, or tested at, the National Reference Laboratory are further sequenced and entered on the WHO global Measles Nucleotide Surveillance (MeaNS) or the Rubella Nucleotide Surveillance (RubeNS) system, respectively, which are hosted at the National Reference Laboratory. Genotyping and further characterisation of measles and rubella is used to support investigation of transmission pathways and sources of infection.
Data presented here is for the fourth quarter of 2024 (October to December). Analyses are executed using the onset date of a rash or, more broadly, symptoms, and regional breakdown figures relate to the Government Office Regions.
Historical annual and quarterly measles, mumps and rubella epidemiological data is available from 2013 onwards:
The results from all samples tested at Colindale are reported to our laboratory information system MOLIS. The results are then reported back to the respective general practitioner (GP) and local HPT.
Overview
Table 1. Number of suspected cases of measles, mumps and rubella reported to HPTs with breakdown of: a) proportion tested by Oral Fluid (OF); b) other samples referred to the Virus Reference Department (VRD), Colindale, from local NHS hospital and private laboratories; c) cases confirmed at the VRD; d) cases confirmed at regional, local NHS hospital and private laboratories; e) discard rate (measles and rubella only): week 40 of 2024 to week 1 of 2025
| Notified as | Total suspected cases* | Number (%) tested by OF** | Other samples received by VRD | Number of samples IgM positive or viral detection in VRD | Number locally confirmed | Discard rate based on negative tests per 100,000 population (all samples)*** |
|---|---|---|---|---|---|---|
| Measles | 1,011 | 389 (38.5) | 113 | 252 | 45 | 1.24 |
| Mumps | 1,043 | 524 (50.2) | 42 | 7 | 0 | 1.80 |
| Rubella | 36 | 20 (55.6) | 1 | 0 | 0 | 0.06 |
*This represents all cases reported to HPTs in England; that is: possible, probable, confirmed and discarded cases on HPZone.
**The target set by WHO is 80% for measles and rubella only.
***The WHO has set a target for the annual discard rate of 2 cases per 100,000 population, which translates to a quarterly target of 0.5 per 100,000. It should be noted that we have proportionally adjusted the annual target, to ensure there is consistent testing across each quarter. This ensures we regularly achieve the target, rather than batch testing in one quarter to achieve the annual discard rate. The discard rate is based on VRD testing only because local negative tests are not routinely reported to UKHSA. Therefore, this is likely to be an underestimation of the true discard rate.
Measles
In the period between October to December 2024, there were 306 laboratory confirmed cases of measles reported in England, a 50% decrease compared to the previous quarter (n=612) (2) (Figure 1). The cases this quarter were mainly due to outbreaks in the South East, Yorkshire and Humber, and London regions. Details of the latest measles epidemiology is available (3).
Of the 306 cases reported this quarter, 19 (6.2%) were classified as imported or import-related. The majority, 60.1% (184 of 306) of cases were in children aged 10 years or younger. Ten cases (3.3%) had been previously vaccinated with one dose of the MMR vaccine and 8 (2.6%) with at least two doses.
One laboratory confirmed measles case was reported in Wales during the fourth quarter of 2024.
Figure 1. Laboratory confirmed cases of measles by month of onset of rash or symptoms reported, London and England: January 2012 to December 2024
Across the WHO European Region was an increase in measles infections in 2024, with more cases reported in the first 6 months of 2024 than in all of 2023. In the region, cases were reported by 92% of countries (n=49) (4), which is potentially decelerating progress towards reaching the measles elimination goal (5).
In 2024, most cases were reported by Kazakhstan (n=28,147), the Russian Federation (n=22,076) and Azerbaijan (n=16,690). Measles Incidence in 2024 was also very high in Romania (633 per 1,000,000) (4) and activity was also increasing in the WHO African, Eastern Mediterranean and South-East Asian regions (6).
All suspected cases of measles and rubella should be reported promptly to HPTs, a risk assessment conducted and an Oral Fluid Kit (OFK) sent for confirmatory testing even if local diagnostic testing is underway. This quarter, an oral fluid sample was returned for 389 (38.5%) of all suspected measles cases reported in England and, therefore, did not meet the WHO target of 80% (Table 1).
Mumps
In England, there were 7 laboratory confirmed mumps infections in the period between October to December, a reduction of 59% since the last quarter (n=17) (1).
Two of the 7 cases this quarter (28.6%) were in children under the age of 15 years. Of these, 1 individual had no doses of MMR vaccine recorded and 1 had received at least two doses. Of the 5 cases in those aged 15 years and older, 1 individual had received one dose of MMR, and none had received two doses. The remaining cases had no vaccine recorded
Figure 2. Laboratory confirmed cases of mumps by quarter, England: January 2012 to December 2024
Rubella
There were no laboratory confirmed cases of rubella reported in this quarter.
References
1. PHE (2019). UK Measles and rubella elimination strategy 2019
2. UKHSA (2024). ‘Laboratory confirmed cases of measles, rubella and mumps in England: July to September 2024’. Health Protection Report volume 18 number 11
3. UKHSA (2025). ‘Confirmed cases of measles in England by month, age, region and upper tier local authority: 2025’
4. WHO Europe (2025). Measles/Rubella (MR) Dashboard: Summary table - cases by year and final classification.
5. Muscat M, Ben Mamou M, Reynen-de Kat C, Jankovic D, and others (2024). ‘Progress and challenges in measles and rubella elimination in the WHO European Region’. Vaccines: volume 12, number 6.
6. US Centers for Disease Control and Prevention (2024). Global Measles Vaccination – Global Measles Outbreaks.