Background and Objectives:
Measles is a vaccine-preventable contagious acute viral illness targeted for elimination in all six WHO Regions. Elimination requires high two-dose vaccination coverage in the population. In Italy, vaccination uptake in 2021 was 93.8% among two year-old children (one dose) and 85.6% for two doses at 5-6 years. Measles cases are reported to the national integrated measles and rubella surveillance system, implemented in 2013 and coordinated by the National Health Institute. The aim of this study is to describe measles epidemiology in Italy in the last decade.

Methods:
We analyzed reporting trends in measles cases with symptom onset during January 2013 to November 2022.

Results:
During 1 January 2013 to 30 November 2022, 14,913 measles cases were reported to the Italian national integrated measles and rubella surveillance system, of which 2,270 in 2013, 1,695 in 2014, 256 in 2015, 862 in 2016, 5,397 in 2017, 2,683 in 2018, 1,622 in 2019, 105 in 2020, 8 in 2021 and 15 in 2022. Epidemic peaks of over 300 cases occurred in the months of June 2013 and January 2014, March 2017 (973 cases), April 2018 (495 cases) and April 2019 (309 cases) From May to December 2019 there was a progressive decrease in the number of reported cases but an increasing trend was observed in the first months of 2020, followed by a drastic decline during the COVID-19 pandemic (range 0-4 monthly cases from April 2020 to November 2022). Overall, 74% of reported cases were laboratory confirmed, 13% of cases were probable cases and 13% were classified as a possible cases.

Conclusion:
Widespread circulation of measles occurred in Italy during 2017 to 2019, as in other EU/EEA countries. This was followed by an abrupt decrease in the number of reported cases since April 2020. Measles vaccination coverage remains suboptimal.