Situation at a glance
Since late 2023, Morocco has been experiencing a widespread measles outbreak. Cases have been recorded across all regions of the country, particularly among children and people who are unvaccinated. In response, the Ministry of Health and Social Protection (MOHSP), in collaboration with relevant sectors, activated the National Center for Public Health Emergency Operations, launched urgent catch-up vaccination campaigns, and strengthened surveillance, case management, and risk communication and community engagement efforts. Measles is a highly transmissible viral disease that can lead to severe complications and death. While Morocco has made significant progress toward measles elimination, the disease remains endemic in the country. The overall risk is assessed as moderate at the national level and moderate at the regional level, particularly given the risk of cross-border transmission in areas with low vaccination coverage.
Description of the situation
Since late 2023, Morocco has been experiencing a widespread measles outbreak. The first cases were reported in limited provinces of the Souss Massa region in central Morocco, before spreading to additional provinces within the region during the first quarter of 2024, and subsequently to other regions of the country.
From 1 October 2023 through 13 April 2025, more than 25 000 suspected measles cases were reported from all 12 regions, 13 706 of which were laboratory-confirmed cases and 184 people died.
During the week ending 27 April 2025, Morocco reported 995 suspected measles cases, representing an incidence rate of 2.7 per 100,000 population. While a national peak incidence was recorded in week 4 of 2025 (week ending 25 January), a declining trend in case numbers has been observed for ten consecutive weeks, starting from week 5 of 2025.
The distribution of cases by gender has been nearly equal, with 50.7% of cases among males and 49.3% among females. From 1 January 2024 to 28 February 2025, 68% of cases occurred among individuals under the age of 18, and 49% of all cases were reported in unvaccinated individuals.
Genomic characterization of measles virus specimens collected during the 2024–2025 outbreak revealed exclusive circulation of genotype B3, which is common in many parts of Africa and has been associated with outbreaks globally. One isolated case was associated with genotype D8 and likely indicates a sporadic importation, with no evidence of sustained local transmission.
The measles vaccine was introduced into Morocco’s national immunization schedule in 2003 and is currently administered in two doses: the first at 9 months of age, and the second between 15 and 18 months. According to WHO/UNICEF Estimates of National Immunization Coverage (WUENIC), Morocco has reported coverage with two doses of measles-containing vaccine (MCV2) above the 95% threshold required to achieve the elimination goal. However, this threshold was not achieved in the last three years.
Epidemiology
Measles is a highly contagious, acute viral illness that affects people across all age groups and remains a leading cause of death among young children globally. Transmission occurs via airborne droplets or direct contact with respiratory secretions from infected individuals.
The incubation period typically ranges from 10 to 14 days. Prodromal symptoms include high fever, cough, coryza, and conjunctivitis, followed by the appearance of Koplik spots (small white lesions on the buccal mucosa). A characteristic maculopapular rash emerges approximately 2–4 days after fever onset, beginning on the face and upper neck before progressing to the trunk and lower limbs. Individuals are considered infectious from approximately four days before until four days after the rash appears.
While there is no specific antiviral therapy for measles, the majority of patients recover within 2–3 weeks with supportive care. However, the disease can result in severe complications, including pneumonia, diarrhea, otitis media, acute encephalitis, blindness, and death. Post-infectious encephalitis occurs in approximately 1 in 1000 cases. Measles also induces immune amnesia, a phenomenon in which the virus erases previously acquired immune memory, increasing susceptibility to other infections for months or even years after recovery.
Vaccination remains the cornerstone of measles prevention. The measles-containing vaccine is among the most effective vaccines available, with a two-dose schedule providing approximately 97% lifelong protection. Immunization not only prevents measles but also significantly reduces the risk of its potentially life-threatening complications.
Public health response
Leadership and coordination
In response to the ongoing measles outbreak, the National Center for Public Health Emergency Operations at the Ministry of Health and Social Protection (MOHSP) of Morocco was activated to coordinate the response, with other involved sectors, through the national public health emergency management system. This system is supported by 12 regional public health emergency operation centres and 82 rapid epidemiological intervention teams deployed across the country.
Surveillance and case management
The MOHSP strengthened measles surveillance by establishing a system for early case detection and monitoring, facilitating timely response and continuous epidemiological tracking. In parallel, a laboratory confirmation plan was implemented in coordination with relevant partners to ensure accurate case verification.
In terms of case management, health facilities were equipped with vitamin A supplementation and essential medical supplies, distributed according to need. The national case management protocol was updated, and new protocols were developed and implemented for contact management, outbreak investigation, and infection prevention and control at the facility level.
Vaccination
A nationwide catch-up vaccination campaign was launched on 20 March last year, in collaboration with the Ministry of Interior, Ministry of National Education, Preschool and Sports, and the Ministry of Islamic Affairs. Initially targeting children under six years of age, the campaign was quickly expanded to include all children under 18 years, with encouragement for adult vaccination as part of outbreak control efforts. Provinces were supplied with vaccines, syringes, and vitamin A. The campaign included immunization against measles, as well as rubella, diphtheria-tetanus-pertussis (DTP), and polio.
Risk communication and community engagement
To support risk communication and community engagement (RCCE), the MOHSP developed a communication strategy to raise public awareness and increase vaccination uptake. Activities included:
- A national media campaign, including a short video broadcast on television and radio highlighting the importance of measles vaccination.
- A digital campaign, comprising five short digital video (reels), over 30 social media posts, articles, and an interactive Q&A.
- Community-level mobilization, engaging local leaders and actors to enhance public outreach and promote vaccine acceptance.
WHO risk assessment
Since October 2023, Morocco has been experiencing a measles outbreak that has spread to all regions of the country, with varying degrees of transmission and notable inter- and intra-regional disparities. In response, the MOHSP launched a nationwide catch-up vaccination campaign in March 2024, targeting individuals under the age of 18. The campaign was conducted through both fixed and mobile teams operating in schools and health centres and brought to light challenges related to vaccine hesitancy.
At the national level, the risk is considered moderate for unvaccinated or incompletely vaccinated and immunocompromised individuals, based on the following factors:
- A significant improvement in the national epidemiological situation, including resolution of the outbreak in the initially affected regions. However, transmission remains moderate in a few limited areas.
- A declining trend in the number of cases has been observed since 1 February 2025. This trend is particularly evident in the most recently affected areas where case numbers have decreased by 64%. Healthcare services have not been significantly impacted, and hospital capacity has remained adequate.
- Morocco has demonstrated strong public health response capacity, including successful management of past health emergencies, supported by active engagement of key stakeholders.
- Following the national vaccination campaign, the immunization status verification rate reached 98.45% as of 25 April 2025, with a total of 10.74 million children whose status has been verified. A rate of 73.6% was achieved for vaccination against measles-rubella (MR), 61.8% for the DTP (diphtheria, tetanus, pertussis) component and 57.7% for oral polio vaccine (OPV).
At the regional and global levels, the risk is assessed as moderate due to:
- Morocco's geographical location as a crossroads between Africa, Europe and the Middle East.
- High volumes of travel movement, which raise the likelihood of cross-border disease transmission.
- Widening pockets of unvaccinated children have created a pathway for the spread of measles.
- Inadequate immunization coverage globally remains a significant public health concern.
WHO advice
WHO recommends maintaining sustained, homogeneous coverage of at least 95% with both the first and second doses of measles-containing vaccine (MCV) to achieve and sustain population immunity. Integrated epidemiological surveillance for measles and rubella should be strengthened across both public and private healthcare sectors to allow for timely detection and confirmation of all suspected cases.
In countries and areas with high cross-border movement, including high-traffic border regions, WHO advises strengthening epidemiological surveillance, preparedness, and response capacities to ensure rapid identification and control of suspected measles cases. The activation of trained rapid response teams and implementation of established protocols are critical to prevent the re-establishment of endemic transmission following imported cases. Sustained coordination between national, sub-national, and local levels must be ensured, with effective communication channels across all tiers of the health system.
During outbreaks, WHO recommends ensuring adequate case management and infection prevention and control capacity in health facilities to prevent healthcare-associated infection transmission. This includes referring patients to airborne infection isolation rooms, where available, and preventing exposure to other patients in common areas such as waiting rooms.
WHO recommends ensuring broad access to measles-mumps-rubella (MMR) vaccination, especially for high-risk groups, including health workers and international travellers. Individuals residing in outbreak-affected areas should follow local public health guidance to reduce transmission risk.
In all settings, post-exposure prophylaxis should be considered for susceptible contacts. This includes administering MCV within 72 hours of exposure or normal human immunoglobulin (NHIG) within six days of exposure for individuals in whom vaccination is contraindicated. Infants, pregnant women, and immunocompromised individuals should be prioritized.
Countries are advised to maintain adequate stocks of MR/MMR vaccines and vaccination supplies, and ensure access to vaccination services for incoming and outgoing international travellers, including those traveling to or from areas with ongoing outbreaks and for vulnerable populations such as displaced persons or indigenous communities.
International travellers are advised to verify and update their measles vaccination status prior to departure, including those planning travel to Morocco. Individuals who are unvaccinated, have been exposed to measles, or show symptoms compatible with measles virus infection should consult local health authorities before undertaking international travel.
WHO does not recommend any restrictions on travel or trade to or from Morocco based on currently available information.
Further information
- World Health Organization. Measles Fact sheets
- Measles outbreak guide. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO
- World Health Organization. Health topics. Measles
- Measles and rubella strategic framework 2021–2030. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO
- World Health Organization. Measles cases surge worldwide, infecting 10.3 million people in 2023
- El Hafa H. Measles outbreak in Morocco: Current situation and remedial measures. Indian J Med Microbiol. 2025 Apr 3;55:100844. doi: 10.1016/j.ijmmb.2025.100844. Epub ahead of print. PMID: 40187564
- World Health Organization. (2016). Planning and implementing high-quality supplementary immunization activities for injectable vaccines using an example of measles and rubella vaccines: field guide. World Health Organization
- Targeted and selective strategies in measles and rubella vaccination campaigns: interim guidance. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO
Citable reference: World Health Organization (13 May 2025). Disease Outbreak News; Measles in Morocco. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON568