Incidence and Epidemiologic Characteristics of Measles in the Republic of Korea Following Elimination Verification...

The Republic of Korea was verified by the World Health Organization as having eliminated measles in March 2014. This study analyzed the epidemiologic characteristics of measles cases reported between 2014, when elimination was verified, and 2025, and proposed strategies to sustain elimination status.

A case series study was conducted among 824 individuals reported to Korea's national infectious disease surveillance system from January 2014-December 2025 who were classified as measles cases by the National Measles Elimination Verification Committee. Descriptive analyses examined occurrence patterns, infection sources, age distribution, nationality (Korean and foreign nationals), vaccination status, and outbreak characteristics.

The domestic pattern of measles incidence showed a trend similar to the global epidemic cycle. Of the 824 cases, 96.7% (797) were imported or import-related. Adults aged ≥19 years accounted for 51.5% (424), indicating a shift from children to adults. The proportion of cases among foreign nationals increased from 4.1% in 2014 to 65.3% in recent years, and the proportion of cases among young adults who had completed two doses of measles-containing vaccine increased from 16.0% in 2019 to 33.3% in 2025. Healthcare facilities accounted for over 50.0% of the settings where secondary domestic transmission associated with imported cases occurred.

Although the Republic of Korea has maintained measles elimination status, small importation-related outbreaks continue to occur, consistent with global epidemiologic trends. Sustaining elimination status requires maintaining high vaccination coverage, strengthening surveillance and rapid response, and implementing targeted immunization and risk communication strategies for high-risk populations.