PHWR Public Health Weekly Report

Vol.19 No.23, June 18, 2026 Article TypeOriginal ArticlesOutbreak ReportsPolicy NotesQuickStatsReview & PerspectiveSurveillance Reports

• QuickStats 2026-06-18

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  Trends in the Prevalence of Seat Belts Non-use among Adolescents, 2016–2025

  Yangha Kim

  Public Health Weekly Report 2026; 19(23): 963-964 https://doi.org/10.56786/PHWR.2026.19.23.1

  

  

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• Policy Notes 2026-06-18

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  Evolution and Future Directions of the National Measles Immunization Program in the Republic of Korea

  Hyeokjin Lee , Haengjin Jeong , Hyewook Hwang , Mihye Choi , Jae Young Lee , Hyerim Lee

  Public Health Weekly Report 2026; 19(Suppl 23): S1-S16

  

  

  Abstract

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  Objectives: Measles is a highly contagious airborne disease capable of rapid transmission in healthcare and school settings when immunity gaps accumulate. This review aims to examine the evolution of the measles immunization program in the Republic of Korea (ROK) and analyzes policy implications through international comparison.
  Methods: This narrative review uses the Korea Disease Control and Prevention Agency guidelines, national statistics, 2018–2019 outbreak reports, World Health Organization and United Nations Children’s Fund coverage estimates, and official guidelines and reports from the United States, the United Kingdom, Japan, and Canada. The comparison is based on four criteria: the two-dose schedule, coverage, school-entry verification, and outbreak response.
  Results: ROK strengthened measles control through routine measles-mumps-rubella vaccination, the measles-rubella catch-up campaign in 2001, and a mandatory school-entry verification system. The 2018–2019 import-related outbreaks were contained through rapid reporting, laboratory confirmation, contact management, and targeted vaccination. From 2015 to 2024, first-dose coverage remained at 97.3–97.9% and second-dose coverage ranged from 94.6–97.8%. International comparison showed that the ROK maintained a high two-dose coverage and a stable school-entry verification system, while regional immunity gaps persisted in some countries.
  Conclusions: High two-dose coverage and school-entry verification have resulted in the elimination of measles in the ROK. Continued management of susceptible populations and policy evaluation using internationally comparable indicators remain important.

• Surveillance Reports 2026-06-18

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  Incidence and Epidemiologic Characteristics of Measles in the Republic of Korea Following Elimination Verification (2014–2025)

  Subin Park , Jihee Lee , Dongkeun Kim , Yeoeun Yun , Hyejin Kim , Jangmi Kwon , Hyungmin Lee

  Public Health Weekly Report 2026; 19(Suppl 23): S17-S41

  

  

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  Objectives: 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.
  Methods: 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.
  Results: 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.
  Conclusions: 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.

• Surveillance Reports 2026-06-18

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  Laboratory-based Surveillance to Sustain Measles Elimination in the Republic of Korea

  Su Jin Kim , Eun-Ji Choi , BooMi La , Deog-Yong Lee , Heui Man Kim , Hyuk Chu

  Public Health Weekly Report 2026; 19(Suppl 23): S42-S54

  

  

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  Objectives: To describe the operation of a laboratory-based measles surveillance system required to sustain measles elimination and to provide directions to reinforce molecular surveillance.
  Methods: The study used a case-based surveillance system linked to the mandatory reporting of suspected measles cases. It employed measles-specific antibody testing and real-time reverse transcription polymerase chain reaction for laboratory confirmation, enabling differentiation between wild-type and vaccine-associated cases. Positive specimens were subjected to N450 and non-coding region located between the Matrix and Fusion protein genes (MF-NCR) sequencing, and the obtained sequence data were submitted to the World Health Organization. Regular proficiency testing and training support laboratory capacity.
  Results: A total of 2,377 measles diagnostic tests were performed between 2021 and 2025. Of these specimens, 1,267 cases were tested in 2025, an increase of 130.4% from 2024. Genotyping was completed for 130 of the 135 confirmed cases, and genotypes B3 (74.6%) and D8 (25.4%) were identified. Genotype H1, which is historically endemic in the Republic of Korea (ROK), was not detected.
  Conclusions: National laboratory-based surveillance supports the sustained elimination of measles by integrating diagnostic and molecular confirmation. However, the resolution of N450 and Sanger sequencing–based analysis is limited by reduced genotype diversity and sequence variation in the MF-NCR. Laboratory capacity must be maintained, and high-resolution MF-NCR analysis using NGS must be performed to sustain ROK’s current measles elimination status.

• Original Articles 2026-06-18

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  Nationwide Measles Seroprevalence in the Republic of Korea, 2023

  Ah-Ra Kim , Seung-Jung Kee , Hyun-Woo Choi , Hyun Sook Shin , Su Jeong Lee , Min Jeong Kang , Hyeon Nam Do , June-Woo Lee , Hye-Sook Jeong

  Public Health Weekly Report 2026; 19(Suppl 23): S55-S69

  

  

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  Objectives: Although measles–mumps–rubella vaccination coverage remains above 95% in the Republic of Korea, imported measles cases continue to occur. This study aimed to assess the population-level immunity to measles to inform the evaluation of the national immunization program and to identify potential immunity gaps relevant to outbreak risk.
  Methods: Serum specimens were collected from 1,719 individuals aged 0–93 years ( birth cohorts 1930–2023) across six regions. Anti-measles virus IgG binding antibodies were measured using an enzyme-linked immunosorbent assay (ELISA). A subset of 286 specimens was further analyzed using plaque reduction neutralization test (PRNT). Antibody concentrations were standardized to the World Health Organization 3 rd International Standard for Anti-Measles (NIBSC 97/648; 3,000 mIU/mL).
  Results: Overall, ELISA seropositivity was 75.9% across all ages and increased to 77.4% after exclusion of infants aged <1 year. Among participants aged ≥1 year, ELISA geometric mean titers (GMTs) were lowest in adolescents and young adults (approximately 10–29 years), ranging from 154.1 to 273.5 mIU/mL. PRNT seropositivity was ≥70% across all 10-year age groups among participants aged ≥1 year, and the age-group-specific pattern of neutralizing antibody GMTs was broadly consistent with the susceptible age groups identified in the binding antibody analysis.
  Conclusions: This national serosurvey identified reduced binding and neutralizing antibody levels in parts of the adolescent and early-adult populations, indicating a possible immunity gap ( immune pocket). Given the age distribution of measles cases reported during 2024–2025, these findings highlight the need for strengthened surveillance and systematic review of vaccination history in these age groups to help reduce secondary transmission at the community level.

• Outbreak Reports 2026-06-18

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  Analysis of the Epidemiological Characteristics and Public Health Response to Healthcare Facility-associated Measles Outbreaks in the Honam Region, Republic of Korea, 2025

  Jeewoun Kim , Eunyoung Kim , Seungjin Kim , Jieun Jung , Yuna Kim

  Public Health Weekly Report 2026; 19(Suppl 23): S70-S87

  

  

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  Objectives: This report aims to analyze the notification processes of source cases, transmission characteristics, and response measures associated with four healthcare facility-associated measles outbreaks that occurred in the Honam region in 2025 and to identify strategies to strengthen future outbreak prevention and response capacity.
  Methods: A retrospective analysis was conducted on four measles outbreaks ( Facilities A–D) in healthcare facilities in the Honam region. Data were obtained from the Korea Disease Control and Prevention Agency Integrated Quarantine Information System and epidemiological investigation records. The analysis focused on outbreak timelines, notification processes, transmission patterns, demographic and clinical characteristics, and institutional response frameworks.
  Results: Nineteen cases were identified across the four outbreaks. All source cases were unvaccinated children with international travel history. The mean interval from the initial healthcare facility visit to notification was 3.25 days, and the mean interval from rash onset to notification was 1.25 days. Ward transmission occurred while the source cases were hospitalized without isolation because of non-specific prodromal symptoms. Among the 15 secondary cases, 46.7% were healthcare workers who had completed two doses of the measles-mumps-rubella vaccine, indicating breakthrough infections. The Honam Regional Center for Disease Control and Prevention implemented a multi-institutional response that included daily review meetings, contact management, serological testing, and work exclusion of susceptible staff. However, these measures were constrained by staff shortages and limited bed availability, contributing to prolonged outbreaks in some facilities.
  Conclusions: To prevent healthcare facility-associated measles outbreaks associated with imported cases, including international travel history within the recent incubation period, routine assessment of patients with non-specific respiratory symptoms may be necessary. Pre-employment serologic screening of healthcare workers and vaccination based on screening results should also be considered. During outbreaks, flexible institutional strategies and pre-emptive resource allocation are required to minimize healthcare disruption.

• Review & Perspective 2026-06-18

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  Lessons from Measles Elimination in the Republic of Korea: Public Health Implications

  Jong-Koo Lee

  Public Health Weekly Report 2026; 19(Suppl 23): S88-S106

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  Objectives: To determine key policy implications, this study aims to examine the comprehensive national strategy implemented for measles elimination in 2001, the subsequent development of a public health system to sustain elimination, and its international verification.
  Methods: The author conducted a review of government-issued measles outbreak control guidelines from 2000 to 2001, domestic and international academic literature and theses, and materials from the World Health Organization (WHO) immunization-related meetings, including firsthand observations from participation in these meetings.
  Results: Following the Republic of Korea (ROK)’s introduction of a monovalent measles vaccine in 1965, the measles-mumps-rubella vaccine was incorporated into the National Immunization Program in 1983. In 1997, a second dose was added for children aged 4–6 years due to recurrent outbreaks; however, a large nationwide outbreak occurred in 2000–2001. Incidence was highest among infants aged 0–1 years and school-aged children, and was associated with by low second-dose coverage. Furthermore, serological surveys indicated that 13.5–15.5% of elementary school students were seronegative for measles antibodies, and viruses consistent with the H1 genotype were detected. In response to these findings, the government launched a 5-Year National Measles Elimination Plan, including school-based mass vaccination campaigns and pre-entry vaccination verification. This resulted in approximately 5.8 million children receiving two doses of measles-containing vaccine and strengthening surveillance. Consequently, measles was declared eliminated in 2006. In 2014, the ROK introduced fully subsidized National Immunization Program services, and the WHO Western Pacific Regional Verification Commission verified that the ROK had effectively eliminated measles. Since then, this elimination status has been maintained.
  Conclusions: The 2000–2001 measles epidemic in the ROK triggered a policy transformation that went beyond immediate outbreak control, fundamentally strengthening the public health system and positioning the country for greater engagement in global health collaboration.