Importation of viruses from other continents caused prolonged circulation and large outbreaks in the WHO European Region.

Phylogenetic analysis of 19 complete VZV genomic sequences resolves wild-type strains into 5 genotypes (E1, E2, J, M1, and M2). Complete sequences for M3 and M4 strains are unavailable, but targeted analyses of representative strains suggest they are stable, circulating VZV genotypes. Sequence analysis of VZV isolates identified both shared and specific markers for every genotype and validated a unified VZV genotyping strategy. Despite high genotype diversity no evidence for intra-genotypic recombination was observed. Five of seven VZV genotypes were reliably discriminated using only four single nucleotide polymorphisms (SNP) present in ORF22, and the E1 and E2 genotypes were resolved using SNP located in ORF21, ORF22 or ORF50. Sequence analysis of 342 clinical varicella and zoster specimens from 18 European countries identified the following distribution of VZV genotypes: E1, 221 (65%); E2, 87 (25%); M1, 20 (6%); M2, 3 (1%); M4, 11 (3%). No M3 or J strains were observed.

Measles virus infection remains a significant cause of childhood mortality and morbidity despite continued global efforts and the availability of a safe and effective vaccine.. After a 9 year period without confirmed measles cases an imported outbreak occurred in Pogradec district in 2017. Epidemiological investigation was carried out to identify sources of infection, transmission routes, and implement measures of control and prevention. Epidemiological service of Directorate of Public health of Pogradec district (DPH) reported 11 suspected cases out of whom 9 (82.%) were laboratory-confirmed. The outbreak was imported from Macedonia. The outbreak management team took several measures in response to the outbreak. Immediately a districtwide emergency MCV vaccination campaign was initiated. The campaign included screening and vaccination activities in the city and suburban areas, as well as in a school and recreational center for roma children. Also contact in some remote villages were traced and also vaccinated. The target ages included children 12 months to 14 years of age.

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