The two described outbreaks, which involved 449 cases (incidence 9/100,000) notified from June 2006 to August 2007, represent the most serious episodes after the 2002-2003 measles outbreak [7] . They confirmed that pockets of low vaccination coverage exist in some areas of the Lazio region, particularly among Roma/Sinti communities and adolescents Thanks to relatively high immunisation rates amongst new born children (90,7%) [10] and the work done by the local health authorities, conducting contact investigation of cases', vaccination of susceptible school and household contacts, and implementing isolation measures, the outbreaks did not affect the whole region and, in the city of Rome, was mainly limited to a few peripheral districts (Figure 2 ). Both outbreaks started in populations known to have low coverage, (Roma/Sinti community, and students of a secondary school). The subsequent spread to the rest of the population, at least for the first outbreak, was facilitated by nosocomial transmission.