Background: A monthly time series of measles case notifications exists for Italy from 1949
onwards, although its usefulness is seriously undermined by extensive under-reporting which varies
strikingly between regions, giving rise to the possibility of significant distortions in epidemic
patterns seen in aggregated national data.
Results: A corrected national time series is calculated using an algorithm based upon the
approximate equality between births and measles cases; under-reporting estimates are presented
for each Italian region, and poor levels of reporting in Southern Italy are confirmed.
Conclusion: Although an order of magnitude larger, despite great heterogeneity between regions
in under-reporting and in epidemic patterns, the shape of the corrected national time series
remains close to that of the aggregated uncorrected data. This suggests such aggregate data may
be quite robust to great heterogeneity in reporting and epidemic patterns at the regional level. The
corrected data set maintains an epidemic pattern distinct from that of England and Wales.