Bucharest, RO) Background: A dramatic increase in the number of both measles and rubella cases was recorded during the last year in Europe with Romania being the most affected country. Objective: describe the epidemiology of rubella and measles cases presenting to a large hospital from South-Eastern (SE) Romania and assess the two epidemics at National level. Method: Retrospective analysis of rubella and measles cases (January 2011-October 2012), diagnosed at the National Institute for Infectious Diseases "Matei Bals" (INBI), Bucharest and of National Data from Romania as reported to the European Centre for Disease Prevention and Control. Results: At country-level, the rubella epidemic started earlier (September 2011), peaked in February-March 2012 and returned to pre-epidemic level in August. For measles, the epidemic started before January 2011, had multiple peaks (highest in January 2012) then had a descending trend. The total number of cases reported between October 2011-September 2012 was 24536 for rubella (1143.2 per million) and 3217 for measles (149.9 per million), Romania registering the highest notification rates in UE/EEA for both diseases. INBI (figure): The 2 epidemics started at the same time (January 2012). While for rubella the peak occurred in April-May 2012 (670 and 648 cases, respectively) and then the number of cases decreased abruptly (<20 cases since July), the measles epidemic maintains an average of 65 cases/month during February-September. In October 2012, 91 cases were reported. The total number of INBI cases between October 2011 and September 2012 was 3063 for rubella and 617 for measles. During this period, 12 rubella encephalitis cases were diagnosed. All cases occurred between December 2011-April 2012, with a maximum of 4 cases in February. All patients were young adults, with a predominance of male gender 11/12. Severe neurological impairment was present in most patients, with 10/12 requiring mechanical ventilation for an average of 2.6 days. All patients recovered completely. No measles-related encephalitis cases were recorded. Conclusions: In 2011/2012 Romania recorded a major double rubella-measles epidemic, the largest in Europe. While rubella returned to the pre-epidemic level, the measles epidemic seems to be on-going and has not yet reached the peak in the SE Romania. The rubella encephalitis cases, grouped at the beginning of the epidemic, affected young adults and had a very good outcome despite the dramatic symptoms on admission.