Global Measles and Rubella Update October 2018
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1 Global Measles and Rubella Update October 218
2 Measles
3 Number of Reported Measles Cases by WHO Regions 218 Region Member States* Suspected cases Measles cases Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Received AFR 42/ AMR 3/ EMR 2/ EUR 53/ SEAR 11/ WPR 26/ Total 182/ Region Member States* Suspected cases Measles cases Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Received AFR 43/ AMR 31/ EMR 2/ EUR 53/ SEAR 11/ WPR 26/ Total 184/ Notes: Based on data received This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region
4 Number of Reported Measles Cases by WHO Regions 218 Region Member States* Suspected cases Measles cases Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Received AFR 42/ AMR 3/ EMR 2/ EUR 53/ SEAR 11/ WPR 26/ Total 182/ Region Membe r States* Suspecte d cases Measles cases Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Received AFR 43/ AMR 3/ EMR 2/ EUR 5/ SEAR 11/ WPR 26/ Total 18/ Notes: Based on data received and This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region
5 Measles cases (Lab+Epi+Clinical) Measles case distribution by month and WHO Region ( ) WPR SEAR EUR EMR AMR AFR Notes: Based on data received Data Source: IVB Database - This is surveillance data, hence for the last month(s), the data may be incomplete.
6 Measles Incidence Rate per Million (12M period) Top 1** Country Cases Rate India Ukraine Philippines Yemen Nigeria Serbia China Russian Federation Pakistan DR Congo Other countries with high incidence rates*** Country Cases Rate Albania Liberia Georgia Greece Lebanon Romania Measles cases from countries with known discrepancies between case-based and aggregate surveillance, as reported by country Country Year Cases Data Source DR Congo SITUATION EPIDEMIOLOGIQUE DE LA ROUGEOLE EN RDC, Week of 16/1/218 Somalia Somali EPI/POL Weekly Update Week Notes: Based on data received and covering the period between and Incidence: / population* * 1, - * World population prospects, 217 revision - ** Countries with the highest number of cases for the period - *** Countries with the highest incidence rates (excluding those already listed in the table above)
7 Number of Reported Measles Cases (6M period) Country Top 1* Cases India Ukraine Philippines 8472 Yemen 559 Nigeria 3255 Serbia 2888 Sudan 273 China 2624 DR Congo 2219 Russian Federation 2142 Notes: Based on data received Surveillance data from to * Countries with highest number of cases for the period
8 Number of measles cases Measles case distribution (AFR), Uganda Others Nigeria Niger Liberia Gabon Ethiopia Equatorial Guinea DR Congo Cameroon Angola Notes: Based on data received Data Source: IVB Database DRC has experienced a nationwide epidemic that has affected all Provinces, however, only a small proportion of the measles cases in the IDSR aggregate reporting system are reflected in the case based data. As of 27 May 213, South Sudan has reassigned to the Africa region (AFR) from the Eastern Mediterranean region (EMR). For data presentation and statistical purposes, South Sudan data is presented in AFR for all the
9 Disclaimer This document contains data provided to WHO by member states. Note that some member states only provide aggregate data to WHO, and for these, we are unable to generate a country profile. Some member states report all cases at one time point for the entire year, and thus epidemiologic curves generated are not accurate and a reporting artifact. For some countries, cases are reported by age category, not by exact age in months and/or years. Thus, age distribution/incidence is approximate. Cases classified as pending by countries are classified at WHO as clinically compatible at this time, and thus numbers might different between data shown here and provided by the member state or WHO country/regional offices. *UN population data is used as the denominator for calculating incidence.
10 Incidence rate per 1,, Measles cases: Democratic Republic of the Congo 4 Sub-national (6-59 M) Cov: 13.5% Discarded Clinical Epi Lab National SIA Sub-national SIA Democratic Republic of the Congo age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
11 Incidence rate per 1,, Measles cases: Ethiopia 6 Sub-national (9 M-14 Y) Cov: 96.3% Sub-national (6-179 M) Cov: 98% 4 2 Discarded Clinical Epi Lab National SIA Sub-national SIA Ethiopia age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
12 Incidence rate per 1,, Measles cases: Nigeria 3 Sub-national (6 M-1 Y) NA (9-59 M) 2 1 Discarded Clinical Epi Lab National SIA Sub-national SIA 4 2 Nigeria age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
13 Incidence rate per 1,, Measles cases: Uganda Discarded Clinical Epi Lab Uganda age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
14 Number of measles cases Measles case distribution (AMR), The clustering of cases at specific time points is an artifact of reporting Venezuela (Bolivarian Republic of) USA Peru Others Mexico Ecuador Colombia Chile Canada Brazil Argentina Notes: Based on data received Data Source: IVB Database
15 Incidence rate per 1,, Measles cases: Venezuela (Bolivarian Republic of) The clustering of cases at specific time points is an artifact of reporting 4 2 Discarded Clinical Epi Lab Venezuela (Bolivarian Republic of) age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
16 Number of measles cases Measles case distribution (EMR), Yemen United Arab Emirates Syrian Arab Republic Sudan Somalia Saudi Arabia Pakistan Others Iraq Egypt Afghanistan Notes: Based on data received Data Source: IVB Database
17 Incidence rate per 1,, Measles cases: Pakistan Discarded Clinical Epi Lab Pakistan age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
18 Incidence rate per 1,, Measles cases: Sudan Discarded Clinical Epi Lab Sudan age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
19 Incidence rate per 1,, Measles cases: Yemen Discarded Clinical Epi Lab 4 2 Yemen age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
20 Number of measles cases Measles case distribution (EUR), Ukraine Serbia Russian Federation Romania Others Kyrgyzstan Italy Germany Georgia France Bosnia and Herzegovina Notes: Based on data received Data Source: IVB Database
21 Incidence rate per 1,, Measles cases: Georgia Discarded Clinical Epi Lab Georgia age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
22 Incidence rate per 1,, Measles cases: Russian Federation Discarded Clinical Epi Lab Russian Federation age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
23 Incidence rate per 1,, Measles cases: Ukraine Discarded Clinical Epi Lab Ukraine age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years 2-29 years 3+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
24 Number of measles cases Measles case distribution (SEAR (excl. India)), Timor-Leste Thailand Sri Lanka Nepal Myanmar Maldives Indonesia DPR Korea Bhutan Bangladesh Notes: Based on data received Data Source: IVB Database
25 Incidence rate per 1,, Measles cases: Indonesia 6 Sub-national (9 M-15 Y) Cov: 1.5% 4 2 Discarded Clinical Epi Lab National SIA Sub-national SIA Indonesia age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown 2 1 Year Confirmed Cases
26 Number of measles cases Measles case distribution (SEAR, India), India 1 5 Notes: Based on data received Data Source: IVB Database
27 Incidence rate per 1,, Measles cases: India Rollover-Nat (9 M-15 Y) Discarded Clinical Epi Lab National SIA Sub-national SIA India age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset Year Confirmed Cases doses 1 dose 2+ doses Unknown
28 Number of measles cases Measles case distribution (WPR), Viet Nam Singapore Republic of Korea Philippines Papua New Guinea Others Mongolia Malaysia Japan China Australia Notes: Based on data received Data Source: IVB Database
29 Incidence rate per 1,, Measles cases: Philippines Discarded Clinical Epi Lab Philippines age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases
30 Distribution of measles genotypes (last 12 months) Notes: Data Source: MeaNS database (Genotypes) and IVB Database (Incidence) as of and covering the period to Pie charts proportional to the number of sequenced viruses
31 Rubella
32 Number of Reported Rubella Cases by WHO Regions 218 Region Member States* Rubella cases Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Received AFR 41/ AMR 24/ EMR 2/ EUR 36/ SEAR 11/ WPR 15/ Total 147/ Region Member States* Rubella cases Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Received AFR 42/ AMR 26/ EMR 2/ EUR 3/ SEAR 11/ WPR 14/ Total 143/ Notes: Based on data received This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region
33 Rubella cases (Lab+Epi+Clinical) Rubella Case Distribution by Month and WHO Region ( ) WPR SEAR EUR EMR AMR AFR Notes: Based on data received Data Source: IVB Database - This is surveillance data, hence for the last month(s), the data may be incomplete.
34 (IgM+ only) (IgM+ only) Rubella cases: AFR AFR Rubella Case Distribution (October 216-September 218) 6 Top 1 countries (last 12 M) 4 label RCV in RI Cases % of Total 2 South Africa No Ethiopia No Nigeria No DR Congo No Others Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Uganda No 37 8 Cote d'ivoire No Mali No AFR Age distribution of Rubella IgM+ cases by vaccine introduction status in the National EPI Programme (October 217-September 218) Congo No 9 2 Liberia No 59 2 Chad No Age at onset (in years) Rubella vaccine not introduced before 1 January 217 Rubella vaccine introduced before 1 January 217 Notes: Based on data received Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.
35 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: EMR EMR Rubella Case Distribution (October 216-September 218) 15 1 label Top 1 countries (last 12 M) RCV in RI Cases % of Total 5 Sudan No Yemen Pakistan No Saudi Arabia Afghanistan No 43 4 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Others Iran (Islamic Republic of) EMR Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (October 217-September 218) United Arab Emirates Egypt Iraq Tunisia Age at onset (in years) Rubella vaccine not introduced before 1 January 217 Rubella vaccine introduced before 1 January 217 Notes: Based on data received Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.
36 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Notes: Based on data received Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216. Spikes in age-distribution curve are an artifact of reporting by age bands ( =<1 yrs, 2=1-4 yrs, 7=5-9 yrs, 12=1-14 yrs, 17=15-19 yrs, 25=2-29 yrs, 45=3+yrs) instead of by age from some member states Rubella cases: EUR EUR Rubella Case Distribution (October 216-September 218) label Top 1 countries (last 12 M) RCV in RI Cases % of Total Poland Ukraine Germany Others Italy Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Austria Turkey Kyrgyzstan EUR Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (October 217-September 218) Ireland Romania Russian Federation Age at onset (in years) Rubella vaccine not introduced before 1 January 217 Rubella vaccine introduced before 1 January 217
37 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: SEAR (excl. India) SEAR (excl. India) Rubella Case Distribution (October 216-September 218) 6 4 label Top 1 countries (last 12 M) RCV in RI Cases % of Total 2 Indonesia No Bangladesh Nepal Thailand Myanmar Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Timor-Leste Bhutan 26 2 Sri Lanka SEAR (excl. India) Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (October 217-September 218) Age at onset (in years) Rubella vaccine not introduced before 1 January 217 Rubella vaccine introduced before 1 January 217 Notes: Based on data received Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.
38 Incidence rate per 1,, Rubella cases: Bangladesh 6 SIA (9 M-<5 Y) Cov: 11% 4 2 Clinical Epi Lab National SIA Sub-national SIA 8 6 Bangladesh age distribution, vaccination status, and incidence, to Year Confirmed Cases <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset 1 5 doses 1 dose 2+ doses Unknown
39 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: SEAR, India 1 SEAR, India Rubella Case Distribution (October 216-September 218) label Top 1 countries (last 12 M) RCV in RI Cases % of Total India No Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) SEAR, India Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (October 217-September 218) Age at onset (in years) Rubella vaccine not introduced before 1 January 217 Rubella vaccine introduced before 1 January 217 Notes: Based on data received Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.
40 Incidence rate per 1,, Rubella cases: Indonesia SIA (9 M-15 Y) Cov: 1.5% Clinical Epi Lab National SIA Sub-national SIA Indonesia age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset Year Confirmed Cases doses 1 dose 2+ doses Unknown
41 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: WPR 8 WPR Rubella Case Distribution (October 216-September 218) label Top 1 countries (last 12 M) RCV in RI Cases % of Total China Malaysia Philippines Viet Nam Japan Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Singapore Lao People's Democratic Republic WPR (Excl. China) Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (October 217-September 218) Republic of Korea Cambodia Mongolia 29 2 Others Age at onset (in years) Rubella vaccine not introduced before 1 January 217 Rubella vaccine introduced before 1 January 217 Notes: Based on data received Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.
42 Rubella cases: China Clinical Epi Lab Age distribution not available from China Year Confirmed Cases
43 Incidence rate per 1,, Rubella cases: Philippines Clinical Epi Lab 4 2 Philippines age distribution, vaccination status, and incidence, to <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset Year Confirmed Cases doses 1 dose 2+ doses Unknown
44 Distribution of rubella genotypes (last 12 months) Notes: Data Source: RubNS database (Genotypes) and IVB Database (Incidence) as of and covering the period to Pie charts proportional to the number of sequenced viruses
45 Laboratory
46 Measles and Rubella IgM Data Summary 218 Region Member States* Specimens received Measles tested Measles positive n(%) Measles equivocal n(%) Measles negative n(%) Rubella tested Rubella positive n(%) Rubella equivocal n(%) Rubella negative n(%) AFR 37/ (21) 569 (2) (76) (16) 969 (6) (78) AMR 27/ (9) 115 (1) 1253 (86) (3) 236 (2) 9324 (9) EMR 2/ (35) 142 (1) 163 (65) (5) 422 (2) 2256 (93) EUR 37/ (34) 236 (1) 2598 (64) (2) 52 () (97) SEAR 11/ (36) 378 (3) 95 (61) (15) 292 (3) 8171 (82) WPR 27/ (17) 44 (2) 9926 (54) (3) 299 (2) 8237 (58) Total 159/ (28) 1844 (1) 8778 (67) (7) 227 (2) (85) 217 Region Member States* Specimens received Measles tested Measles positive n(%) Measles equivocal n(%) Measles negative n(%) Rubella tested Rubella positive n(%) Rubella equivocal n(%) Rubella negative n(%) AFR 4/ (13) 665 (2) 2988 (85) (17) 126 (4) 2338 (79) AMR 27/ (7) 58 (1) 7452 (85) (4) 17 (1) 692 (87) EMR 2/ (3) 127 () 2494 (69) (3) 99 () (96) EUR 38/ (37) 272 (1) (61) (2) 66 () (98) SEAR 11/ (41) 781 (2) 262 (62) (24) 741 (4) 1484 (73) WPR 27/ (14) 333 (2) (79) (5) 418 (3) 1748 (85) Total 163/ (27) 2236 (1) (71) (9) 2691 (2) (87) Notes: Based on data received * Member States Reporting / Total Member States in Region
47 Measles and Rubella IgM Data Summary Based on data received * Member States Reporting / Total Member States in Region Region Member States* Specimens received Measles tested Measles positive n(%) Measles equivocal n(%) 218 Measles negative n(%) Rubella tested Rubella positive n(%) Rubella equivocal n(%) Rubella negative n(%) AFR 37/ (21) 569 (2) (76) (16) 969 (6) (78) AMR 27/ (9) 115 (1) 1253 (86) (3) 236 (2) 9324 (9) EMR 2/ (35) 142 (1) 163 (65) (5) 422 (2) 2256 (93) EUR 37/ (34) 236 (1) 2598 (64) (2) 52 () (97) SEAR 11/ (36) 378 (3) 95 (61) (15) 292 (3) 8171 (82) WPR 27/ (17) 44 (2) 9926 (54) (3) 299 (2) 8237 (58) Total 159/ (28) 1844 (1) 8778 (67) (7) 227 (2) (85) Based on data received * Member States Reporting / Total Member States in Region 217 Region Member States* Specimens received Measles tested Measles positive n(%) Measles equivocal n(%) Measles negative n(%) Rubella tested Rubella positive n(%) Rubella equivocal n(%) Rubella negative n(%) AFR 37/ (13) 587 (2) (85) (17) 881 (4) (79) AMR 25/ (2) 79 (1) 4941 (61) (3) 91 (1) 484 (62) EMR 2/ (34) 111 () 1568 (66) (6) 75 () 2129 (93) EUR 37/ (41) 21 (1) (56) (2) 41 () (98) SEAR 11/ (39) 425 (2) (54) (24) 443 (3) 9336 (73) WPR 27/ (12) 257 (2) 8816 (85) (5) 285 (3) 7996 (91) Total 157/ (27) 1669 (1) (67) (1) 1816 (2) (85)
48 Performance of Surveillance
49 Surveillance sensitivity reporting rate of measles and rubella (12 months, discarded cases* per 1, population) Notes: Based on data received and covering the period between and Target: >= 2 discarded cases* / 1, population** - * Suspected cases investigated and discarded as non-measles non-rubella using laboratory testing and/or epidemiological linkage to another etiology ** World population prospects, 217 revision
50 Supplementary Immunization Activities
51 Next 6 months MMR, MR and Measles campaigns Region Name Activity Type Year StartDate EndDate Age Group(s) Extent Target EMR Djibouti FollowUp Measles M National SEAR India CatchUp MR M-15 Y Rollover-Nat 1194 SEAR Bhutan CatchUp MR M-4 Y Sub-national 1e+5 SEAR India CatchUp MR M-15 Y Rollover-Nat 493 SEAR Bangladesh FollowUp MR M National
52 Regional Bulletins and Newsletters (Switch to presentation mode if links are inactive) AFR Monthly feedback tables AMR: Weekly bulletin (published every Friday) EMR: Home page EUR : Periodical bulletin Monthly data SEAR: Monthly bulletin EPI country fact sheets WPR: Monthly Bulletin Country profiles Link to global Measles Surveillance HQ website
Global Measles and Rubella Update November 2018
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