Legend: No confirmed case With confirmed case No case based data

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Volume 11 Issue 3 ch ISSN 1814 3601 Figure 1.

might not reflect the exact location of the case DISCLAIMER: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of

1 Volume 11 Issue 3 ch ISSN Figure 1. Distribution of measles cases with rash onset 1 28 ruary, WHO Western Pacific Region Legend: No case With case No case based data Dots are placed at random within the corresponding district, and might not reflect the exact location of the case DISCLAIMER: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. WHO Regional Office for the Western Pacific All rights reserved *Map of Australia is from the Australian Bureau of Statistics Source: and rubella monthly country reports to the Western Pacific Regional Office by 20 ch Table 1. Confirmed measles cases by month of rash onset, ch ruary, WHO Western Pacific Region May Jun Jul Aug Sep Oct Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Western Pacific Region "-" No data Source: Case based and aggregate data reports to the Western Pacific Regional Office by 20 ch

2 May Jun Jul Aug Sep Oct May Jun Jul Aug Sep Oct May Jun Jul Aug Sep Oct May Jun Jul Aug Sep Oct May Jun Jul Aug Sep Oct Number of measles cases Figure 2. Confirmed measles cases by month of rash onset, WHO Western Pacific Region, 2012 as of 20 ch China Philippines Viet Nam Malaysia Papua New Guinea Others Source: and rubella monthly country reports to WHO by 20 ch Includes laboratory, epi-linked and clinically cases for 2012 Table 2. Status of measles verification, WHO Western Pacific Region Source of infection % of cases Source of infection % of cases Year with with Imported Importrelated source of cases related source of Unknown / not Endemic Imported Import- Unknown verified known known / not Endemic cases reported infection reported infection Australia % % Brunei Darussalam % Cambodia % % China % % China, Hong Kong SAR % % China, Macao SAR Japan % % Lao People's Democratic Republic % Malaysia % % Mongolia % % New Zealand % % Papua New Guinea Philippines % Republic of Korea % % Singapore % % Viet Nam % Pacific island countries and areas % % % Blue No measles cases Green 80% Yellow 60 79% Red <60% Source: and rubella monthly country reports to WHO by 20 ch 2

3 Table 3. case classification and incidence by country and area, WHO Western Pacific Region, 2013 as of 20 ch Rash 1 incidence per 1 million pop. 1 incidence per 1 million pop. 1 incidence per 1 million pop. incidence per 1 million pop. Population (in millions) 2 Suspected measles cases Pending classification Discarded Compatible cases 3 cases Lab Confirmed measles cases Epi-linked Annualized measles incidence per 1 million pop. Deaths due to measles onset of last measles case Australia NA Brunei Darussalam Aug-16 Cambodia China China, Hong Kong SAR China, Macao SAR Jun-14 Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Sep-15 Philippines Not available Republic of Korea Singapore Viet Nam Not available Oct-16 Pacific island countries and areas Jun-16 Western Pacific Region Includes laboratory and epi-linked cases Green <1 measles case / population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects. Yellow measles case / population 3 Australia reports cases only. Red >= 10 cases / population 4 Classification is provisional based on laboratory data only. 3

4 Table 4. surveillance performance indicators by country and area, WHO Western Pacific Region, as of 20 ch Discarded non-measles rate per pop Second level units with 2 discarded cases per pop [annualized] 1 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 Annualized discarded non-measles rate per pop Second level units with 2 discarded cases per pop [annualized] 1 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation % 80% 80% 2 80% 80% 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 2.8 Not applicable 100.0% 100.0% 0.0 Not applicable Not applicable Not applicable Cambodia % 88.3% 99.0% % 94.9% 99.3% China % 97.1% 87.9% % 91.3% 81.3% China, Hong Kong SAR 2.5 Not applicable 97.9% 99.5% 0.0 Not applicable 80.0% 80.0% China, Macao SAR 2.0 Not applicable 100.0% 100.0% 2.0 Not applicable 100.0% 100.0% Japan % Insufficient data Insufficient data % Insufficient data Insufficient data Lao People's Democratic Republic % 98.6% 47.6% % 95.4% 96.3% Malaysia % 79.7% 88.8% % 78.5% 86.4% Mongolia % 8.0% 14.4% % 90.2% 86.3% New Zealand 1.1 Insufficient data Insufficient data Insufficient data 0.0 Insufficient data Insufficient data Insufficient data Papua New Guinea % 65.3% 89.8% % 0.0% 0.0% Philippines % 57.3% 70.2% Not available Not available Not applicable Not applicable Republic of Korea % 92.1% 79.9% % 86.8% 92.1% 4 Singapore 1.6 Not applicable 85.1% 51.8% 3.1 Not applicable 85.3% 55.9% Viet Nam % 57.1% 78.1% Not available Not available Not applicable Not applicable Pacific island countries and areas % 0.0% 82.4% % 0.0% 90.5% Western Pacific Region % 70.7% 67.7% % 88.4% 83.2% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only cases. Green Yellow Red Reached or surpassed target Nearly reached target: for non-measles suspected case rate; % for percent clinically cases; 60 79% for other indicators Substantially below target 24

5 Table 5. case classification and incidence by country and area, WHO Western Pacific Region, 2014 as of 20 ch Confirmed rubella cases Population Annualized Congenital Investigated Pending Discarded Compatible incidence per incidence per incidence per (in rubella rubella Lab Epi-linked 1 million pop. 1 million pop. millions) 1 rubella cases classification cases cases 1 million pop. incidence per syndrome 1 million pop. Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Western Pacific Region United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects. Green <1 measles case / population 2 Classification is provisional based on laboratory data only. Yellow measles case / population "-" No data Red >= 10 cases / population Gray No data 5

6 Table 6A. and rubella laboratory testing, WHO Western Pacific Region, as of 20 ruary No. No. % No. No. received Australia VIDRL Brunei Darussalam DLS Cambodia NIPH China CCDC China, Hong Kong SAR PHLC China, Macao SAR PHL Japan NIID Lao People's Democratic Republic NCLE Malaysia NPHL Mongolia NCCD New Zealand CHL Papua New Guinea CPHL Philippines RITM Republic of Korea KCDC Singapore SGH Viet Nam national lab (Northern) NIHE Viet Nam national lab (Southern) PI Viet Nam subnational lab (Central) PI Viet Nam subnational lab (Highland) IHE Fiji FCCDC Vanuatu FCCDC "-" No data Laboratory of received and rubella of of cases Samples for measles IgM Serum IgM (+) Serology IgM equiv Blood DBS No. (+) % of with results 4 days Virus detection Virus isolation/ detection (swab, urine and others) isolates Reverse Transcription- Polymerase Chain Samples of for IgM (+) IgM lab rubella IgM equiv Reaction cases No. (+) No. No. % No. Serum and blood (includes DBS) 6

7 Table 6B. and rubella laboratory testing, WHO Western Pacific Region, as of 20 ch No. No. % No. No. received Australia VIDRL Brunei Darussalam DLS Cambodia NIPH China CCDC China, Hong Kong SAR PHLC China, Macao SAR PHL Japan NIID Lao People's Democratic Republic NCLE Malaysia NPHL Mongolia NCCD New Zealand CHL Papua New Guinea CPHL Philippines RITM Republic of Korea KCDC Singapore NPHL Viet Nam national lab (Northern) NIHE Viet Nam national lab (Southern) PI Viet Nam subnational lab (Central) PI Viet Nam subnational lab (Highland) IHE Fiji FCCDC "-" No data Laboratory of received and rubella of of cases Samples for measles IgM Serum IgM (+) Serology IgM equiv Blood DBS No. (+) % of with results 4 days Virus detection Virus isolation/ detection (swab, urine and others) isolates Reverse Transcription- Polymerase Chain Samples of for IgM (+) IgM lab rubella IgM equiv Reaction cases No. (+) No. No. % No. Serum and blood (includes DBS) 7

8 Figure 3. genotype distribution of cases with rash onset in and, WHO Western Pacific Region B3 D4 D8 D9 The boundaries and names shown and the designations used on the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. WHO Regional Office for the Western Pacific All rights reserved. D11 G3 H1 Table 7. genotype distribution of cases with rash onset in ch to ruary, WHO Western Pacific Region May Jun Jul Aug Sep Oct B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D4 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia Brunei Darussalam 2 Cambodia China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia 9 18 New Zealand Papua New Guinea Philippines 1 Republic of Korea Singapore Viet Nam Pacific island countries and areas Sources: Includes all cases reported to the Western Pacific Regional Office by 20 ch and the Nucleotide Surveillance online database (MeaNS). 8

9 Figure 4. genotype distribution of cases with rash onset in and, WHO Western Pacific Region 2B 1E 9 The boundaries and names shown and the designations used on the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. WHO Regional Office for the Western Pacific All rights reserved. Table 8. genotype distribution of cases with rash onset in ch to ruary, WHO Western Pacific Region May Jun Jul Aug Sep Oct 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia 1 1 Brunei Darussalam Cambodia China China, Hong Kong SAR 1 China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Sources: Includes all cases reported to the Western Pacific Regional Office by 20 ch and the Nucleotide Surveillance online database (RubeNS).

10 Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, Country 1 1 Completeness 2 Timeliness 3 Completeness 2 Timeliness 3 Australia 100% 75% % 100% Brunei Darussalam 100% 100% % 100% Cambodia 100% 100% % 100% China 100% 83% % 100% China, Hong Kong SAR 100% 100% % 100% China, Macao SAR 100% 100% % 100% Japan 100% 100% % 100% Lao People's Democratic Republic 100% 100% % 100% Malaysia 100% 100% % 100% Mongolia 100% 83% % 100% New Zealand 100% 100% % 100% Papua New Guinea 92% 50% % 100% Philippines 100% 75% 0% 0% Republic of Korea 100% 100% % 100% Singapore 100% 100% % 100% Viet Nam 100% 92% % 100% Pacific island countries and areas 100% 100% % 100% Completeness 100% 94% 94% 94% Timeliness 92% 94% 94% 94% 1 National measles surveillance monthly reports from ruary. Legend: black = timely report; red = untimely report 2 Completeness is defined as the of reports received by the end of the reporting month divided by the of expected reports for the year. 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 1 Genotype results by source of data Completeness 2 Timeliness 3 Completeness 2 Timeliness 3 MeaNS Submission to WPRO Rubens Submission to WPRO Australia 100% 100% % 100% Brunei Darussalam 100% 100% % 100% Cambodia 100% 100% % 100% China 100% 100% % 100% China, Hong Kong SAR 100% 100% % 100% China, Macao SAR 100% 100% % 100% Japan 100% 100% % 100% Lao People's Democratic Republic 100% 100% % 100% Malaysia 100% 83% % 100% Mongolia 92% 67% % 100% New Zealand 100% 100% % 100% Papua New Guinea 100% 33% % 50% Philippines 100% 92% % 50% Republic of Korea 100% 100% % 100% Singapore 100% 100% % 100% Viet Nam national lab (Northern) 100% 92% % 100% Viet Nam national lab (Southern) 100% 100% % 100% Viet Nam subnational lab (Central) 100% 92% % 100% Viet Nam subnational lab (Highland) 100% 92% % 100% Fiji 100% 92% % 100% Completeness 100% 100% 100% 100% Timeliness 92% 100% 100% 95% National measles laboratory monthly reports from ruary. Legend: black = timely report; red = untimely report 2 Completeness is defined as the of reports received by the end of the reporting month divided by the of expected reports for the year. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Expanded Programme on Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) Fax No. (63 2) , Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination 10

Legend: No confirmed case With confirmed case No case based data

Volume 11 Issue 1 uary 2017 ISSN 1814 3601 Figure 1. Distribution of confirmed measles cases with rash onset 1 31 ember, WHO Western Pacific Region Legend: No confirmed case With confirmed case No case