Figure 1. Incidence rate of total (confirmed and compatible) measles cases with rash onset 1 31 March 2018, WHO Western Pacific Region

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Volume 12 Issue 4 April ISSN 1814 3601 Figure 1. Incidence rate of total ( compatible) measles cases with rash onset 1 31 ch, WHO Western Pacific Region Legend: No cases <1 per million population 1.

0 per million population No data submitted No geographical distribution information available Pacific isl countries areas DISCLAIMER: The boundaries names shown the designations used on this map do

1 Volume 12 Issue 4 April ISSN Figure 1. Incidence rate of total ( compatible) measles cases with rash onset 1 31 ch, WHO Western Pacific Region Legend: No cases <1 per million population per million population >10.0 per million population No data submitted No geographical distribution information available Pacific isl countries areas DISCLAIMER: The boundaries names shown 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: rubella monthly country reports to the Western Pacific Regional Office by 20 April Table 1. Numbers of total ( compatible) measles cases by month of rash onset, October ch, WHO Western Pacific Region Oct Nov Dec no. no. no. no. no. no. Source: Case based aggregate data reports to the Western Pacific Regional Office by 20 April Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zeal Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific isl countries areas Western Pacific Region "-" No data 1 Reports only cases

2 Apr May Jun Jul Aug Oct Nov Dec Apr May Jun Jul Aug Oct Nov Dec Apr May Jun Jul Aug Oct Nov Dec Apr May Jun Jul Aug Oct Nov Dec Apr May Jun Jul Aug Oct Nov Dec Number of measles cases Figure 2. ( compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2013 as of 20 April Source: rubella monthly country reports to WHO by 20 April China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Table 2. Status of verification of measles elimination, WHO Western Pacific Region 2016 % Source of infection % Source of infection % Year with with with Imported Importrelated source related source of Unknown Endemic / not Imported Import- Unknown verified known known known Endemic / not source infection reported infection reported infection Australia % % % Brunei Darussalam % Cambodia % % China - 0.0% % % China, Hong Kong SAR % % % China, Macao SAR % Japan % % % Lao People's Democratic Republic - 0.0% % % Malaysia % % % Mongolia % % New Zeal 0.0% % % Papua New Guinea % % Philippines % % % Republic of Korea % % % Singapore % % % Viet Nam - 0.0% % % Pacific isl countries areas - 0.0% % % % % Blue No measles cases Green 80% Yellow 60 79% Red <60% Source: rubella monthly country reports to WHO by 20 April 2

3 Table 3. case classification incidence by country area, WHO Western Pacific Region, 2014 as of 20 April compatible incidence per 1 million pop. compatible 1 incidence per 1 million pop. compatible 1 incidence per 1 million pop. compatible 1 incidence per 1 million pop. Rash Confirmed compatible measles cases onset of Population Suspected Annualized Deaths last Pending Discarded (in millions) measles Compatible Epilinked incidence per measles measles 2 classification cases 3 due to Lab cases measles cases case compatible 1 million pop. Australia Brunei Darussalam Aug-16 Cambodia Jun-17 China China, Hong Kong SAR China, Macao SAR Jul-17 Japan Lao People's Democratic Republic Malaysia Mongolia May-17 New Zeal Papua New Guinea Philippines Apr-18 Republic of Korea Singapore Viet Nam Pacific isl countries areas May-17 Fiji May-17 Federated States of Micronesia Aug-14 Guam Solomon Isls Vanuatu Western Pacific Region Includes compatible, laboratory epi-linked cases Green <1 measles case / population 2 United Nations, Department of Economic Social Affairs, Population Division World Population Prospects revision. 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 area, WHO Western Pacific Region, as of 20 April Discarded non-measles rate per pop Second level units with 2 discarded cases per pop [annualized] 1 Suspected cases with Suspected cases with adequate specimens for adequate investigation 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 4.2 Not applicable 100.0% 100.0% 6.5 Not applicable 100.0% 100.0% Cambodia % 81.9% 78.8% % 77.5% 99.6% China % 97.8% 91.5% % 96.5% 89.6% China, Hong Kong SAR 0.1 Not applicable 100.0% 100.0% 0.0 Not applicable 100.0% 100.0% China, Macao SAR 2.6 Not applicable 83.3% 100.0% 2.5 Not applicable 100.0% 100.0% Japan % Insufficient data Insufficient data % Insufficient data Insufficient data Lao People's Democratic Republic % 82.4% 85.4% % 60.6% 66.1% Malaysia % 84.4% 91.3% % 84.9% 85.2% Mongolia % 88.3% 93.5% % 100.0% 100.0% New Zeal 0.4 Insufficient data Insufficient data Insufficient data 0.4 Insufficient data Insufficient data Insufficient data Papua New Guinea % 70.6% 84.3% % 68.4% 84.2% Philippines % 46.0% 69.3% % 65.3% 57.4% Republic of Korea % 71.2% 84.9% % 86.9% 86.9% Singapore 1.4 Not applicable 66.3% 67.5% 1.2 Not applicable 85.7% 82.1% Viet Nam % 57.9% 77.3% % 53.2% 90.1% Pacific isl countries areas % 87.5% 82.3% % 85.2% 92.6% Western Pacific Region % 89.3% 89.2% % 81.3% 77.2% 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 4 Surveillance performance indicators refer to all the Pacific isl countries areas as one epidemiological block; each country is considered as second level unit 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 incidence by country area, WHO Western Pacific Region, 2014 as of 20 April Confirmed compatible rubella cases Population Annualized Congenital Investigated Pending Discarded incidence per incidence per incidence per incidence per (in Compatible Epilinked incidence per syndrome rubella rubella Lab millions) 1 for rubella classification cases 1 million pop. 1 million pop. 1 million pop. 1 million pop. cases compatible compatible compatible compatible compatible 1 million pop. Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zeal Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific isl countries areas Fiji Solomon Isls Vanuatu Western Pacific Region United Nations, Department of Economic Social Affairs, Population Division World Population Prospects revision Green <1 measles case / population 2 Classification is provisional based on laboratory data only. Yellow measles case / population "-" No data Red >= 10 cases / population 5

6 Table 6A. rubella laboratory testing, WHO Western Pacific Region, 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 Zeal 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 (Highl) IHE % % Fiji FCCDC % % % % "-" No data Laboratory of received rubella of Samples for measles IgM Serum IgM (+) Serology IgM equiv Blood DBS No. (+) % of with results 4 days Virus detection Virus isolation/ detection (swab, urine others) isolates Reverse Transcription- Polymerase Chain Samples of for IgM (+) lab IgM equiv rubella IgM Reaction cases No. (+) No. No. % No. % Serum blood (includes DBS) 6

7 Table 6B. rubella laboratory testing, WHO Western Pacific Region, as of 20 April No. No. % No. % No. received Australia VIDRL % Brunei Darussalam DLS % % 0 0% Cambodia NIPH % % 0 0% China CCDC China, Hong Kong SAR PHLC % % 1 2% China, Macao SAR PHL % % 0 0% Japan NIID % Lao People's Democratic Republic NCLE % % 5 7% Malaysia NPHL % % 48 4% Mongolia NCCD % % 0 0% New Zeal CHL % % 0 0% Papua New Guinea CPHL % % 0 0% Philippines RITM % % 10 0% Republic of Korea KCDC % % 10 15% Singapore NPHL % % 0 0% Viet Nam national lab (Northern) NIHE % % 0 0% Viet Nam national lab (Southern) PI % % 1 2% Viet Nam subnational lab (Central) PI % % 0 0% Viet Nam subnational lab (Highl) IHE % % 0 0% Fiji FCCDC % % 2 7% % % 77 2% "-" No data Laboratory of received rubella of Samples for measles IgM Serum IgM (+) Serology IgM equiv Blood DBS No. (+) % of with results 4 days Virus detection Virus isolation/ detection (swab, urine others) isolates Reverse Transcription- Polymerase Chain Serum blood (includes DBS) Samples of for IgM (+) lab IgM equiv rubella IgM Reaction cases No. (+) No. No. % No. % 7

8 Figure 3. genotype distribution with rash onset in, WHO Western Pacific Region B3 D4 D8 D9 The boundaries names shown 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 with rash onset in April to ch, WHO Western Pacific Region Apr May Jun Jul Aug Oct Nov Dec 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 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR 2 Japan Lao People's Democratic Republic Malaysia 2 Mongolia New Zeal Papua New Guinea Philippines Republic of Korea 1 Singapore Viet Nam Pacific isl countries areas Sources: Includes all cases reported to the Western Pacific Regional Office by 20 April the Nucleotide Surveillance online database (MeaNS). 8

9 Figure 4. genotype distribution with rash onset in, WHO Western Pacific Region 2B 1E The boundaries names shown 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 with rash onset in April to ch, WHO Western Pacific Region Australia Brunei Darussalam Cambodia Apr May Jun Jul Aug Oct Nov Dec 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 China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zeal Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific isl countries areas Sources: Includes all cases reported to the Western Pacific Regional Office by 20 April the Nucleotide Surveillance online database (RubeNS). 9

10 Table 9A. Completeness timeliness of epidemiologic reporting, WHO Western Pacific Region, 1 Country Completeness 2 Timeliness 3 Completeness 2 Timeliness 3 Australia 100% 100% Apr 100% 100% Brunei Darussalam 100% 100% Apr 100% 100% Cambodia 100% 100% Apr 100% 100% China 100% 75% Apr 100% 100% China, Hong Kong SAR 100% 100% Apr 100% 100% China, Macao SAR 100% 100% Apr 100% 100% Japan 100% 92% Apr 100% 100% Lao People's Democratic Republic 100% 100% Apr 100% 100% Malaysia 100% 100% Apr 100% 100% Mongolia 100% 100% Apr 100% 100% New Zeal 100% 100% Apr 100% 100% Papua New Guinea 100% 92% Apr 67% 33% Philippines 58% 25% Apr 67% 0% Republic of Korea 100% 92% Apr 100% 100% Singapore 100% 92% Apr 100% 67% Viet Nam 100% 92% Apr 100% 100% Pacific isl countries areas 100% 67% Apr 100% 67% Completeness 98% 94% 94% 100% 96% Timeliness 92% 82% 76% 88% 86% 1 National measles surveillance monthly reports from ch. Legend: black = timely report; red = untimely report 2 Completeness is defined as the of reports received by the end of the day) of the following month; Pacific isl countries areas China may report to the Regional Office by the 15th (or the next working day) of the Table 9B. Completeness 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 Rubens Submission to WPRO to WPRO Australia 100% 100% Apr 100% 100% Brunei Darussalam 100% 100% % 100% Cambodia 100% 100% Apr 100% 100% China 100% 100% Apr 100% 100% China, Hong Kong SAR 100% 100% Apr 100% 100% China, Macao SAR 100% 100% Apr 100% 100% Japan 100% 92% Apr 100% 100% Lao People's Democratic Republic 100% 100% Apr 100% 100% Malaysia 100% 100% Apr 100% 100% Mongolia 100% 83% Apr 100% 100% New Zeal 100% 100% Apr 100% 100% Papua New Guinea 100% 67% Apr 100% 100% Philippines 100% 92% Apr 100% 100% Republic of Korea 100% 100% Apr 100% 100% Singapore 100% 100% Apr 100% 100% Viet Nam national lab (Northern) 100% 100% Apr 100% 100% Viet Nam national lab (Southern) 100% 100% Apr 100% 100% Viet Nam subnational lab (Central) 100% 100% Apr 100% 100% Viet Nam subnational lab (Highl) 100% 100% Apr 100% 100% Fiji 100% 75% Apr 100% 33% Completeness 100% 100% 100% 100% 100% Timeliness 95% 95% 95% 100% 97% National measles laboratory monthly reports from ch. 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 rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Exped 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 monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional country profile of measles elimination 10

Figure 1. Incidence rate of total (confirmed and compatible) measles cases with rash onset 1 31 December 2017, WHO Western Pacific Region

Volume 12 Issue 1 January 2018 ISSN 1814 3601 Figure 1. Incidence rate of total ( compatible) measles with rash onset 1 31 ember, WHO Western Pacific Region Legend: Pacific isl countries areas No