Global Measles and Rubella Update November 2018
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1 Global Measles and Rubella Update November 218
2 Measles
3 Number of Reported Measles 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 32/ EMR 2/ EUR 53/ SEAR 11/ WPR 26/ Total 184/ 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 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 32/ EMR 2/ EUR 53/ SEAR 11/ WPR 26/ Total 184/ 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 3/ EMR 2/ EUR 52/ SEAR 11/ WPR 26/ Total 182/ 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 ( ) The clustering of cases in AMR at specific time points is an artifact of reporting 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 Rate India Ukraine Philippines Yemen Nigeria Serbia China Pakistan DR Congo Indonesia Other countries with high incidence rates*** Country Rate Albania Liberia Georgia Montenegro Greece Lebanon Measles cases from countries with known discrepancies between case-based and aggregate surveillance, as reported by country Country Year Data Source DR Congo SITUATION EPIDEMIOLOGIQUE DE LA ROUGEOLE EN RDC, Week of 6/11/218 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 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. 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.
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 Incidence rate per 1,, Measles cases: Chad 3 Sub-national (9-59 M) Cov: 112.4% Sub-national (9-59 M) 2 1 Discarded Clinical Epi Lab National SIA Sub-national SIA Chad 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
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
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 2 1 Year Confirmed
12 Incidence rate per 1,, Measles cases: Kenya Discarded Clinical Epi Lab Kenya 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
13 Incidence rate per 1,, Measles cases: Madagascar Discarded Clinical Epi Lab Madagascar 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
14 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
15 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
16 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
17 Measles cases: Brazil 4 2 Discarded Clinical Epi Lab Year Confirmed
18 Incidence rate per 1,, Measles cases: Venezuela (Bolivarian Republic of) 6 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
19 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
20 Incidence rate per 1,, Measles cases: Libya Discarded Clinical Epi Lab Libya 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
21 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
22 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
23 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
24 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
25 Incidence rate per 1,, Measles cases: Israel 2 1 Discarded Clinical Epi Lab Israel 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
26 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
27 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
28 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
29 Number of measles cases Measles case distribution (SEAR, India), India 1 5 Notes: Based on data received Data Source: IVB Database
30 Incidence rate per 1,, Measles cases: India 3 Rollover-Nat (9 M-15 Y) 2 1 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 doses 1 dose 2+ doses Unknown
31 Incidence rate per 1,, Measles cases: Thailand Discarded Clinical Epi Lab Thailand 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
32 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
33 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
34 Rubella
35 Number of Reported Rubella 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 42/ AMR 26/ EMR 2/ EUR 36/ SEAR 11/ WPR 15/ Total 15/ 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
36 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.
37 (IgM+ only) (IgM+ only) Rubella cases: AFR AFR Rubella Case Distribution (November 216-October 218) 6 Top 1 countries (last 12 M) 4 label RCV in RI % of Total 2 Ethiopia No South Africa No Nigeria No Others DR Congo No Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Uganda No 37 9 Cote d'ivoire No Mali No AFR Age distribution of Rubella IgM+ cases by vaccine introduction status in the National EPI Programme (November 217-October 218) Congo No 94 3 Mozambique No 9 3 Liberia 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.
38 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: EMR EMR Rubella Case Distribution (November 216-October 218) 15 1 label Top 1 countries (last 12 M) RCV in RI % of Total 5 Sudan No Yemen Pakistan No Afghanistan No 42 4 Saudi Arabia Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Iran (Islamic Republic of) Others EMR Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (November 217-October 218) Tunisia United Arab Emirates Iraq Libya 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.
39 (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 (November 216-October 218) label Top 1 countries (last 12 M) RCV in RI % 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 (November 217-October 218) Romania Ireland Portugal Age at onset (in years) Rubella vaccine not introduced before 1 January 217 Rubella vaccine introduced before 1 January 217
40 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: SEAR (excl. India) SEAR (excl. India) Rubella Case Distribution (November 216-October 218) 6 4 label Top 1 countries (last 12 M) RCV in RI % 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 SEAR (excl. India) Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (November 217-October 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.
41 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 Bangladesh 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 doses 1 dose 2+ doses Unknown
42 Incidence rate per 1,, Rubella cases: India SIA (9 M-15 Y) 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 doses 1 dose 2+ doses Unknown
43 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 doses 1 dose 2+ doses Unknown
44 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: WPR 8 WPR Rubella Case Distribution (November 216-October 218) label Top 1 countries (last 12 M) RCV in RI % 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 (November 217-October 218) Cambodia Republic of Korea Mongolia 29 2 Others - 1 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.
45 Rubella cases: China Clinical Epi Lab Year Confirmed
46 Incidence rate per 1,, Rubella cases: Japan 15 Japan is having a rubella outbreak but most cases are not reported to WHO 1 5 Clinical Epi Lab Japan 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 1.5 Year Confirmed doses 1 dose 2+ doses Unknown
47 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
48 Laboratory
49 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 38/ (2) 648 (2) (78) (16) 1142 (6) (79) AMR 29/ (12) 65 (1) 667 (82) (4) 159 (2) 563 (87) EMR 2/ (35) 153 (1) 174 (64) (5) 385 (2) (93) EUR 37/ (34) 241 (1) (65) (2) 57 () (97) SEAR 11/ (37) 453 (3) 1895 (61) (15) 361 (3) 9969 (82) WPR 27/ (18) 441 (2) 1962 (53) (3) 319 (2) 9161 (56) Total 162/ (28) 21 (1) (66) (7) 2423 (2) 8769 (84) 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) 664 (2) 2987 (85) (17) 126 (4) (79) AMR 27/ (8) 46 (1) 6179 (83) (5) 85 (1) 5683 (85) 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/ (28) 2223 (1) (71) (1) 2669 (2) (87) Notes: Based on data received * Member States Reporting / Total Member States in Region
50 Measles and Rubella IgM Data Summary Notes: Based on data received * Member States Reporting / Total Member States in Region 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 38/ (2) 648 (2) (78) (16) 1142 (6) (79) AMR 29/ (12) 65 (1) 667 (82) (4) 159 (2) 563 (87) EMR 2/ (35) 153 (1) 174 (64) (5) 385 (2) (93) EUR 37/ (34) 241 (1) (65) (2) 57 () (97) SEAR 11/ (37) 453 (3) 1895 (61) (15) 361 (3) 9969 (82) WPR 27/ (18) 441 (2) 1962 (53) (3) 319 (2) 9161 (56) Total 162/ (28) 21 (1) (66) (7) 2423 (2) 8769 (84) Notes: 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) 531 (2) (85) (16) 912 (4) (8) AMR 25/ (2) 91 (1) 5692 (61) (3) 16 (1) 5523 (62) EMR 2/ (3) 124 () 1816 (69) (4) 135 (1) (96) EUR 37/ (41) 222 (1) (57) (2) 42 () 1842 (98) SEAR 11/ (42) 553 (2) (56) (23) 54 (3) (74) WPR 27/ (14) 284 (2) 9792 (84) (5) 319 (3) 8875 (91) Total 157/ (28) 185 (1) (68) (9) 218 (2) 8552 (86)
51 Performance of Surveillance
52 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
53 Supplementary Immunization Activities
54 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
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