Global Measles and Rubella Update. April 2018
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1 Global Measles and Rubella Update April 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 38/ AMR 26/ EMR 15/ EUR 49/ SEAR 1/ WPR 25/ Total 163/ 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 52/ SEAR 11/ WPR 26/ Total 183/ 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 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.
5 Measles Incidence Rate per Million (12M period) Top 1** Country Rate India Nigeria Indonesia Ukraine Pakistan China Italy Romania Bangladesh Serbia Other countries with high incidence rates*** Country Rate Liberia Gabon Greece Georgia Malaysia Tajikistan 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 27/3/218 Somalia , Somali EPI/POL Weekly Update Week 14, 218 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)
6 Number of Reported Measles (6M period) Top 1* Country India Ukraine 6184 Nigeria 3157 Serbia 2822 Pakistan 248 Indonesia 1959 Greece 174 Philippines 1684 China 1567 Malaysia 1167 Notes: Based on data received Surveillance data from to * Countries with highest number of cases for the period
7 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
8 Incidence rate per 1,, Measles cases: Benin 2 1 Discarded Clinical Epi Lab Benin 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
9 Incidence rate per 1,, Measles cases: Democratic Republic of the Congo 4 Rollover-Nat (6-59 M) Cov: 12% Sub-national (6-59 M) Cov: 13.5% Sub-national (6-59 M) Cov: 99.5% 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
10 Incidence rate per 1,, Measles cases: Ethiopia 1 Sub-national (6 M-<15 Y) Cov: 97% Sub-national (9 M-14 Y) Cov: 96.3% Sub-national (6-179 M) Cov: 98% 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
11 Incidence rate per 1,, Measles cases: Guinea Extent unknown (6-59 M) Discarded Clinical Epi Lab National SIA Sub-national SIA Guinea 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
12 Incidence rate per 1,, Measles cases: Liberia National (9-59 M) Discarded Clinical Epi Lab National SIA Sub-national SIA Liberia 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
13 Incidence rate per 1,, Measles cases: Mali Discarded Clinical Epi Lab Mali 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
14 Incidence rate per 1,, Measles cases: Niger Discarded Clinical Epi Lab Niger 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: Nigeria Sub-national (6 M-1 Y) Extent unknown (9-59 M) Discarded Clinical Epi Lab National SIA Sub-national SIA 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
16 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
17 Number of measles cases Measles case distribution (AMR), Venezuela (Bolivarian Republic of) USA Peru Others Mexico Ecuador Colombia Chile Canada Brazil Argentina Notes: Based on data received Data Source: IVB Database
18 Incidence rate per 1,, Measles cases: Venezuela (Bolivarian Republic of) Note: Given the current outbreaks in the country, data reporting delays are occurring. Data shown here are a combination of aggregate data for the epicurve and case-based data for the age/vaccination status, which are currently not entirely up to date. Additionally, the large numbers of cases in December 217 and March 218 (with none in January-February) are reporting artifacts 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 Pakistan Others Iraq Iran (Islamic Republic of) Egypt Afghanistan Notes: Based on data received Data Source: IVB Database
20 Incidence rate per 1,, Measles cases: Pakistan 2 1 Discarded Clinical Epi Lab 4 2 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
21 Incidence rate per 1,, Measles cases: Syrian Arab Republic 2 1 Discarded Clinical Epi Lab Syrian Arab Republic 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 Number of measles cases Measles case distribution (EUR), Ukraine Serbia Russian Federation Romania Others Kyrgyzstan Kazakhstan Italy Germany Georgia Bosnia and Herzegovina Notes: Based on data received Data Source: IVB Database
23 Incidence rate per 1,, Measles cases: France Discarded Clinical Epi Lab France 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 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
25 Incidence rate per 1,, Measles cases: Greece Discarded Clinical Epi Lab Greece 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: Italy Discarded Clinical Epi Lab Italy 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
27 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
28 Incidence rate per 1,, Measles cases: Serbia Discarded Clinical Epi Lab Serbia 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
29 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
30 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
31 Incidence rate per 1,, Measles cases: Indonesia 6 Sub-national (9-59 M) Cov: 86% 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 4 2 Year Confirmed
32 Number of measles cases Measles case distribution (SEAR, India), India 1 5 Notes: Based on data received Data Source: IVB Database
33 Incidence rate per 1,, Measles cases: India 4 Rollover-Nat (9 M-15 Y) Discarded Clinical Epi Lab National SIA Sub-national SIA India age distribution, vaccination status, and incidence, to Year Confirmed <1 year 1-4 years 5-9 years 1-14 years years years 4+ years Age at onset doses 1 dose 2+ doses Unknown
34 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
35 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
36 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
37 Rubella
38 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 29/ AMR 19/ EMR 15/ EUR 21/ SEAR 9/ WPR 9/ Total 12/ 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 13/ Total 142/ 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
39 Rubella cases (Lab+Epi+Clinical) Rubella Case Distribution by Month and WHO Region ( ) WPR SEAR EUR EMR 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.
40 (IgM+ only) (IgM+ only) Rubella cases: AFR AFR Rubella Case Distribution (April 216-March 218) 6 Top 1 countries (last 12 M) 4 label RCV in RI % of Total 2 South Africa No DR Congo No Others Ethiopia No Uganda No Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Nigeria No Cote d'ivoire No Madagascar No AFR Age distribution of Rubella IgM+ cases by vaccine introduction status in the National EPI Programme (April 217-March 218) Mozambique Algeria Sierra Leone 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: Algeria Clinical Epi Lab Algeria 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 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: EMR 4 EMR Rubella Case Distribution (April 216-March 218) 3 Top 1 countries (last 12 M) 2 label RCV in RI % of Total 1 Pakistan No Sudan No Saudi Arabia Afghanistan No 29 4 Others Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) United Arab Emirates Egypt EMR Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (April 217-March 218) Iran (Islamic Republic of) Yemen Lebanon 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.
43 (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 2 EUR Rubella Case Distribution (April 216-March 218) 1 label Top 1 countries (last 12 M) RCV in RI % of Total Poland Germany Italy Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) EUR Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (April 217-March 218) Austria Others Georgia Romania Russian Federation Kyrgyzstan Turkey United Kingdom of Great Britain and Northern Ireland Age at onset (in years) Rubella vaccine not introduced before 1 January 217 Rubella vaccine introduced before 1 January 217
44 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: SEAR (excl. India) SEAR (excl. India) Rubella Case Distribution (April 216-March 218) 6 4 label Top 1 countries (last 12 M) RCV in RI % of Total 2 Indonesia No Bangladesh Nepal Thailand Bhutan 26 4 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Timor-Leste Myanmar Sri Lanka SEAR (excl. India) Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (April 217-March 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.
45 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: SEAR, India 4 SEAR, India Rubella Case Distribution (April 216-March 218) 3 2 label Top 1 countries (last 12 M) RCV in RI % of Total 1 India No Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) 2 SEAR, India Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (April 217-March 218) 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.
46 (lab + epi-linked + clinical) (lab + epi-linked + clinical) Rubella cases: WPR WPR Rubella Case Distribution (April 216-March 218) 2 1 label Top 1 countries (last 12 M) RCV in RI % of Total China Philippines Malaysia Viet Nam Mongolia 29 8 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Cambodia Lao People's Democratic Republic WPR (Excl. China) Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (April 217-March 218) Singapore Fiji Japan Others - 2 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.
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 26/ (24) 59 (2) 1873 (74) (17) 11 (5) 1546 (78) AMR 23/ (3) 2 (1) 151 (86) (4) 55 (3) 1384 (84) EMR 16/ (3) 4 () 221 (7) (5) 18 (1) 261 (94) EUR 35/ (29) 75 (1) 5856 (69) (2) 14 () 4679 (98) SEAR 11/ (5) 97 (4) 1181 (46) (12) 34 (2) 127 (87) WPR 27/ (2) 52 (2) 1727 (51) (3) 46 (2) 1284 (47) Total 138/ (28) 37 (1) (66) (6) 268 (2) (83) 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 39/ (13) 665 (2) (85) (17) 1263 (4) 2343 (79) AMR 27/ (3) 65 (1) 6777 (88) (2) 118 (2) 639 (87) EMR 2/ (3) 127 () (7) (3) 99 () 3472 (96) EUR 38/ (38) 272 (1) 2739 (59) (2) 66 () (98) SEAR 11/ (41) 768 (2) (57) (24) 733 (4) (73) WPR 27/ (14) 333 (2) (79) (5) 418 (3) 1748 (85) Total 162/ (27) 223 (1) (7) (1) 2697 (2) (87) Notes: Based on data received * Member States Reporting / Total Member States in Region
50 Performance of Surveillance
51 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
52 Supplementary Immunization Activities
53 Next 6 months MMR, MR and Measles campaigns Region Name Activity Type Year StartDate EndDate Age Group(s) Extent Target AFR Angola CatchUp MR M-14 Y National AFR Mozambique CatchUp MR M-14 Y National AFR Benin CatchUp MR M-14 Y National SEAR Timor-Leste FollowUp MR M National 17 SEAR Indonesia CatchUp MR M-15 Y Rollover-Nat 3.4e+7 AFR Ghana FollowUp MR M National 46561
54 Regional Bulletins and Newsletters 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: Periodical newsletter Country profiles Link to global Measles Surveillance HQ website
Global Measles and Rubella Update October 2018
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