Global Measles and Rubella Update October PDF Free Download

Global Measles and Rubella Update October 218

Measles

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 42/47 4895 23753 13187 5364 522 2975 4264 567 3556 2562 1634 1695 133 697 218-1 AMR 3/35 22222 6672 6672 3 16 84 152 291 216 411 137 5362 218-1 EMR 2/21 33843 17884 4782 471 841 2228 1739 262 2647 332 2112 2127 16 373 218-1 EUR 53/53 61717 52958 28976 222 2196 5942 6884 7638 7831 8862 721 5149 3427 15 218-1 SEAR 11/11 7573 53599 4742 3678 2519 659 622 189 1312 9634 458 2777 256 288 218-1 WPR 26/27 48183 18311 1952 479 688 1928 2485 339 3251 2964 2131 144 75 8 218-1 Total 182/194 281933 173177 1529 9 16244 51634 19666 2141 29689 27749 27345 17883 13563 9129 6743 217 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 43/47 51561 24834 117 8841 4986 3215 2896 3647 237 226 1859 1475 1412 1519 1695 1315 145 218-1 AMR 31/35 1881 895 895 1 8 19 13 5 1 1 847 218-1 EMR 2/21 36139 12777 1918 693 1166 113 18 1296 128 146 157 161 812 76 941 95 131 218-1 EUR 53/53 393 2439 4419 653 13918 1422 1873 34 2885 292 2572 138 868 965 1327 2352 2822 218-1 SEAR 11/11 99117 76429 55532 1543 5854 8639 9645 1357 132 7516 4337 3639 424 3357 2913 4246 452 218-1 WPR 26/27 5313 1296 2692 17 7497 778 894 151 1222 112 8 772 7 725 77 617 397 218-1 Total 184/194 281758 149621 75568 3737 43316 15158 16396 22524 189 1547 1625 8327 833 7273 7646 948 1122 Notes: Based on data received 218-1 - This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region

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 42/47 4895 23753 13187 5364 522 2975 4264 567 3556 2562 1634 1695 133 697 218-1 AMR 3/35 22222 6672 6672 3 16 84 152 291 216 411 137 5362 218-1 EMR 2/21 33843 17884 4782 471 841 2228 1739 262 2647 332 2112 2127 16 373 218-1 EUR 53/53 61717 52958 28976 222 2196 5942 6884 7638 7831 8862 721 5149 3427 15 218-1 SEAR 11/11 7573 53599 4742 3678 2519 659 622 189 1312 9634 458 2777 256 288 218-1 WPR 26/27 48183 18311 1952 479 688 1928 2485 339 3251 2964 2131 144 75 8 218-1 Total 182/194 281933 173177 1529 9 16244 51634 19666 2141 29689 27749 27345 17883 13563 9129 6743 217 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 43/47 35554 16819 847 539 3733 342 2692 3238 1922 172 1457 11 172 675 217-1 AMR 3/35 7582 216 216 1 8 19 13 5 1 3 26 14 217-1 EMR 2/21 23711 1875 3274 63 6971 147 1168 1179 2161 2441 1469 968 78 4 217-1 EUR 5/53 16219 12922 2365 345 7152 192 1847 2919 175 1862 1482 127 744 1 217-1 SEAR 11/11 6381 5582 38187 7413 4982 7255 8556 1247 943 672 349 2563 379 16 217-1 WPR 26/27 3298 7744 2191 47 556 64 831 1468 1298 1176 838 787 76 217-1 Total 18/194 179784 99158 5464 16534 2856 13437 1512 287 16529 1396 8737 6592 35 98 Notes: Based on data received 218-1 and 217-1 - This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region

Measles Incidence Rate per Million (12M period) Top 1** Country Cases Rate India 6724 45.86 Ukraine 32618 734. Philippines 1252 121. Yemen 8353 32.82 Nigeria 7576 4.73 Serbia 571 647.39 China 4291 3.6 Russian Federation 394 27.37 Pakistan 3859 19.97 DR Congo 3558 45.19 Other countries with high incidence rates*** Country Cases Rate Albania 1379 471.24 Liberia 193 412.46 Georgia 1212 38.76 Greece 3142 28.94 Lebanon 894 148.83 Romania 1766 89.29 Measles cases from countries with known discrepancies between case-based and aggregate surveillance, as reported by country Country Year Cases Data Source DR Congo 217 45165 SITUATION EPIDEMIOLOGIQUE DE LA 218 3191 ROUGEOLE EN RDC, Week of 16/1/218 Somalia 217 23394 Somali EPI/POL Weekly Update Week 4 218 7765 Notes: Based on data received 218-1 and covering the period between 217-9 and 218-8 - 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)

Number of Reported Measles Cases (6M period) Country Top 1* Cases India 37372 Ukraine 23335 Philippines 8472 Yemen 559 Nigeria 3255 Serbia 2888 Sudan 273 China 2624 DR Congo 2219 Russian Federation 2142 Notes: Based on data received 218-1 - Surveillance data from 218-3 to 218-8 - * Countries with highest number of cases for the period

214-1 214-2 214-3 214-4 214-5 214-6 214-7 214-8 214-9 214-1 214-11 214-12 215-1 215-2 215-3 215-4 215-5 215-6 215-7 215-8 215-9 215-1 215-11 215-12 216-1 216-2 216-3 216-4 216-5 216-6 216-7 216-8 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Number of measles cases Measles case distribution (AFR), 214-218 8 Uganda Others Nigeria Niger Liberia Gabon Ethiopia Equatorial Guinea DR Congo Cameroon Angola 6 4 2 Notes: Based on data received 218-1 - 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

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.

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Democratic Republic of the Congo 4 Sub-national (6-59 M) Cov: 13.5% 3 2 1 Discarded Clinical Epi Lab National SIA Sub-national SIA Democratic Republic of the Congo age distribution, vaccination status, and incidence, 217-9 to 218-8 2 181.8 2 15 143.3 15 1 67.4 1 5 5 13.5 5.1 2.3.3 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases 26 112 27 539 28 214 29 83 21 28 211 1651 212 2332 213 2527 214 1649 215 529 216 4932 217 3617 218 3253

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 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 5 4 3 2 1 Ethiopia age distribution, vaccination status, and incidence, 217-9 to 218-8 26.4 25.7 21.9 18.7 14 7.1.5 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 3 2 1 Year Confirmed Cases 26 1278 27 1472 28 3161 29 2642 21 625 211 3552 212 4616 213 6137 214 14282 215 17778 216 4568 217 1912 218 947

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 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, 217-9 to 218-8 156 128.2 67 24.1 8.5 5.9 2.6 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 15 1 5 Year Confirmed Cases 26 119 27 3129 28 1453 29 1498 21 972 211 1962 212 6423 213 55392 214 685 215 12391 216 17581 217 11188 218 5946

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Uganda 6 5 4 3 2 1 Discarded Clinical Epi Lab 15 1 5 Uganda age distribution, vaccination status, and incidence, 217-9 to 218-8 212.9 215.1 1 46.9 16.9 4.2 1.7 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 25 2 15 1 5 Year Confirmed Cases 26 135 27 291 28 115 29 86 21 41 211 132 212 72 213 46 214 315 215 466 216 252 217 892 218 275

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 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, 217-9 to 218-8 15 1678.3 2 15 1 1 6.4 5 5 171.8 121.3 33.5 13.6 6.3 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown Year Confirmed Cases 28 29 21 211 212 1 213 214 215 216 217 727 218 465

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Pakistan 15 1 5 Discarded Clinical Epi Lab 25 2 15 1 5 Pakistan age distribution, vaccination status, and incidence, 217-9 to 218-8 162.9 11 28.7 5.2.7.5 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 15 1 5 Year Confirmed Cases 26 35 27 33 28 53 29 472 21 1111 211 2676 212 848 213 83 214 137 215 1117 216 286 217 678 218 2358

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Sudan 1 8 6 4 2 Discarded Clinical Epi Lab 15 1 5 Sudan age distribution, vaccination status, and incidence, 217-9 to 218-8 456.8 271.7 71.5 32.8 38.5 31.7 4.9 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 5 4 3 2 1 Year Confirmed Cases 26 274 27 483 28 97 29 68 21 613 211 5616 212 8521 213 2811 214 676 215 3585 216 1767 217 665 218 2929

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Yemen 15 1 5 Discarded Clinical Epi Lab 4 2 Yemen age distribution, vaccination status, and incidence, 217-9 to 218-8 1779.7 1329.7 526 125 3.7 4.5 8.1 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 2 15 1 5 Year Confirmed Cases 26 4989 27 5 28 53 29 127 21 372 211 847 212 2143 213 571 214 817 215 465 216 143 217 211 218 7285

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Georgia 3 2 1 Discarded Clinical Epi Lab 4 3 2 1 Georgia age distribution, vaccination status, and incidence, 217-9 to 218-8 2475.4 88.3 477 584.9 379 432.4 44.7 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 25 2 15 1 5 Year Confirmed Cases 26 8 27 2 28 55 29 23 21 22 211 64 212 3 213 7868 214 319 215 43 216 14 217 96 218 1129

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Russian Federation 1 8 6 4 2 Discarded Clinical Epi Lab 12 1 8 6 4 2 Russian Federation age distribution, vaccination status, and incidence, 217-9 to 218-8 243.2 144.1 56.7 28 29.7 24.8 6.8 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 25 2 15 1 5 Year Confirmed Cases 26 1129 27 172 28 27 29 11 21 152 211 783 212 1975 213 251 214 3263 215 635 216 179 217 926 218 3313

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Ukraine 6 4 2 Discarded Clinical Epi Lab 6 4 2 Ukraine age distribution, vaccination status, and incidence, 217-9 to 218-8 3862.6 2872.3 2612.3 277.4 741 517.2 26.5 <1 year 1-4 years 5-9 years 1-14 years 15-19 years 2-29 years 3+ years Age at onset doses 1 dose 2+ doses Unknown 4 3 2 1 Year Confirmed Cases 26 945 27 232 28 41 29 24 21 42 211 1313 212 12744 213 338 214 2326 215 141 216 9 217 4782 218 29464

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Indonesia 6 Sub-national (9 M-15 Y) Cov: 1.5% 4 2 Discarded Clinical Epi Lab National SIA Sub-national SIA 5 4 3 2 1 Indonesia age distribution, vaccination status, and incidence, 217-9 to 218-8 22.2 2.8 18.4 11.7 5.5 1.1.2 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 2 1 Year Confirmed Cases 26 21911 27 2837 28 16417 29 218 21 23471 211 2351 212 16786 213 193 214 9498 215 629 216 724 217 11389 218 1556

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: India 25 2 15 1 5 Rollover-Nat (9 M-15 Y) Discarded Clinical Epi Lab National SIA Sub-national SIA 12 1 8 6 4 2 India age distribution, vaccination status, and incidence, 217-9 to 218-8 18.9 99.4 84.5 24.1 5.2 1.7.3 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset 12 1 8 6 4 2 Year Confirmed Cases 214 836 215 8326 216 7798 217 57392 218 4852 doses 1 dose 2+ doses Unknown

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Measles cases: Philippines 3 2 1 Discarded Clinical Epi Lab 6 4 2 Philippines age distribution, vaccination status, and incidence, 217-9 to 218-8 1556.5 548.2 94.3 43.9 73.3 39 5 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset doses 1 dose 2+ doses Unknown 15 1 5 Year Confirmed Cases 26 216 27 612 28 838 29 1351 21 6363 211 6519 212 1441 213 4855 214 5396 215 221 216 647 217 165 218 1167

Distribution of measles genotypes (last 12 months) Notes: Data Source: MeaNS database (Genotypes) and IVB Database (Incidence) as of 218-1-17 and covering the period 217-9-1 to 218-8-31 - Pie charts proportional to the number of sequenced viruses

Rubella

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 41/47 2593 2593 337 362 56 353 344 218 221 161 37 218-1 AMR 24/35 2 2 1 1 218-1 EMR 2/21 876 92 49 735 13 117 16 128 126 9 89 56 7 218-1 EUR 36/53 662 585 6 71 82 97 75 97 93 81 63 74 218-1 SEAR 11/11 149 55 1435 233 254 345 262 218 93 36 49 218-1 WPR 15/27 2549 142 47 236 118 17 291 511 751 338 255 178 218-1 Total 147/194 8172 819 157 7196 873 938 1431 1352 1532 82 664 518 44 217 Region Member States* Rubella cases Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Received AFR 42/47 4569 4569 278 515 586 328 343 372 212 331 388 647 459 11 218-1 AMR 26/35 218-1 EMR 2/21 914 43 1 87 76 111 121 16 156 112 49 22 25 5 47 39 218-1 EUR 3/53 73 568 19 116 59 6 87 69 85 58 54 47 38 54 46 46 218-1 SEAR 11/11 7676 2257 5419 583 11 1576 1242 88 357 325 512 341 361 253 218 218-1 WPR 14/27 2287 258 162 1867 154 21 342 37 295 194 195 128 115 81 11 165 218-1 Total 143/194 16149 869 2439 12841 115 1987 2712 252 1687 193 835 14 97 1193 915 578 Notes: Based on data received 218-1 - This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region

215-1 215-2 215-3 215-4 215-5 215-6 215-7 215-8 215-9 215-1 215-11 215-12 216-1 216-2 216-3 216-4 216-5 216-6 216-7 216-8 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 Rubella cases (Lab+Epi+Clinical) Rubella Case Distribution by Month and WHO Region (215-218) 55 5 45 4 35 3 25 2 15 1 5 WPR SEAR EUR EMR AMR AFR Notes: Based on data received 218-1 - Data Source: IVB Database - This is surveillance data, hence for the last month(s), the data may be incomplete.

1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 (IgM+ only) 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 (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 186 29 Ethiopia No 697 18 Nigeria No 455 12 DR Congo No 432 11 Others - 362 1 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 174 5 Mali No 95 2 6 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 52 1 4 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 218-1 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.

1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 (lab + epi-linked + clinical) 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 (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 324 32 Yemen 215 271 27 Pakistan No 217 21 Saudi Arabia 1991 45 4 Afghanistan No 43 4 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Others - 37 4 Iran (Islamic Republic of) 24 36 4 12 1 8 6 4 2 EMR Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (October 217-September 218) United Arab Emirates 1985 12 1 Egypt 1999 9 1 Iraq 1995 9 1 Tunisia 24 9 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 218-1 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.

(lab + epi-linked + clinical) (lab + epi-linked + clinical) 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 Notes: Based on data received 218-1 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. 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Rubella cases: EUR EUR Rubella Case Distribution (October 216-September 218) 1 8 6 4 2 label Top 1 countries (last 12 M) RCV in RI Cases % of Total Poland 1988 458 57 Ukraine 21 186 23 Germany 1991 58 7 Others - 26 3 Italy 1972 24 3 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Austria 1973 2 2 Turkey 26 11 1 Kyrgyzstan 21 1 1 EUR Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (October 217-September 218) Ireland 1971 5 1 Romania 22 5 1 2 Russian Federation 2 5 1 1 Age at onset (in years) Rubella vaccine not introduced before 1 January 217 Rubella vaccine introduced before 1 January 217

1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 (lab + epi-linked + clinical) 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 (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 1498 81 Bangladesh 212 273 15 Nepal 213 35 2 Thailand 1993 18 1 Myanmar 215 1 1 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Timor-Leste 216 8 Bhutan 26 2 Sri Lanka 1996 1 SEAR (excl. India) Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (October 217-September 218) 15 1 5 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 218-1 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 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, 217-9 to 218-8 18.7 2 15 Year Confirmed Cases 215 189 216 165 217 298 218 224 4 2 6 4.3 1.8 1.3.4.2 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset 1 5 doses 1 dose 2+ doses Unknown

1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 (lab + epi-linked + clinical) 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 (lab + epi-linked + clinical) Rubella cases: SEAR, India 1 SEAR, India Rubella Case Distribution (October 216-September 218) 8 6 4 2 label Top 1 countries (last 12 M) RCV in RI Cases % of Total India No 477 1 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) 5 4 3 2 1 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 218-1 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Rubella cases: Indonesia 6 4 2 SIA (9 M-15 Y) Cov: 1.5% Clinical Epi Lab National SIA Sub-national SIA 6 5 4 3 2 1 Indonesia age distribution, vaccination status, and incidence, 217-9 to 218-8 23 18.8 15.1 1.7 7.2 2.4.6 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset 25 2 15 1 5 Year Confirmed Cases 215 1379 216 117 217 4349 218 862 doses 1 dose 2+ doses Unknown

1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 (lab + epi-linked + clinical) 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 (lab + epi-linked + clinical) Rubella cases: WPR 8 WPR Rubella Case Distribution (October 216-September 218) 6 4 2 label Top 1 countries (last 12 M) RCV in RI Cases % of Total China 28 2592 89 Malaysia 1998 125 4 Philippines 21 84 3 Viet Nam 215 51 2 Japan 1989 19 1 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Singapore 199 15 1 Lao People's Democratic Republic 212 11 15 WPR (Excl. China) Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (October 217-September 218) Republic of Korea 1982 3 Cambodia 213 2 1 Mongolia 29 2 Others - 1 5 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 218-1 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.

216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Rubella cases: China 8 6 4 2 Clinical Epi Lab Age distribution not available from China Year Confirmed Cases 214 11887 215 8247 216 4477 217 161 218 2289

Incidence rate per 1,, 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 Rubella cases: Philippines 8 6 4 2 Clinical Epi Lab 4 2 Philippines age distribution, vaccination status, and incidence, 217-9 to 218-8 7 2.5 2.1.5.6.8.1 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset 8 6 4 2 Year Confirmed Cases 214 343 215 154 216 165 217 443 218 82 doses 1 dose 2+ doses Unknown

Distribution of rubella genotypes (last 12 months) Notes: Data Source: RubNS database (Genotypes) and IVB Database (Incidence) as of 218-1-17 and covering the period 217-9-1 to 218-8-31 - Pie charts proportional to the number of sequenced viruses

Laboratory

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 37/47 22876 22876 4839 (21) 569 (2) 17468 (76) 1666 2716 (16) 969 (6) 12921 (78) AMR 27/35 12645 11881 11 (9) 115 (1) 1253 (86) 1337 348 (3) 236 (2) 9324 (9) EMR 2/21 28772 24784 8612 (35) 142 (1) 163 (65) 21732 154 (5) 422 (2) 2256 (93) EUR 37/53 4336 393 1347 (34) 236 (1) 2598 (64) 2391 553 (2) 52 () 22465 (97) SEAR 11/11 1945 14693 53 (36) 378 (3) 95 (61) 9987 1521 (15) 292 (3) 8171 (82) WPR 27/27 2268 18218 3182 (17) 44 (2) 9926 (54) 14321 428 (3) 299 (2) 8237 (58) Total 159/194 149387 131455 3644 (28) 1844 (1) 8778 (67) 9674 662 (7) 227 (2) 81374 (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 4/47 35178 35178 4633 (13) 665 (2) 2988 (85) 2962 4962 (17) 126 (4) 2338 (79) AMR 27/35 913 8757 635 (7) 58 (1) 7452 (85) 7946 329 (4) 17 (1) 692 (87) EMR 2/21 36251 34782 1561 (3) 127 () 2494 (69) 32726 115 (3) 99 () 31522 (96) EUR 38/53 4245 37192 13748 (37) 272 (1) 22642 (61) 26322 434 (2) 66 () 25736 (98) SEAR 11/11 35379 32335 13177 (41) 781 (2) 262 (62) 2383 4831 (24) 741 (4) 1484 (73) WPR 27/27 16467 15211 21 (14) 333 (2) 11952 (79) 12656 66 (5) 418 (3) 1748 (85) Total 163/194 174828 163455 44854 (27) 2236 (1) 11682 (71) 129635 12267 (9) 2691 (2) 11311 (87) Notes: Based on data received 218-1 - * Member States Reporting / Total Member States in Region

Measles and Rubella IgM Data Summary Based on data received 218-1 - * 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 37/47 22876 22876 4839 (21) 569 (2) 17468 (76) 1666 2716 (16) 969 (6) 12921 (78) AMR 27/35 12645 11881 11 (9) 115 (1) 1253 (86) 1337 348 (3) 236 (2) 9324 (9) EMR 2/21 28772 24784 8612 (35) 142 (1) 163 (65) 21732 154 (5) 422 (2) 2256 (93) EUR 37/53 4336 393 1347 (34) 236 (1) 2598 (64) 2391 553 (2) 52 () 22465 (97) SEAR 11/11 1945 14693 53 (36) 378 (3) 95 (61) 9987 1521 (15) 292 (3) 8171 (82) WPR 27/27 2268 18218 3182 (17) 44 (2) 9926 (54) 14321 428 (3) 299 (2) 8237 (58) Total 159/194 149387 131455 3644 (28) 1844 (1) 8778 (67) 9674 662 (7) 227 (2) 81374 (85) Based on data received 217-1 - * 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 37/47 25697 25697 3231 (13) 587 (2) 21879 (85) 21765 3629 (17) 881 (4) 17255 (79) AMR 25/35 8458 8158 167 (2) 79 (1) 4941 (61) 7763 242 (3) 91 (1) 484 (62) EMR 2/21 24329 23781 799 (34) 111 () 1568 (66) 21554 135 (6) 75 () 2129 (93) EUR 37/53 28342 2483 1292 (41) 21 (1) 13951 (56) 1632 299 (2) 41 () 15921 (98) SEAR 11/11 25348 2231 869 (39) 425 (2) 11922 (54) 12858 378 (24) 443 (3) 9336 (73) WPR 27/27 11135 1379 1291 (12) 257 (2) 8816 (85) 8761 474 (5) 285 (3) 7996 (91) Total 157/194 12339 114849 3158 (27) 1669 (1) 77189 (67) 8921 972 (1) 1816 (2) 75441 (85)

Performance of Surveillance

Surveillance sensitivity reporting rate of measles and rubella (12 months, discarded cases* per 1, population) Notes: Based on data received 218-1 and covering the period between 217-9 and 218-8 - 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

Supplementary Immunization Activities

Next 6 months MMR, MR and Measles campaigns Region Name Activity Type Year StartDate EndDate Age Group(s) Extent Target EMR Djibouti FollowUp Measles 218 218-11-1-9-59 M National 11885 SEAR India CatchUp MR 218 218-11-1 218-12-31 9 M-15 Y Rollover-Nat 1194 SEAR Bhutan CatchUp MR 218 218-12-1-9 M-4 Y Sub-national 1e+5 SEAR India CatchUp MR 219 219-1-1-9 M-15 Y Rollover-Nat 493 SEAR Bangladesh FollowUp MR 219 219-2-1-9-59 M National 15656579

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 October 2018