Monthly Vaccine Preventable Disease and Immunization Update Published: January 03, 2018 Immunization and Vaccine Development (IVD) SEARO Protecting People from Vaccine Preventable Diseases
Last wild poliovirus case by type, SEAR WPV Type 2 District: Aligarh State: Uttar Pradesh (India) Date of onset: 24-Oct-1999 WPV Type 3 District: Pakur State: Jharkhand (India) Date of onset: 22-Oct-2010 WPV Type 1 District: Howrah State: West Bengal (India) Date of onset: 13-Jan-2011 Last wild poliovirus case by country Country Year Bangladesh 2006 Bhutan 1986 DPR Korea 1996 India 2011 Indonesia 2006 Maldives 1994 Myanmar 2007 Nepal 2010 Sri Lanka 1993 Thailand 1997 Timor-Leste 1995 *Dots are randomly placed within blocks (Sub-districts)
AFP Surveillance Indicators by First Administrative Level*, 2018 Non-polio AFP Rate % Adequate Stool Specimen Collection Non-Polio AFP Rate < 1 1 1.99 >2 No Non-Polio AFP Case *Bhutan, Maldives & Timor-Leste by country * Number of discarded AFP cases per 100,000 children under 15 years of age. ** Percentage with 2 specimens 24 hours apart and within 14 days of paralysis onset. Note: Some AFP cases may still be pending final classification. Total AFP Cases = 38372 Non-Polio AFP Rate =5.67 Adequate Stool specimen = 85% Countries reporting AFP cases= 10 (91%) Adequate Stool Specimen Collection < 60% 60% 79% > 80% No AFP Case 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 2015. All rights reserved
Non-polio AFP Cases by Month of Onset SEAR, 2014-2018 Month 2014 2015 2016 2017 2018 Jan 4451 4106 4166 3461 3122 Feb 3990 3718 3749 3064 2912 Mar 4185 3680 3610 3188 2917 Apr 4018 3497 3472 3069 2680 May 4500 3788 4064 3365 3062 Jun 5149 4124 4175 3385 3071 Jul 5518 4155 5304 4332 3318 Aug 6414 5124 6034 5129 3415 Sep 6122 5421 4943 4075 3857 Oct 5086 4994 4023 3598 3324 Nov 4952 4196 3655 3501 2558 Dec 4095 4091 3495 3175 319 Total 58480 50894 50690 43342 34555 4
Non-Polio AFP Rate 5.5 12.48 10.77 and above 6 ~~~~~~~~ Non-polio AFP Rate* SEAR, 2014 2018 10.60 8.92 7.03 7.40 ~~~~~~~~ 5 4.5 SEAR Minimum Target 4 3.5 3 2.5 2 1.5 1 0.5 0 BAN BHU DPRK IND INO MAV MMR NEP SRL THA TLS * Number of discarded AFP cases per 100,000 children under 15 years of age 2014 2015 2016 2017 2018 5
Percent 100 Percent Adequate Stool Specimen Collection* SEAR, 2014-2018 Minimum Target 80 60 40 20 0 BAN BHU DPRK IND INO MAV MMR NEP SRL THA TLS 2014 2015 2016 2017 2018 *Percentage with 2 specimens 24 hours apart and within 14 days of paralysis onset. 6
N=838 N=863 N=790 Percent of Non-Polio AFP Cases Under Immunized for OPV (6 Months to 5 Yrs), SEAR, 2014-2018 N=764 N=782 N=28997 N=24881 N=23612 N=220078 N=15525 N=898 N=748 N=751 N=882 N=615 N=158 N=126 N=173 N=133 N=105 N=236 N=199 N=209 N=184 N=134 N=80 N=70 N=100 N=68 N=46 7
AFP Surveillance Indicators by District India, 2018 Non-polio AFP Rate* Percent Adequate Stool Specimen Collection ** Non-Polio AFP Rate < 1 1 1.99 >2 No Non-Polio AFP Case Adequate Stool Specimen Collection < 60% 60% 79% > 80% No AFP Case * Number of discarded AFP cases per 100,000 children under 15 years of age ** Percentage with 2 specimens 24 hours apart and within 14 days of paralysis onset. Note: Some AFP cases may still be pending final classification. Total AFP Cases = 34504 Non-Polio AFP Rate =7.03 Adequate Stool specimen = 85% Districts reporting AFP cases= 677 (96%) 8
Non-polio AFP Cases by Month of Onset India, 2014-2018 Month 2014 2015 2016 2017 2018 Jan 4110 3774 3838 3140 2852 Feb 3657 3442 3440 2739 2625 Mar 3781 3329 3214 2860 2567 Apr 3621 3207 3124 2735 2324 May 4042 3430 3691 3040 2707 Jun 4683 3763 3787 3128 2806 Jul 5168 3888 4911 3941 2946 Aug 6035 4765 5635 4723 3082 Sep 5747 5082 4579 3723 3509 Oct 4711 4612 3675 3133 3023 Nov 4565 3866 3361 3041 2396 Dec 3790 3799 3229 2888 317 Total 53910 46957 46484 39091 31154 9
AFP Surveillance Indicators by District Nepal, 2018 Non-polio AFP Rate* Percent Adequate Stool Specimen Collection ** Non-Polio AFP Rate < 1 1 1.99 >2 No Non-Polio AFP Case Total AFP Cases = 318 Non-Polio AFP Rate =3.48 Adequate Stool specimen = 97% Districts reporting AFP cases= 66 (86%) Adequate Stool Specimen Collection < 60% 60% 79% > 80% No AFP Case * Number of discarded AFP cases per 100,000 children under 15 years of age ** Percentage with 2 specimens 24 hours apart and within 14 days of paralysis onset. Note: Some AFP cases may still be pending final classification. 10
Non-polio AFP Cases by Month of Onset Nepal, 2014-2018 Month 2014 2015 2016 2017 2018 Jan 50 32 31 35 28 Feb 48 32 23 27 23 Mar 40 46 38 34 32 Apr 31 25 42 32 31 May 41 20 44 33 26 Jun 42 38 58 24 29 Jul 47 38 57 38 38 Aug 38 39 38 43 34 Sep 40 36 48 21 29 Oct 37 29 37 26 21 Nov 38 24 19 21 11 Dec 34 35 20 37 Total 486 394 455 371 302 11
AFP Surveillance Indicators by Province Myanmar, 2018 Non-polio AFP Rate* Percent Adequate Stool Specimen Collection ** Adequate Stool Specimen Collection Non-Polio AFP Rate < 1 1 1.99 >2 No Non-Polio AFP Case < 60% 60% 79% > 80% No AFP Case * Number of discarded AFP cases per 100,000 children under 15 years of age ** Percentage with 2 specimens 24 hours apart and within 14 days of paralysis onset. Note: Some AFP cases may still be pending final classification. Total AFP Cases = 316 Non-Polio AFP Rate = 2.23 Adequate Stool specimen = 94% Provinces reporting AFP cases= 18 (100%) 12
Non-polio AFP Cases by Month of Onset Myanmar, 2014-2018 Month 2014 2015 2016 2017 2018 Jan 41 22 29 18 26 Feb 24 21 27 24 16 Mar 19 17 17 14 19 Apr 22 14 18 18 19 May 38 27 23 24 33 Jun 38 19 50 28 13 Jul 39 26 79 52 31 Aug 47 33 56 64 40 Sep 42 35 51 39 53 Oct 29 42 54 37 33 Nov 24 25 33 44 17 Dec 26 52 29 34 Total 389 333 466 396 300 13
AFP Surveillance Indicators by District Bangladesh, 2018 Non-polio AFP Rate* Percent Adequate Stool Specimen Collection ** Non-Polio AFP Rate < 1 1 1.99 >2 No Non-Polio AFP Case Adequate Stool Specimen Collection < 60% 60% 79% > 80% No AFP Case * Number of discarded AFP cases per 100,000 children under 15 years of age ** Percentage with 2 specimens 24 hours apart and within 14 days of paralysis onset. Note: Some AFP cases may still be pending final classification. Total AFP Cases = 1371 Non-Polio AFP Rate =2.60 Adequate Stool specimen = 99% Districts reporting AFP cases= 64 (100%) 14
Non-polio AFP Cases by Month of Onset Bangladesh, 2014-2018 Month 2014 2015 2016 2017 2018 Jan 73 87 126 112 78 Feb 69 100 118 119 100 Mar 115 127 139 135 119 Apr 130 121 136 147 154 May 169 171 143 126 151 Jun 198 134 121 96 133 Jul 154 110 146 153 165 Aug 168 139 122 109 121 Sep 117 101 122 110 114 Oct 102 137 100 128 95 Nov 104 115 99 80 56 Dec 79 71 65 46 Total 1478 1413 1437 1361 1286 15
Non-polio AFP Rate* AFP Surveillance Indicators by Province Indonesia, 2018 Non-Polio AFP Rate < 1 1 1.99 >2 No Non-Polio AFP Case Percent Adequate Stool Specimen Collection ** Total AFP Cases = 1479 Non-Polio AFP Rate = 1.75 Adequate Stool specimen = 82% Provinces reporting AFP cases= 32 (94%) Adequate Stool Specimen Collection < 60% 60% 79% > 80% No AFP Case * Number of discarded AFP cases per 100,000 children under 15 years of age ** Percentage with 2 specimens 24 hours apart and within 14 days of paralysis onset. Note: Some AFP cases may still be pending final classification. 16
Non-polio AFP Cases by Month of Onset Indonesia, 2014-2018 Month 2014 2015 2016 2017 2018 Jan 135 153 101 105 112 Feb 149 110 101 113 123 Mar 198 123 163 113 147 Apr 184 107 135 110 133 May 172 110 130 117 127 Jun 155 129 109 77 60 Jul 66 53 75 118 106 Aug 87 115 134 144 108 Sep 158 133 102 155 120 Oct 165 150 117 240 127 Nov 170 136 113 294 68 Dec 125 109 129 152 Total 1764 1428 1409 1738 1231 17
AFP Surveillance Indicators by Province Thailand, 2018 Annualized Non-polio AFP Rate* Percent Adequate Stool Specimen Collection ** Non-Polio AFP Rate < 1 1 1.99 >2 No Non-Polio AFP Case Adequate Stool Specimen Collection Total AFP Cases = 196 Non-Polio AFP Rate = 1.24 Adequate Stool specimen = 69% Provinces reporting AFP cases= 60 (78%) < 60% 60% 79% > 80% No AFP Case * Number of discarded AFP cases per 100,000 children under 15 years of age ** Percentage with 2 specimens 24 hours apart and within 14 days of paralysis onset. Note: Some AFP cases may still be pending final classification. 18
Non-polio AFP Cases by Month of Onset Thailand, 2014-2018 Month 2014 2015 2016 2017 2018 Jan 24 15 25 30 11 Feb 25 5 25 19 8 Mar 12 12 21 16 16 Apr 16 16 5 6 6 May 17 17 16 11 9 Jun 18 18 24 15 11 Jul 27 18 16 21 12 Aug 18 14 24 27 20 Sep 11 19 30 15 27 Oct 19 11 24 7 18 Nov 25 21 20 13 5 Dec 26 17 16 9 Total 238 183 246 189 143 19
# Cases # Deaths # Tested for serology # Measles +ve # Rubella +ve # Outbreaks # Outbreaks Investigated # Cases # Deaths # Outbreaks # Cases # Outbreaks # Cases # Outbreaks # Cases Neonatal Tetanus Diphtheria Pertussis Encephalitis Number of Cases of AEFI 2 Date of last report # reports expected % Completeness % Timeliness VPD Reporting, 2018 Routine Reporting of clinically suspected measles cases Suspected measles outbreaks Laboratory Confirmed 1 Number of Cases Country Measles Outbreaks Rubella Outbreaks Mixed Outbreaks Bangladesh 4138 1 4103 1301 209 104 104 1207 0 32 475 6 61 7 57 63 0 2 1182 1728 15-Nov-18 10 100 90 Bhutan 332 0 332 15 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 19-Nov-18 10 100 90 DPR Korea NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR 10 0 0 India 48909 158 NR NR NR 2093 1238 20340 114 516 9163 61 1018 7 89 NR NR NR NR NR 24-Nov-18 10 90 30 Indonesia 3869 0 1938 154 237 72 72 810 0 23 289 30 285 7 73 6 1359 2 NR NR 18-Oct-18 10 80 10 Maldives 27 0 27 1 2 1 25 25 0 1 1 0 0 0 0 0 0 0 0 0 09-Nov-18 10 80 80 Myanmar 555 0 546 187 10 24 24 405 1 19 331 0 0 0 0 20 152 28 0 0 19-Nov-18 10 100 0 Nepal 1164 0 980 99 30 9 9 132 2 6 90 0 0 0 0 2 NR NR 944 11 15-Nov-18 10 100 80 Sri Lanka 136 0 104 7 2 0 0 0 0 0 0 0 0 0 0 0 0 44 171 8891 13-Nov-18 10 100 90 Thailand 2395 3 2003 961 24 49 49 542 3 46 424 1 12 0 0 0 11 101 631 343 22-Oct-18 10 90 50 Timor-Leste 144 0 141 0 6 0 0 0 0 0 0 0 0 0 0 1 7 0 0 4 21-Nov-18 10 80 20 Total 61669 162 10174 2725 528 2352 1521 23461 120 643 10773 98 1376 21 219 92 1529 177 2928 10982 1 At least 5 blood samples should be collected and tested from each outbreak. 2 Adverse Events Follow ing Immunization; Sri Lanka AEFI data do not reflect cases but events. 3 Monthly VPD and AEFI reports due to SEARO/IVD on or before 15th of each month. NR=No report Source: SEAR Monthly VPD reports Data as of 30 November 2018
Measles and Rubella Serology (IgM), 2018 # % # % Bangladesh Dhaka 5190 5190 1547 29.8 271 7.4 91.9 Bhutan Thimphu 405 405 18 4.4 11 2.8 91.1 DPR Korea Pyongyang 431 431 0 0.0 0 0.0 0.0 India Indonesia Indonesia Total Ahmedabad 324 294 161 54.8 32 24.1 60.9 Bengaluru 670 569 129 22.7 18 4.1 59.4 Bhopal 191 160 116 72.5 4 9.1 86.3 Chandigarh 346 346 201 58.1 11 7.6 45.4 Chennai 1244 288 49 17.0 88 36.8 70.8 Delhi 364 364 237 65.1 14 11.0 34.3 Guw ahati 171 160 108 67.5 5 9.6 15.6 Hyderabad 80 80 32 40.0 7 14.6 100.0 Jaipur 338 246 152 61.8 7 7.4 58.9 Kolkata 2404 2037 887 43.5 381 33.1 47.9 Lucknow 3464 2230 1323 59.3 80 8.8 33.2 Manipal 13 9 1 11.1 0 0.0 88.9 Mumbai 956 718 442 61.6 52 18.8 39.0 Patna 1062 1062 368 34.7 45 6.5 4.8 11627 8563 4206 49.1 744 17.1 40.2 Bandung 263 251 2 0.8 24 9.6 88.4 Jakarta 2231 1384 221 16.0 613 52.7 141.0 Palembang 420 237 10 4.2 209 92.1 163.7 Surabaya 1460 1277 401 31.4 359 41.0 0.0 Yogyakarta 1189 28 1149 4103.6 994-88.7 4246.4 5563 3177 1783 56.1 2199 157.7 118.0 Maldives Male 29 29 2 6.9 1 3.7 72.4 Myanmar Yangon 1056 1048 535 51.0 18 3.5 95.9 Nepal Kathmandu 1318 1293 167 12.9 35 3.1 54.5 Sri Lanka Colombo 129 129 7 5.4 4 3.3 85.3 Thailand Thailand Total Bangkok 1563 1563 854 54.6 13 1.8 100.0 Chiang Mai 211 211 132 62.6 1 1.3 100.0 Chiang Rai 64 64 3 4.7 0 0.0 100.0 Chon Buri 211 211 95 45.0 1 0.9 100.0 Khon Kaen 65 65 23 35.4 0 0.0 100.0 Nakhon Saw an 10 10 2 20.0 0 0.0 80.0 Nakhonratchasima 63 63 23 36.5 0 0.0 100.0 Phitsanulok 77 77 30 39.0 3 6.4 100.0 Samut Songkhram 165 165 81 49.1 1 1.2 100.0 Songkhla 2251 2251 1437 63.8 15 1.8 100.0 Surat Thani 12 12 3 25.0 0 0.0 100.0 Trang 54 54 9 16.7 0 0.0 100.0 Ubon Ratchathani 132 132 53 40.2 3 3.8 100.0 Udon Thani 178 178 64 36.0 4 3.5 100.0 5056 5056 2809 55.6 41 1.8 100.0 Timor-Leste Dili 158 105 0 0.0 6 5.7 100.0 TOTAL Country India Total Laboratories Source: Reported by SEAR Measles Laboratory Netw ork Number of Serum Samples Received Number Tested 30962 25426 11074 43.6 3330 23.2 76.0 NR=No Report Measles +ve Results Rubella +ve % Measles Results Reported within 4 Days Source: SEAR Monthly lab reports Data as of 30 November 2018