Global Measles and Rubella Update November PDF Free Download

Global Measles and Rubella Update November 218

Measles

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 42/47 44749 25494 12955 6897 5642 2998 4295 558 3533 2547 1543 1564 1121 1399 1436 218-11 AMR 32/35 24627 1342 1342 3 16 84 152 291 216 41 138 779 8253 218-11 EMR 2/21 35676 19384 3975 6812 8597 2234 1744 266 271 3129 2245 243 1157 996 16 218-11 EUR 53/53 63873 54354 3579 28 21767 5647 6589 7376 7658 873 737 537 3611 2411 15 218-11 SEAR 11/11 8556 61273 49884 8828 2561 7787 76 1274 1789 179 4786 2849 2983 299 227 218-11 WPR 26/27 52221 18545 1757 483 735 1921 2478 3386 3232 2941 298 1348 55 54 51 218-11 Total 184/194 3172 189392 1815 2528 56214 259 22722 3638 2874 2769 17925 13881 956 8224 188 217 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 51565 24838 117 8845 4986 3216 2896 3648 237 226 1859 1475 1412 1519 1695 1315 147 218-11 AMR 31/35 1886 895 895 1 8 19 13 5 1 1 847 218-11 EMR 2/21 36139 12777 1918 693 1166 113 18 1296 128 146 157 161 812 76 941 95 131 218-11 EUR 53/53 31134 24592 4427 659 1416 1422 1873 34 2885 2921 2572 138 868 965 1327 2352 323 218-11 SEAR 11/11 99722 79368 56164 17492 5712 8572 9758 13139 1343 7564 4627 3888 4412 3846 3167 511 541 218-11 WPR 26/27 5313 1296 2692 17 7497 778 894 151 1222 112 8 772 7 725 77 617 397 218-11 Total 184/194 282576 152766 7628 33196 43362 1592 1659 2267 18113 1596 1915 8576 825 7762 79 1245 11746 Notes: Based on data received 218-11 - 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 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 44749 25494 12955 6897 5642 2998 4295 558 3533 2547 1543 1564 1121 1399 1436 218-11 AMR 32/35 24627 1342 1342 3 16 84 152 291 216 41 138 779 8253 218-11 EMR 2/21 35676 19384 3975 6812 8597 2234 1744 266 271 3129 2245 243 1157 996 16 218-11 EUR 53/53 63873 54354 3579 28 21767 5647 6589 7376 7658 873 737 537 3611 2411 15 218-11 SEAR 11/11 8556 61273 49884 8828 2561 7787 76 1274 1789 179 4786 2849 2983 299 227 218-11 WPR 26/27 52221 18545 1757 483 735 1921 2478 3386 3232 2941 298 1348 55 54 51 218-11 Total 184/194 3172 189392 1815 2528 56214 259 22722 3638 2874 2769 17925 13881 956 8224 188 217 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 38479 17856 8587 5248 421 337 2674 3228 1893 174 1383 929 121 1173 814 217-11 AMR 3/35 8658 224 224 1 8 19 13 5 1 3 29 24 121 217-11 EMR 2/21 26933 8585 21 665 771 193 918 969 1584 1676 899 73 46 234 22 217-11 EUR 52/53 17256 13713 2499 3485 7729 192 185 2919 178 1869 1492 1281 87 691 4 217-11 SEAR 11/11 7198 5594 42574 82 5166 7344 8621 12151 9474 6884 3849 283 3165 156 143 217-11 WPR 26/27 37444 8657 2533 74 65 639 823 1461 1295 1174 846 784 83 832 217-11 Total 182/194 199868 14975 5643 17672 39 1326 14894 2747 15967 13312 847 653 6285 446 114 Notes: Based on data received 218-11 and 217-11 - This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region

214-1 214-2 214-3 214-4 214-5 214-6 214-7 214-8 214-9 214-1 214-11 214-12 215-1 215-2 215-3 215-4 215-5 215-6 215-7 215-8 215-9 215-1 215-11 215-12 216-1 216-2 216-3 216-4 216-5 216-6 216-7 216-8 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases (Lab+Epi+Clinical) Measles case distribution by month and WHO Region (214-218) The clustering of cases in AMR at specific time points is an artifact of reporting 4 35 3 WPR SEAR EUR EMR AMR AFR 25 2 15 1 5 Notes: Based on data received 218-11 - Data Source: IVB Database - This is surveillance data, hence for the last month(s), the data may be incomplete.

Measles Incidence Rate per Million (12M period) Top 1** Country Rate India 66794 5.44 Ukraine 34218 77.1 Philippines 12243 118.5 Yemen 9499 344.36 Nigeria 7299 39.24 Serbia 5725 649.9 China 42 2.99 Pakistan 3721 19.26 DR Congo 3672 46.64 Indonesia 3476 13.31 Other countries with high incidence rates*** Country Rate Albania 1396 477.5 Liberia 192 412.24 Georgia 1471 374.74 Montenegro 23 322.93 Greece 332 271.11 Lebanon 97 151. Measles cases from countries with known discrepancies between case-based and aggregate surveillance, as reported by country Country Year Data Source DR Congo 217 45165 SITUATION EPIDEMIOLOGIQUE DE LA 218 39496 ROUGEOLE EN RDC, Week of 6/11/218 Somalia 217 23394 Somali EPI/POL Weekly Update Week 43 218 897 Notes: Based on data received 218-11 and covering the period between 217-1 and 218-9 - 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)

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.

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 218-11 - 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

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 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 3 25 2 15 1 5 Chad age distribution, vaccination status, and incidence, 217-1 to 218-9 132.1 111.8 69.1 54.7 39.8 31.8 1.4 <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 26 15 27 65 28 7 29 632 21 219 211 156 212 153 213 217 214 1251 215 418 216 168 217 26 218 814

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 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, 217-1 to 218-9 25 188.8 2 2 151.7 15 15 1 1 69 5 5 13.4 4.6 2.4.4 <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 26 112 27 539 28 214 29 83 21 28 211 1651 212 2332 213 2527 214 1649 215 529 216 4932 217 3621 218 3445

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 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 4 3 2 1 Ethiopia age distribution, vaccination status, and incidence, 217-1 to 218-9 23.1 24.5 17 17.9 11.9 6.1.5 <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 2 1 Year Confirmed 26 1278 27 1472 28 3161 29 2642 21 625 211 3552 212 4616 213 6137 214 14282 215 17778 216 4568 217 1912 218 967

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Kenya 15 1 5 Discarded Clinical Epi Lab 1 8 6 4 2 Kenya age distribution, vaccination status, and incidence, 217-1 to 218-9 17.4 14.1 6.6 3 3.8 1.8.6 <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 2 1 Year Confirmed 26 235 27 486 28 34 29 65 21 15 211 2462 212 238 213 243 214 39 215 112 216 124 217 63 218 374

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Madagascar 1 8 6 4 2 Discarded Clinical Epi Lab 6 5 4 3 2 1 Madagascar age distribution, vaccination status, and incidence, 217-1 to 218-9 18.7 16.5 14.5 12.3 3.4 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 2 1 Year Confirmed 26 2 27 28 12 29 2 21 1 211 1 212 3 213 7 214 1 215 6 216 17 217 84 218 974

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 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, 217-1 to 218-9 149.7 123.7 65.7 24 7.9 5.2 2.3 <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 15 1 5 Year Confirmed 26 119 27 3129 28 1453 29 1498 21 972 211 1962 212 6423 213 55392 214 685 215 12391 216 17581 217 11188 218 644

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Uganda 6 5 4 3 2 1 Discarded Clinical Epi Lab 15 1 5 Uganda age distribution, vaccination status, and incidence, 217-1 to 218-9 224.4 22.5 16.5 51.8 17.9 4.5 1.9 <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 25 2 15 1 5 Year Confirmed 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 2311

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 (AMR), 214-218 9 85 8 75 7 65 6 55 5 45 4 35 3 25 2 15 1 5 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 218-11 - Data Source: IVB Database

216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Brazil 4 2 Discarded Clinical Epi Lab Year Confirmed 28 29 21 68 212 2 213 192 214 78 215 214 216 217 218 4299

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 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, 217-1 to 218-9 15 1541.4 15 1 1 5 546 5 15.5 16.6 29.9 11.8 5.5 <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 Year Confirmed 28 29 21 211 212 1 213 214 215 216 217 727 218 5525

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Libya 4 3 2 1 Discarded Clinical Epi Lab 25 2 15 1 5 Libya age distribution, vaccination status, and incidence, 217-1 to 218-9 1455.6 39.4 115.5 76.6 32 33.6 14.5 <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 26 38 27 59 28 8 29 329 21 54 211 126 212 325 213 164 214 176 215 87 216 28 217 3 218 622

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Sudan 1 8 6 4 2 Discarded Clinical Epi Lab 15 1 5 Sudan age distribution, vaccination status, and incidence, 217-1 to 218-9 454.4 27.6 71.2 32.8 38.4 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 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,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Pakistan 15 1 5 Discarded Clinical Epi Lab 25 2 15 1 5 Pakistan age distribution, vaccination status, and incidence, 217-1 to 218-9 157.6 15.9 27.5 5.2.8.4 <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 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,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Yemen 15 1 5 Discarded Clinical Epi Lab 4 2 Yemen age distribution, vaccination status, and incidence, 217-1 to 218-9 1916.4 1525.7 611.7 143.4 36.1 45.9 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 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 8742

Incidence rate per 1,, 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Israel 2 1 Discarded Clinical Epi Lab 15 1 5 Israel age distribution, vaccination status, and incidence, 217-1 to 218-9 378.8 226.9 166.1 65.5 32.6 29.9 18.9 <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 4 3 2 1 Year Confirmed 26 8 27 539 28 891 29 5 21 19 211 46 212 149 213 57 214 3 215 8 216 1 217 16 218 526

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Ukraine 6 4 2 Discarded Clinical Epi Lab 8 6 4 2 Ukraine age distribution, vaccination status, and incidence, 217-1 to 218-9 3981.3 295.6 2768.5 2239.1 773.3 543.4 272.9 <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 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 31312

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Indonesia 6 Sub-national (9 M-15 Y) Cov: 1.5% 4 2 Discarded Clinical Epi Lab National SIA Sub-national SIA 3 2 1 Indonesia age distribution, vaccination status, and incidence, 217-1 to 218-9 17.9 15.1 13.8 9 4.5.9.2 <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 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 2374

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: India 3 Rollover-Nat (9 M-15 Y) 2 1 Discarded Clinical Epi Lab National SIA Sub-national SIA 12 1 8 6 4 2 India age distribution, vaccination status, and incidence, 217-1 to 218-9 98.3 91.5 77.5 21.5 4.5 1.4.2 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset 1 8 6 4 2 Year Confirmed 214 836 215 8326 216 7798 217 6468 218 55399 doses 1 dose 2+ doses Unknown

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Measles cases: Thailand 4 3 2 1 Discarded Clinical Epi Lab 3 2 1 Thailand age distribution, vaccination status, and incidence, 217-1 to 218-9 29.2 77.6 27.5 14.8 25.9 2.7.8 <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 26 3962 27 3517 28 6339 29 5272 21 2273 211 2873 212 472 213 256 214 834 215 19 216 19 217 232 218 96

Distribution of measles genotypes (last 12 months) Notes: Data Source: MeaNS database (Genotypes) and IVB Database (Incidence) as of 218-11-8 and covering the period 217-1-1 to 218-9-3 - Pie charts proportional to the number of sequenced viruses

Rubella

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 42/47 2774 2774 337 362 562 357 352 253 236 196 11 18 218-11 AMR 26/35 2 2 1 1 218-11 EMR 2/21 928 111 48 769 14 116 16 128 131 92 111 75 1 1 218-11 EUR 36/53 74 62 6 78 82 96 75 96 92 78 63 76 46 218-11 SEAR 11/11 2245 557 1688 297 411 543 332 342 147 49 74 34 16 218-11 WPR 15/27 2846 159 47 264 113 14 29 57 75 337 252 226 266 1 218-11 Total 15/194 9499 89 658 7951 933 19 163 1421 1667 97 711 647 457 36 217 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 11 218-11 AMR 26/35 218-11 EMR 2/21 914 43 1 87 76 111 121 16 156 112 49 22 25 5 47 39 218-11 EUR 3/53 73 57 17 116 59 6 87 69 85 58 54 47 38 54 46 46 218-11 SEAR 11/11 757 28 549 614 192 1519 1132 81 361 329 511 345 367 256 234 218-11 WPR 14/27 2287 258 162 1867 154 21 342 37 295 194 195 128 115 81 11 165 218-11 Total 143/194 1643 871 226 12912 1181 1979 2655 1942 1689 197 839 139 911 1199 918 594 Notes: Based on data received 218-11 - This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region

215-1 215-2 215-3 215-4 215-5 215-6 215-7 215-8 215-9 215-1 215-11 215-12 216-1 216-2 216-3 216-4 216-5 216-6 216-7 216-8 216-9 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 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 218-11 - 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) 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 (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 692 21 South Africa No 616 18 Nigeria No 454 14 Others - 386 12 DR Congo No 379 11 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 171 5 Mali No 95 3 6 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 59 2 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 218-11 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) 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 (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 317 31 Yemen 215 39 3 Pakistan No 199 2 Afghanistan No 42 4 Saudi Arabia 1991 35 3 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Iran (Islamic Republic of) 24 34 3 Others - 31 3 EMR Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (November 217-October 218) Tunisia 24 2 2 United Arab Emirates 1985 1 1 1 5 Iraq 1995 9 1 Libya 1995 8 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 218-11 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 46 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 Notes: Based on data received 218-11 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. 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Rubella cases: EUR EUR Rubella Case Distribution (November 216-October 218) 1 8 6 4 2 label Top 1 countries (last 12 M) RCV in RI % of Total Poland 1988 438 55 Ukraine 21 21 25 Germany 1991 54 7 Others - 24 3 Italy 1972 23 3 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Austria 1973 18 2 Turkey 26 12 2 Kyrgyzstan 21 1 1 2 EUR Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (November 217-October 218) Romania 22 6 1 Ireland 1971 5 1 Portugal 1984 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) 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 (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 1171 77 Bangladesh 212 291 19 Nepal 213 34 2 Thailand 1993 11 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 5 Bhutan 26 2 15 1 5 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 218-11 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Rubella cases: Bangladesh 6 SIA (9 M-<5 Y) Cov: 11% 4 2 Clinical Epi Lab National SIA Sub-national SIA 1 8 6 4 2 Bangladesh age distribution, vaccination status, and incidence, 217-1 to 218-9 19.4 6.5 4.3 2 1.4.4.2 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset 2 15 1 5 Year Confirmed 215 189 216 165 217 299 218 264 doses 1 dose 2+ doses Unknown

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Rubella cases: India 1 8 6 4 2 SIA (9 M-15 Y) Clinical Epi Lab National SIA Sub-national SIA 5 4 3 2 1 India age distribution, vaccination status, and incidence, 217-1 to 218-9 3.4 2.9 2.7 2.2.4.2 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset 4 3 2 1 Year Confirmed 215 3265 216 984 217 2854 218 166 doses 1 dose 2+ doses Unknown

Incidence rate per 1,, 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Rubella cases: Indonesia 6 4 2 SIA (9 M-15 Y) Cov: 1.5% Clinical Epi Lab National SIA Sub-national SIA 5 4 3 2 1 Indonesia age distribution, vaccination status, and incidence, 217-1 to 218-9 19.6 15.5 13 9 5.9 2.4 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset 2 15 1 5 Year Confirmed 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) 216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 (lab + epi-linked + clinical) Rubella cases: WPR 8 WPR Rubella Case Distribution (November 216-October 218) 6 4 2 label Top 1 countries (last 12 M) RCV in RI % of Total China 28 28 9 Malaysia 1998 133 4 Philippines 21 82 3 Viet Nam 215 42 1 Japan 1989 3 1 Not introduced in EPI Introduced <5 years ago (after 212) Introduced >=5 years ago (212 and before) Singapore 199 13 Lao People's Democratic Republic 212 12 WPR (Excl. China) Age distribution of Rubella cases by vaccine introduction status in the National EPI Programme (November 217-October 218) Cambodia 213 3 Republic of Korea 1982 3 1 5 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 218-11 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 216.

216-1 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Rubella cases: China 8 6 4 2 Clinical Epi Lab Year Confirmed 214 11887 215 8247 216 4477 217 161 218 2562

Incidence rate per 1,, 216-11 216-12 217-1 217-2 217-3 217-4 217-5 217-6 217-7 217-8 217-9 217-1 217-11 217-12 218-1 218-2 218-3 218-4 218-5 218-6 218-7 218-8 218-9 218-1 218-11 Rubella cases: Japan 15 Japan is having a rubella outbreak but most cases are not reported to WHO 1 5 Clinical Epi Lab 25 2 15 1 5 Japan age distribution, vaccination status, and incidence, 217-1 to 218-9.9.2.1 <1 year 1-4 years 5-9 years 1-14 years 15-24 years 25-39 years 4+ years Age at onset 1.5 Year Confirmed 214 215 2 216 3 217 5 218 3 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 218-11-8 and covering the period 217-1-1 to 218-9-3 - 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 38/47 27213 27213 5376 (2) 648 (2) 21189 (78) 257 3189 (16) 1142 (6) 16176 (79) AMR 29/35 9356 812 972 (12) 65 (1) 667 (82) 6445 277 (4) 159 (2) 563 (87) EMR 2/21 3147 26469 9312 (35) 153 (1) 174 (64) 23418 1198 (5) 385 (2) 21835 (93) EUR 37/53 45831 417 1412 (34) 241 (1) 27171 (65) 255 584 (2) 57 () 24838 (97) SEAR 11/11 22191 17899 6541 (37) 453 (3) 1895 (61) 12139 185 (15) 361 (3) 9969 (82) WPR 27/27 2689 2574 3643 (18) 441 (2) 1962 (53) 16244 487 (3) 319 (2) 9161 (56) Total 162/194 162447 141975 39856 (28) 21 (1) 93891 (66) 14253 754 (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 4/47 35163 35163 4629 (13) 664 (2) 2987 (85) 29591 4962 (17) 126 (4) 23369 (79) AMR 27/35 7796 7449 618 (8) 46 (1) 6179 (83) 6661 38 (5) 85 (1) 5683 (85) 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 17356 162132 44833 (28) 2223 (1) 114799 (71) 128339 12246 (1) 2669 (2) 111862 (87) Notes: Based on data received 218-11 - * Member States Reporting / Total Member States in Region

Measles and Rubella IgM Data Summary Notes: Based on data received 218-11 - * 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 38/47 27213 27213 5376 (2) 648 (2) 21189 (78) 257 3189 (16) 1142 (6) 16176 (79) AMR 29/35 9356 812 972 (12) 65 (1) 667 (82) 6445 277 (4) 159 (2) 563 (87) EMR 2/21 3147 26469 9312 (35) 153 (1) 174 (64) 23418 1198 (5) 385 (2) 21835 (93) EUR 37/53 45831 417 1412 (34) 241 (1) 27171 (65) 255 584 (2) 57 () 24838 (97) SEAR 11/11 22191 17899 6541 (37) 453 (3) 1895 (61) 12139 185 (15) 361 (3) 9969 (82) WPR 27/27 2689 2574 3643 (18) 441 (2) 1962 (53) 16244 487 (3) 319 (2) 9161 (56) Total 162/194 162447 141975 39856 (28) 21 (1) 93891 (66) 14253 754 (7) 2423 (2) 8769 (84) Notes: Based on data received 217-11 - * 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 2669 2669 3342 (13) 531 (2) 22736 (85) 22436 3562 (16) 912 (4) 17962 (8) AMR 25/35 9646 9331 174 (2) 91 (1) 5692 (61) 8856 262 (3) 16 (1) 5523 (62) EMR 2/21 2728 26227 7997 (3) 124 () 1816 (69) 24386 876 (4) 135 (1) 23375 (96) EUR 37/53 3945 27219 11143 (41) 222 (1) 15492 (57) 18454 35 (2) 42 () 1842 (98) SEAR 11/11 29452 2612 197 (42) 553 (2) 14467 (56) 15971 3719 (23) 54 (3) 11743 (74) WPR 27/27 12556 11686 1599 (14) 284 (2) 9792 (84) 979 519 (5) 319 (3) 8875 (91) Total 157/194 136236 12784 35225 (28) 185 (1) 86285 (68) 99893 9243 (9) 218 (2) 8552 (86)

Performance of Surveillance

Surveillance sensitivity reporting rate of measles and rubella (12 months, discarded cases* per 1, population) Notes: Based on data received 218-11 and covering the period between 217-1 and 218-9 - 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

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 November 2018