Measles and rubella elimination country profile: Slovenia

Measles elimination status 2015 eliminated 2016 eliminated Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/6thRVC Rubella elimination status 2015 eliminated 2016 eliminated Total population 2 069 362 < 1 year old 21 465 < 5 years old 110 252 Demographic information, 2016 Source: World Population Prospects: The 2015 Revision, New York, United Nations National plan of action Does the country have a national plan of action? ND Is it updated? ND Source: Measles and rubella elimination Annual Status Update report, 2016 ND= Data not available Measles and rubella elimination country profile Slovenia Measles and rubella immunization schedule, 2016 Source: Immunization schedule, WHO, Data and Statistics, Immunization Monitoring and Surveillance (http://www.who.int/immunization/monitoring_surveillance/data/en/) MMR = measles-mumps-rubella-containing vaccine; MCV1 = first dose measles-containing vacccine; MCV2 = second dose measles-containing vaccine; RCV = rubella-containing vaccine Measles and rubella cases and immunization coverage, 2007–2016 Source: Disease incidence and immunization coverage, WHO, Data and Statistics, Immunization Monitoring and Surveilance (http://www.who.int/immunization/monitoring_surveillance/data/en/) MCV1 = first dose of measles-containing vaccine MCV2= second dose of measles-containing vaccine Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/6thRVC Definition used for an outbreak Source: Measles and rubella elimination Annual Status Update report, 2016 Two or more epidemiologically linked confirmed cases 0 10 20 30 40 50 60 70 80 90 100 0 10 20 30 40 50 60 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Measles Rubella Coverage MCV1 Coverage MVC2 Confirmed measles cases by month of onset, 2012-2016 Source: CISID2 2016 0 5 10 15 20 25 30 J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D 2012 2013 2014 2015 2016 Vaccine Schedule MCV1 MMR 12 months MCV2 MMR 5 years Year of introduction MCV2 1974 RCV 1972 Measles vaccination in school No Measles and rubella elimination country profile Slovenia ©WHO 2018 Measles cases by first subnational level, 2016 1dot=1case Source:  Measles and rubella elimination Annual Status Update report, 2016 Measles genotypes by first subnational level, 2016 Source: MeaNS 2016 Note: The dots in the maps are placed randomly within the administrative regions Map disclaimer: The boundaries and names shown and the designations used on the maps 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 and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. •B3 •D8 •H1 •D4 Information on CRS, 2016 No cases reported Source: Measles and rubella elimination Annual Status Update report, 2016 CRS = congenital rubella syndrome Measles cases by age group and vaccination status, 2016 Source:  Measles and rubella elimination Annual Status Update report, 2016 Sources of infection, 2016 Measles Rubella Imported 1 0 Import-related 0 0 Unknown/ Not reported 0 0 Endemic 0 0 Source:  Measles and rubella elimination Annual Status Update report, 2016 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < 1 year 1-4 years 5-9 years 10-14 years 15-19 years 20-29 years 30 + 0 doses 1 dose 2 or more doses Unknown Suspected measles cases Confirmed measles cases Discarded as non- measles Measles incidence Genotypes detectedLabora- tory Epi- linked Clincally Total 2012 9 2 0 0 02 7 0 D4 2013 13 1 0 0 1 12 0 D8 2014 113 51 1 0 52 61 21.8 D8 2015 86 17 1 0 18 68 4.4 D8 2016 15 1 0 0 1 14 0 B3 Measles incidence, epidemiologic and virologic characteristics, 2012-2016 Measles surveillance and laboratory performance indicators, 2012-2016 Source: Measles and rubella elimination Annual Status Update report, 2012-2016, and internal communication from country Incidence calculated per 1 million population ND = Data not available; NA= Not applicable Source: ASU 2012-2016, MeaNS 2012-2016 and laboratory accreditation results 2012-2016, and internal communication from country ND = Data not available; NA= Not applicable A proficient laboratory is WHO accredited and/or has an established quality assurance programme with oversight by a WHO accredited laboratory Rubella incidence, epidemiologic and virologic characteristics, 2012-2016 Rubella surveillance and laboratory performance indicators, 2012-2016 Source: Measles and rubella elimination Annual Status Update report, 2012-2016 Incidence calculated per 1 million population ND = Data not available; NA= Not applicable Source: ASU 2012-2016, RubeNS 2012-2016 and laboratory accreditation results 2012-2016, and internal communication from country ND = Data not available; NA= Not applicable A proficient laboratory is WHO accredited and/or has an established quality assurance programme with oversight by a WHO accredited laboratory Surveillance performance indicators and targets a. Rate of discarded cases: at least 2 discarded measles or rubella cases per 100 000 population b. % cases with adequate laboratory investigation: ≥ 80% c. % origin of infection known: ≥ 80% d. Rate of viral detection: ≥ 80%  Measles and rubella elimination country profile Slovenia Discarded non- measles rate % 1st sub- national unit with ≥ 2 discarded cases % cases with adequate laboratory investiga- tion % origin of infection known # specimen tested for measles % positive for measles Rate of viral detection % WHO and proficient labs 2012 2 ND 100% 100% 7 28.6% 100% 100% 2013 0.6 ND 100% 100% 13 77.7% 100% 100% 2014 3 55% 99% 100% 100 6% 100% 100% 2015 3.6 55% 93% 66% 1 0% 100% 100% 2016 0.7 66.7% 100% 100% 15 6.7% 100% 100% Suspected rubella cases Confirmed measles cases Discarded as non- rubella Rubella incidence Genotypes detected Laboratory Epi- linked Clincally Total 2012 0 0 0 0 0 0 0 NA 2013 11 0 0 0 0 11 0 NA 2014 12 0 0 0 0 12 0 NA 2015 1 0 0 0 0 1 0 NA 2016 6 0 0 0 0 6 0 NA Discarded non- rubella rate % 1st sub- national unit with ≥ 2 discarded cases % cases with adequate laboratory investiga- tion % origin of infection known # specimen tested for rubella % positive for rubella Rate of viral detection % WHO and proficient labs 2012 1.5 ND 100% NA ND NA ND 100% 2013 0.6 ND 100% NA ND 0% NA 100% 2014 0.6 0% 100% NA 12 0% NA 100% 2015 0.1 0% 100% NA 86 0% NA 100% 2016 0.3 11.1% 100% NA 6 0% NA 100% RVC comments, based on 2016 reporting The Regional Verification Commission for Measles and Rubella Elimination (RVC) concluded that endemic transmission of both measles and rubella remained interrupted in Slovenia in 2016, and confirmed that measles and rubella elimination has been sustained. The RVC commends the National Verification Commission (NVC), national health authorities and public health system on this achievement but would appreciate further clarification from the NVC and national health authorities on surveillance performance indicators, with an explanation of how they document the presence of high-quality surveillance in the next ASU. The RVC also requests from the NVC an update on immunization coverage among the identified underim- munized subpopulation. The RVC encourages the national health authorities and public health system to consider activities that will ensure timely collection of routine immunization coverage data. Source: Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report (www.euro.who.int/6thRVC) ©WHO 2018