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Measles-Rubella Bulletin - Vol 06 Issue 06

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Volume 6 • Issue 6 • June 2012

ISSN 1814 3601

This issue of the Measles-Rubella Bulletin includes data on cases with rash onset in 2012 through May that were reported to the Regional Office in June. Detailed explanations of the indicators used in this Bulletin may be found in Measles Bulletin Vol. 1 Issue 13 (September 2007) and Measles Bulletin Vol. 2 Issue 4 (December 2008). These indicators are consistent with those recommended in the Weekly Epidemiological Record, No. 49, 2010, 85: 489–496. Table 1A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2010—2012 2010 Country Australia Brunei Darussalam Cambodia China Hong Kong (China) Japan Lao People's Democratic Republic Macao (China) Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries Completeness Timeliness 1 2 3

2011 Completeness 100% 100% 100% 100% 100% 100% 92% 100% 100% 100% 100% 75% 100% 100% 100% 75% 75% 95% 79% 89% Timeliness 100% 100% 92% 100% 100% 100% 92% 100% 92% 100% 83% 42% 92% 92% 92% 50% 67% 07 Feb 07 Feb 03 Feb 01 Mar 04 Feb 94% 82% 03 Mar 06 Mar 07 Mar 01 Mar 10 Mar 94% 88% Jan 10 Feb 02 Feb 08 Feb 10 Feb 15 Feb 06 Feb 07 Feb 15 Feb 07 Feb 10 Feb 08 Feb 07 Feb Feb 10 Mar 08 Mar 07 Mar 10 Mar 20 Mar 02 Mar 02 Mar 10 Mar 08 Mar 07 Mar 10 Mar 06 Mar Mar 10 Apr 04 Apr 04 Apr 10 Apr 10 Apr 05 Apr 10 Apr 18 Apr 02 Apr 06 Apr 09 Apr 04 Apr 17 Apr 31 Mar 09 Apr 09 Apr 10 Apr 03 Apr 100% 88%

2012 Apr 10 May

1

Completeness 100% 100% 75% 100% 100% 100% 83% 100% 92% 100% 100% 67% 100% 92% 100% 92% 92% 94%

Timeliness 100% 100% 42% 58% 100% 100% 75% 100% 83% 92% 92% 33% 92% 92% 100% 25% 58%

May 10 Jun 05 Jun 09 Jun 10 Jun 11 Jun 04 Jun 10 Jun 10 Jun 07 Jun 08 Jun 08 Jun 08 Jun 12 Jun 10 Jun 07 Jun 06 Jun 10 Jun 04 Jun 100% 94%

Completeness 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 60% 100% 100% 100% 100% 100% 98%

2

Timeliness 100% 100% 100% 80% 100% 100% 40% 100% 100% 100% 100% 20% 100% 100% 100% 80% 100% 89%

3

08 May 08 May 10 May 15 May 09 May 09 May 11 May 04 May 10 May 09 May 10 May 04 May 07 May 07 May 04 May 10 May 07 May 100% 94%

National measles surveillance monthly reports as of June 2012.

Legend: black = timely report; red = untimely report

Completeness is defined as the number of reports received by the end of the reporting month divided by the number of expected reports for the year.

Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and China may report to the Regional Office by the 15th (or the next working day) of the following month.

Table 1B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2010—2012 Country Australia Cambodia China Hong Kong (China) Japan Lao People's Democratic Republic Macao (China) Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam (northern) Viet Nam (southern) Fiji Completeness Timeliness 1 2 3

2010 Completeness 100% 42% 0% 100% 0% 58% 100% 92% 100% 100% 75% 100% 100% 100% 100% 83% 67% 77% 62% Timeliness 100% 25% 0% 100% 0% 58% 100% 58% 100% 33% 33% 83% 100% 100% 58% 50% 50% 100% 100% 0% 100% 100% 100% 100% 100% 100% 100% 83% 100% 100% 100% 100% 100% 92% 93%

2011 Completeness Timeliness 100% 100% 0% 100% 100% 100% 100% 100% 100% 92% 67% 100% 100% 100% 75% 100% 58% 88% 08 Feb 07 Feb 10 Feb 07 Feb 13 Feb 08 Feb 09 Feb 13 Feb 10 Feb 07 Feb 10 Feb 10 Feb 10 Feb 04 Feb 94% 82% 10 Mar 02 Mar 10 Mar 09 Mar 11 Mar 07 Mar 09 Mar 08 Mar 08 Mar 10 Mar 10 Mar 10 Mar 08 Mar 10 Mar 94% 88% Jan 09 Feb 06 Feb Feb 06 Mar 08 Mar

2012 Mar

1

Apr 02 May 10 May 10 May 09 May 10 May 04 May 09 May 08 May 10 May 10 May 09 May 10 May 10 May 04 May 10 May 07 May 94% 94%

May 05 Jun 06 Jun 08 Jun 10 Jun 10 Jun 07 Jun 10 Jun 06 Jun 08 Jun 08 Jun 08 Jun 08 Jun 08 Jun 09 Jun 10 Jun 04 Jun 94% 94%

Completeness 100% 100% 0% 100% 100% 100% 100% 100% 100% 100% 80% 100% 100% 100% 100% 100% 100% 93%

2

Timeliness 100% 100% 0% 100% 100% 100% 100% 60% 100% 100% 60% 100% 100% 100% 100% 100% 100% 89%

3

03 Apr 08 Apr 10 Apr 10 Apr 10 Apr 05 Apr 10 Apr 06 Apr 10 Apr 10 Apr 10 Apr 09 Apr 03 Apr 10 Apr 03 Apr 88% 88%

National measles laboratory monthly reports as of June 2012. Completeness is defined as the number of reports received by the end of the reporting month divided by the number of expected reports for the year. National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month.

Table 2A. Measles case classification and incidence, by country and area, WHO Western Pacific Region, 2011—2012 1 2011 Country

2012 1 Discarded cases 0 6 2889 24 692 219 399 326 15 3341 183 0 44 2954 131 0 14 208 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 945

Population (in Suspected 3 millions) 2 measles cases No data

Confirmed measles cases Lab 166 4 320 8951 6 322 12 1 1445 0 428 0 3240 40 143 22 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 102

Epi-linked 26 0 0 13 1 9 17 0 82 0 105 0 171 0 No data

Clinical No data

Total 192 4 722 9943 13 410 113 1 1569 0 599 0 6555 43 143 745 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 054

Measles Pending Deaths due to incidence per classification measles 1 million pop. 0 0 0 7 0 0 0 0 0 0 3 6 3 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 1 10 0 0 0 0 4 0 0 0 28 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 8.5 9.9 50.5 7.4 1.8 3.2 18.0 1.8 54.4 0 135.7 0 69.1 0.9 27.6 8.4 0 0 2.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.6 Green Yellow Red

Population (in 2 millions) 22.92 0.41 14.48 1353.60 7.20 126.43 6.37 0.57 29.32 2.84 4.46 7.17 96.47 48.59 5.26 89.73 0.07 0.02 0.88 0.28 0.18 0.10 0.06 0.11 0.01 0.26 0.00 0.06 0.02 0.18 0.57 0.00 0.10 0.01 0.25 0.01 1819.01

Suspected 3 measles cases No data

Confirmed measles cases Discarded cases Lab 26 0 0 2018 3 100 1 1 795 0 41 0 291 1 19 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3297

Epi-linked 1 0 0 1 0 0 0 0 58 0 3 0 10 0 No data

Clinical No data

Total 27 0 0 2086 5 117 5 1 985 0 44 0 560 1 19 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3937 No data

Pending Deaths due to classification measles 0 0 70 241 0 0 0 0 906 0 15 3 114 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1373 0 0 0 4 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8

Annualized Measles incidence per 1 million pop. 2.8 0 0 3.7 1.7 2.2 1.9 4.2 80.6 0 23.7 0 13.9 0 8.7 2.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.2

Australia 22.61 Brunei Darussalam 0.41 Cambodia 14.31 China 1347.57 Hong Kong (China) 7.12 Japan 126.50 Lao People's Democratic Republic 6.29 Macao (China) 0.56 Malaysia 28.86 Mongolia 2.80 New Zealand 4.41 Papua New Guinea 7.01 Philippines 94.85 Republic of Korea 48.39 Singapore 5.19 Viet Nam 88.79 Pacific island countries and areas American Samoa Cook Islands Fiji 4 French Polynesia Guam Kiribati Marshall Islands Micronesia, Federated States of Nauru New Caledonia Niue Northern Mariana Islands Palau Samoa Solomon Islands Tokelau Tonga Tuvalu Vanuatu Wallis and Futuna Western Pacific Region 1 2 3 4

10 3611 34 642 232 809 439 16 4910 183 No data

50 9512 174 No data

0 402 979 6 79 84 0 42 0 66 0 3144 3 No data

4 460 17 277 79 241 304 5 3709 311 No data

3 1232 46 No data

0 0 67 2 17 4 0 132 0 0 0 259 0 No data

4 390 14 950 73 124 296 4 1818 311 7 0 558 44 No data

14 954 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 080

81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 505

642 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5447

402 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 181

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73

86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567

292 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 979

0.07 0.02 0.87 0.27 0.18 0.10 0.05 0.11 0.01 0.25 0.00 0.06 0.02 0.18 0.55 0.00 0.10 0.01 0.25 0.01 1808.80

National measles surveillance monthly reports as of June 2012. Population figures from United Nations World Population Prospects: The 2010 Revision. Australia, New Zealand and Singapore report only confirmed cases. Classification is provisional based on laboratory data only.

<1 confirmed measles case / 1 000 000 population 1–9.9 confirmed measles case / 1 000 000 population >= 10 confirmed cases / 1 000 000 population

2

Table 2B. Measles surveillance performance indicators, by country and area, WHO Western Pacific Region, 2011—2012 1 1 2011 2012 Country Discarded measles rate per 100 000 pop ≥2 Australia 4 Insufficient data Brunei Darussalam 1.5 Cambodia 20.2 China 1.8 Hong Kong (China) 3.1 Japan 0.3 Lao People's Democratic Republic 5.2 Macao (China) 2.7 Malaysia 11.6 Mongolia 6.5 New Zealand 4 Insufficient data Papua New Guinea 0.6 Philippines 3.1 Republic of Korea 0.3 Insufficient data Singapore 4 Viet Nam 16.0 Pacific island countries and areas American Samoa 0 Cook Islands 0 Fiji 62.0 French Polynesia 0 Guam 0 Kiribati 0 Marshall Islands 0 Micronesia, Federated States of 0 Nauru 0 New Caledonia 0 Niue 0 Northern Mariana Islands 0 Palau 0 Samoa 0 Solomon Islands 0 Tokelau 0 Tonga 0 Tuvalu 0 Vanuatu 0 Wallis and Futuna 0 Western Pacific Region 2.8 Second level units with ≥ 1 discarded cases per 100 000 pop ≥ 80% Insufficient data

Suspected cases with adequate investigation ≥ 80% Insufficient data

Suspected cases with adequate blood specimens ≥ 80% Insufficient data 2

Percent clinically confirmed Discarded measles rate per 3 100 000 pop cases ≤ 10% Insufficient data

Annualized discarded measles rate per 100 000 pop ≥2 Insufficient data

Second level units with ≥ 1 discarded cases per 100 000 pop (annualized) ≥ 80% Insufficient data

Suspected cases with adequate investigation ≥ 80% Insufficient data

Suspected cases with adequate blood specimens ≥ 80% Insufficient data 2

Percent clinically confirmed cases 3

≥2 Insufficient data

≤ 10% Insufficient data

100% 75.0% 71.0% 100% 4.3% 70.6% 100% 93.8% 36.4% Insufficient data

50.0% 14.2% 94.4% 74.6% Insufficient data

90.0% 85.0% 88.0% 97.8% Insufficient data

22.6% 100% 42.6% 59.6% Insufficient data

43.1% 100% 83.8% 100% Insufficient data

20.0% 88.2% 0% Insufficient data

28.0% 47.0% 58.6% Insufficient data

82.0% 76.2% 85.6% Insufficient data

0% 55.7% 9.8% 46.2% 19.3% 74.3% 0% 2.7% 0% 11.0% 0% 48.0% 7.0% Insufficient data

1.0 2.7 1.1 1.0 0.1 4.6 0.7 6.2 10.9 Insufficient data

2.3 6.5 2.7 2.4 0.2 11.1 1.7 14.9 26.2 Insufficient data

100% 50.0% 35.5% 100% 0% 58.8% 100% 93.8% 36.4% Insufficient data

50.0% 27.4% 98.1% 58.2% Insufficient data

75.0% 72.8% 93.6% 96.2% Insufficient data

44.7% 100% 57.7% 46.6% Insufficient data

72.7% 100% 62.5% 99.7% Insufficient data

0 0.6 0.1 Insufficient data

0 1.4 0.2 Insufficient data

0% 41.2% 6.3% Insufficient data

100% 47.0% 76.1% Insufficient data

66.7% 80.2% 95.7% Insufficient data

0% 0% 3.2% 40.0% 14.5% 80.0% 0% 13.4% 0% 0% 0% 46.3% 0% Insufficient data

84.4% 0% 0% 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 52.3%

20.7% Not applicable Not applicable

31.7% Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

86.2% Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

0.3 0 0 12.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.1

0.8 0 0 29.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.5

18.8% 0% 0% Insufficient data

37.8% Not applicable Not applicable

52.5% Not applicable Not applicable Insufficient data Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

98.9% Not applicable Not applicable

0% Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

0% Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

0% Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable

1 2

62.6%

73.5% Green Yellow Red

26.3%

0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 26.3%

84.8%

86.8%

14.6%

National measles surveillance monthly reports as of June 2012. Excludes epidemiologically-linked cases. Among all confirmed cases. Reports only confirmed cases.

3 4

Reached or surpassed target Nearly reached target: 1.00–1.99 for non-measles suspected case rate; 10.1–25% for percent clinically confirmed cases; 60–79% for other indicators Substantially below target

3

Table 3A. Measles and rubella laboratory performance, WHO Western Pacific Region, 20111 Measles Measles and rubella Serum Country Total number of cases tested Total number of samples received Samples tested for measles IgM Measles IgM (+) Measles IgM equiv Measles IgM (-) Measles IgM pending Serology Blood Results ≤ 7 days Virus detection Measles Virus isolation/detection (swab, urine, PBMC) No. of samples tested 0 0 Rubella Serum and blood (includes DBS) Samples Total number tested for of lab rubella IgM confirmed cases No. Rubella IgM (+) Rubella IgM pending

DBS samples

Measles RT - PCR

Rubella IgM equiv

No.

No.

No.

No.

%

No.

No. received 0 170

No. (+) 8

%

No. of isolates 0 0

No. of samples tested 167 0

No. of (+)

No.

No.

No.

Australia Cambodia China Hong Kong (China) Japan Lao People's Democratic Republic Macao (China) Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam (northern) Viet Nam (southern) Fiji Total 1

159 3201

254 3208

77 3038

25 288

6 2

46 2748

59.7 90.5

0 0

100 55.6

134 0

111 296

40 3038

5 1048

1 60

0 0

379

434

342

6

5

331

96.8

0

0

-

98.2

19

2

29

6

7

352

45

2

0

181 47 4923 182 1175 144 7620 243 581 2466 1729 527 23 557

181 47 5009 182 1424 144 7620 288 831 2466 1739 528 24 355

181 47 4975 182 693 60 7620 227 239 1460 1475 518 21 134

12 1 1582 0 161 0 3829 41 56 8 6 2 6017

0 0 109 0 11 0 424 21 2 4 9 1 594

169 46 3284 182 520 60 3367 165 181 1447 1460 515 14 521

93.4 97.9 66.0 100 75.0 100 44.2 72.7 75.7 99.1 99.0 99.4 68.7

0 0 0 0 1 0 0 0 0 1 0 0 2

0 0 0 0 2 84 0 0 0 0 0 10 266

0 0 0 8

82.1 97.9 100 100 99.0 30.7 72.6 98.2 97.6 62.4 92.9 47.2 78.6

0 0 4145 0 17 0 179 17 273 55 10 0 4715

0 0 118 0 2 0 30 1 42 0 0 0 195

0 0 481 0 701 0 0 79 65 0 10 0 1532

0 0 114 0 389 0 0 13 4 0 0 0 660

12 1 1582 0 467 0 3829 42 95 8 6 2 6458

181 47 3360 182 95 144 3831 227 376 2465 1721 527 16 586

37 1 383 14 4 8 1115 19 9 1413 1084 151 5336

21 1 193 5 1 9 322 32 18 134 110 57 966

0 0 1 1 12 2 0 0 0 0 0 0 16

National measles laboratory monthly reports as of March 2012.

4

Table 3B. Measles and rubella laboratory performance, WHO Western Pacific Region, 20121 Measles Measles and rubella Serum Country Total number of cases tested Total number of samples received Samples tested for measles IgM Measles IgM (+) Measles IgM equiv Measles IgM (-) Measles IgM pending Serology Blood Results ≤ 7 days Virus detection Measles Virus isolation/detection (swab, urine, PBMC) No. of samples tested 0 52 Rubella Serum and blood (includes DBS) Samples Total number tested for of lab rubella IgM confirmed cases No. Rubella IgM (+) Rubella IgM pending

DBS samples

Measles RT - PCR

Rubella IgM equiv

No.

No.

No.

No.

%

No.

No. received 0 50

No. (+) 0

%

No. of isolates 0 0

No. of samples tested 18 52

No. of (+)

No.

No.

No.

Australia Cambodia China Hong Kong (China) Japan Lao People's Democratic Republic Macao (China) Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam (northern) Viet Nam (southern) Fiji Total 1

22 390

32 393

12 340

8 0

1 0

3 340

25.0 100

0 0

100 98.8

16 0

15 0

9 390

3 125

0 0

0 0

166

192

165

4

1

160

97.0

0

0

-

98.1

13

2

18

5

4

161

15

3

1

239 22 3866 312 189 3 1190 106 244 214 95 108 7166

239 22 3872 314 206 3 1193 110 387 214 104 108 7389

239 22 3637 312 76 3 1167 106 139 137 95 107 6557

1 2 1054 0 7 0 386 9 10 1 0 0 1482

4 0 66 0 2 0 71 8 4 2 0 0 159

234 20 2517 312 67 3 710 89 125 133 95 107 4915

97.9 90.9 69.2 100 88.2 100 60.8 84.0 89.9 97.1 100 100 75.0

0 0 0 0 0 0 0 0 0 1 0 0 1

0 0 0 0 0 0 0 0 0 0 0 1 51

0 0

84.7 100 99.2 100 100 100 97.5 100 96.1 86.6 100 90.8 97.9

0 0 464 2 1 0 8 0 82 0 9 0 631

0 0 34 0 0 0 0 0 4 0 0 0 40

0 0 0 2 115 0 0 15 0 0 9 0 229

0 0 0 0 41 0 0 0 0 0 0 0 62

1 2 1054 0 45 0 386 9 12 1 0 0 1529

239 22 2531 312 27 3 780 106 186 214 95 108 5183

44 2 287 128 2 0 68 4 6 83 17 23 807

52 0 110 4 1 0 56 8 5 22 6 8 275

0 0 0 0 0 0 1 0 0 1 0 0 3

National measles laboratory monthly reports as of June 2012.

5

Table 4A. Measles genotype distribution of cases with onset in 2011 and 20121, WHO Western Pacific Region 2011 Country Total confirmed cases 1 192 4 722 9943 13 410 113 1 1569 0 599 0 6555 43 143 745 2 21 054

2012 2

GENOTYPES Total Lab confirmed 1 B3 -

Pending D4 31 51 22 1 105

Total

D8 25 1 7 1 9 3 9 55

D9 38 19 3 35 33 12 24 12 33 209

D11 1 1

G3 1 1 1 3

H1 1 6 175 1 6 2 191

A 5 2 4 1 1 13 3 2 5 103 0 25 178 5 98 6 1 44 0 37 0 24 13 46 2 0 582

Total confirmed cases 1 27 0 0 2086 5 117 5 1 985 0 44 0 560 1 19 87 0 3937

GENOTYPES 2 Total Lab confirmed 1 Pending B3 2 2

Total

D4 5 6 11

D8 6 36 8 1 51

D9 2 6 2 8 19 4 41

D11 0

G3 1 1

H1 69 1 2 72

A 1 2 1 4 2 3 5 13 0 0 76 3 53 0 0 27 0 8 0 0 0 7 0 0 187

Australia Brunei Darussalam Cambodia China Hong Kong (China) Japan Lao People's Democratic Republic Macao (China) Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries Total 1 2

166 4 320 8951 6 322 12 1 1445 0 428 0 3240 40 143 22 2 15 102

26 0 0 2018 3 100 1 1 795 0 41 0 291 1 19 1 0 3297

Sources: National measles surveillance monthly reports as of June 2012 (Table 2A). Sources: National and regional measles reference laboratory monthly reports as of June 2012 and the Measles Nucleotide Sequence online database (MeaNS), whichever has the greater number.

6

Table 4B. Rubella genotypes distribution of cases with onset in 2011 and 20121, WHO Western Pacific Region 2011 Country Samples tested for rubella IgM 1 40

2012 2

Rubella IgM positive 1 5

Genotypes 1E -

Total 1j 1 -

2B 18 8 2 4 5 2 15 2 0 0 0 172 15 5 1 0 4 0 5 2 0 0 0 15 2

Samples tested for rubella IgM 1 9

Rubella IgM positive 1 3

Genotypes 1E -

2

Pending 1j -

Total

2B 8 8 1 2 0 0 0 32 14 1 0 0 2 0 0 0 0 0 0 0 0

Australia Brunei Darussalam Cambodia China Hong Kong (China) Japan Lao People's Democratic Republic Macao (China) Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam

3038

1048

154

340

116

24

352

45

7 2

161

15

6 -

181 47 3360 182 95 144 3831 227 376 4186 527

37 1 383 14 4 8 1115 19 9 2497 151

1 -

239 22 2531 312 27 3 780 106 186 309 108

44 2 287 128 2 0 68 4 6 100 23

-

Pacific island countries Total 1 2

16 586

5336

164

1

56

221

5133

798

30

0

19

0

49

Sources: National measles laboratory monthly reports as of June 2012 (Table 3). Sources: National and regional measles reference laboratory monthly reports as of June 2012 and the Measles Nucleotide Sequence online database (MeaNS), whichever has the greater number.

Expanded Programme on Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 5288001 Fax No. (63 2) 5211036, 5260279 Please send your comments and monthly data before the 10th of the month to: WPR_EPIdata@wpro.who.int

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