Measles and rubella elimination country profile: Kazakhstan

Total population 18 204 499 < 1 year old 367 131 < 5 years old 1 970 474 Demographic information, 2017 Source: World Population Prospects: The 2017 Revision, New York, United Nations Measles and rubella surveillance National case-based surveillance for measles, rubella and CRS Lab confirmation for diagnosis of measles, rubella and CRS Source: WHO/UNICEF Joint Reporting Form on Immunization, 2017 Measles and rubella elimination country profile Kazakhstan Measles and rubella immunization schedule, 2017 Source: Immunization schedule, WHO, Data and Statistics, Immunization Monitoring and Surveillance (http://www.who.int/immunization/monitoring_surveillance/data/en/) MMR = measles-mumps-rubella vaccine; MCV1 = first dose measles-containing vaccine; MCV2 = second dose measles-containing vaccine; RCV = rubella-containing vaccine Measles and rubella cases and immunization coverage, 2008–2017 Source: Disease incidence and immunization coverage (WUENIC), WHO, Data and Statistics, Immunization Monitoring and Surveillance (http://www.who.int/immunization/monitoring_surveillance/data/en/) MCV1 = first dose of measles-containing vaccine MCV2= second dose of measles-containing vaccine Definition used for an outbreak Source: Measles and rubella elimination Annual Status Update report, 2017 ND = Data not available ND Confirmed measles cases by month of onset, 2013-2017 Source: CISID 2017 Vaccine Schedule MCV1 MMR 1 year MCV2 MMR 6 years Year of introduction MCV2 1995 RCV 2004 Measles vaccination in school Yes Measles elimination status 2016 endemic 2017 interrupted 2016 endemic 2017 interrupted Rubella elimination status 0 100 200 300 400 500 600 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 2013 2014 2015 2016 2017 N u m b er o f ca se s Month and year 0 10 20 30 40 50 60 70 80 90 100 0 500 1000 1500 2000 2500 3000 3500 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 % co ve ra ge Nu m be r o f c as es Year Measles Rubella MCV1 coverage MCV2 coverage Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thrvc Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thrvc Measles and rubella elimination country profile Kazakhstan ©WHO 2019 Information on CRS, 2017 No cases reported Source: Measles and rubella elimination Annual Status Update report, 2017 CRS = congenital rubella syndrome Measles cases by first subnational level, 2017 Source: Measles and rubella elimination Annual Status Update report, 2017 Measles genotypes by first subnational level, 2017 Source: MeaNS 2017 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. Sources of infection, 2017 Measles Rubella Imported 2 0 Import-related 0 0 Unknown/ Not reported 0 0 Endemic 0 0 Source: Measles and rubella elimination Annual Status Update report, 2017 Measles cases by age group and vaccination status, 2017 Source: Measles and rubella elimination Annual Status Update report, 2017 Supplementary immunization activities Year Target age Vaccine used % Coverage 2015 15-19Y M 43% Source: Supplementary immunization activities, WHO, Data and Statistics, Immunization Monitoring and Surveillance (http://www.who.int/immunization/monitoring_surveillance/data/en/) M = measles vaccine ND = Data not available 1dot=1case •B3 •D8 •H1 •D4 0 20 40 60 80 100 < 1 1-4 5-9 10-14 15-19 20-29 30 + % o f c as es Age group (years) 0 doses 1 dose 2 or more doses Unknown Suspected measles cases Confirmed measles cases Discarded as non- measles Measles incidence Genotypes detected Laboratory Epi- linked Clinically Total 2013 165 73 0 0 73 92 4.3 D8 2014 619 274 27 20 321 298 18.8 D8 2015 2803 1815 346 177 2341 462 132.5 B3,D8 2016 247 122 0 0 122 125 6.9 H1 2017 73 2 0 0 2 71 0.1 D8,H1 Measles incidence, epidemiologic and virologic characteristics, 2013-2017 Measles surveillance and laboratory performance indicators, 2013-2017 Source: Measles and rubella elimination Annual Status Update report, 2013-2017 Incidence calculated per 1 million population ND = Data not available; NA= Not applicable Source: ASU 2013-2017 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, 2013-2017 Rubella surveillance and laboratory performance indicators, 2013-2017 Source: Measles and rubella elimination Annual Status Update report, 2013-2017 Incidence calculated per 1 million population ND = Data not available; NA= Not applicable Source: ASU 2013-2017 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 Kazakhstan Discarded non- measles rate % 1st sub- national unit with ≥ 2 discarded cases % cases with adequate laboratory investigation % origin of infection known # specimen tested for measles % positive for measles Rate of viral detection % WHO and proficient labs 2013 0.6 12.5% 100% 100% НД НД 14% ND 2014 1.8 18.8% 95.6% 14.6% 594 46.1% 0 ND 2015 2.4 50% 100% 80% 2277 79.7% 0 100% 2016 0.7 6.2% 100% 100% 247 49.4% 100% 100% 2017 0.3 0% 100% 100% 73 2.7% ND 100% Suspected rubella cases Confirmed rubella cases Discarded as non- rubella Rubella incidence Genotypes detected Laboratory Epi- linked Clinically Total 2013 72 34 0 2 36 36 1.6 ND 2014 531 13 0 139 152 379 8.9 ND 2015 40 1 0 1 2 38 0.1 ND 2016 43 4 0 0 4 39 0.2 ND 2017 73 0 0 0 0 73 0 NA Discarded non- rubella rate % 1st sub- national unit with ≥ 2 discarded cases % cases with adequate laboratory investigtion % origin of infection known # specimen tested for rubella % positive for rubella Rate of viral detection % WHO and proficient labs 2013 0.2 0% 94% 100% ND ND 0 ND 2014 2.9 37.5% 100% 91.4% 531 2.5% 0 ND 2015 0.2 0% 100% 50% 39 2.6% 0 100% 2016 0.2 0% 100% 100% 43 9.3% 0 100% 2017 0.3 0% 100% NA 71 0% NA 100% RVC comments, based on 2017 reporting The Regional Verification Commission for Measles and Rubella Elimination (RVC) agrees with the NVC conclusion that measles and rubella endemic transmission was interrupted in 2017, and commends the national verification committee for measles and rubella elimination (NVC), national health authorities and public health system on achieving interruption of endemic measles and rubella transmission. Surveillance quality should be improved by increasing surveillance sensitivity and the representativeness of reporting discarded cases. ©WHO 2019 Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thrvc