Measles and rubella elimination country profile: Serbia

Measles elimination status Rubella elimination status Total population 8 802 754 < 1 year old 84 792 < 5 years old 422 177 Demographic information, 2018 Source: World Population Prospects: The 2019 Revision, New York, United Nations Measles and rubella surveillance National case-based surveillance for measles Lab confirmation for diagnosis of measles Source: WHO/UNICEF Joint Reporting Form on immunization, 2018 Measles and rubella elimination country profile Serbia Measles and rubella immunization schedule, 2018 Source: WHO/UNICEF Joint Reporting Form on immunization, 2018 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, 2009–2018 Source: WHO/UNICEF Joint Reporting Form on immunization, 2018 and WHO/UNICEF Estimates of National Immunization Coverage (WUENIC), 2018 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, 2018 Тwo or more measles or rubella cases which are temporarily related and epidemiological- ly or virologically linked, or both Confirmed measles cases by month of onset, 2014-2018 Source: CISID, 2018 Vaccine Schedule MCV1 MMR 12 months MCV2 MMR 7 years Year of introduction MCV2 1994 RCV 1994 Measles vaccination in school No 2017 endemic 2018 endemic Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC 2017 endemic 2018 endemic Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC 0 10 20 30 40 50 60 70 80 90 100 0 1000 2000 3000 4000 5000 6000 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % c o ve ra ge N u m b er o f ca se s Year Measles Rubella Coverage MCV1 Coverage MCV2 0 200 400 600 800 1000 1200 1400 1600 J F M AM J J A S O N D J F M AM J J A S O N D J F M AM J J A S O N D J F M AM J J A S O N D J F M AM J J A S O N D 2014 2015 2016 2017 2018 N u m b er o f ca se s Month and year Serbia Informa�on on CRS, 2018 No cases reported CRS = congenital rubella syndrome Measles cases by first subna�onal level, 2018 Source: Measles genotypes by first subna�onal level, 2018 Source: MeaNS, 2018 Sources of infec�on, 2018 Measles Rubella Imported 2 0 Import-related 0 0 Endemic 5074 5 Unknown/ Not reported 0 0 Source: Source: Note: Excludes imported cases 1dot=1case •B3 •D8 •H1 •D4 0 10 20 30 40 50 60 70 80 90 100 <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 2 Suspected measles cases Confirmed measles cases Discarded as non- measles Measles incidence Genotypes detected Laboratory Epi- linked Clinically Total 2014 81 35 2 0 37 44 5.1 D8,D9 2015 543 308 75 0 383 160 53.7 D8 2016 73 14 1 0 15 58 2.1 B3 2017 1149 285 434 0 719 430 98.2 B3 2018 7783 2661 1113 1304 5076 2702 702.8 B3,D8 Measles incidence, epidemiologic and virologic characteristics, 2014-2018 Measles surveillance and laboratory performance indicators, 2014-2018 Source: Measles and rubella elimination Annual Status Update report, 2014-2018 Incidence calculated per 1 million population ND = Data not available; NA= Not applicable Source: Measles and rubella elimination Annual Status Update report, 2014-2018 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, 2014-2018 Rubella surveillance and laboratory performance indicators, 2014-2018 Source: Measles and rubella elimination Annual Status Update report, 2014-2018 Incidence calculated per 1 million population ND = Data not available; NA= Not applicable Source: Measles and rubella elimination Annual Status Update report, 2014-2018 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 Serbia 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 2014 0.6 8% 100% 73% 79 44.3% ND ND 2015 2.2 44% 67.1% 100% 459 67.1% 50% 100% 2016 0.7 12% 100% 100% 73 19.2% 100% 100% 2017 6.1 48% 47% 37.3% 540 52.8% 18.2% 100% 2018 28.5 100% 54.3% 52.3% 5108 52.1% 30.8% 82.8% Suspected rubella cases Confirmed rubella cases Discarded as non- rubella Rubella incidence Genotypes detected Laboratory Epi- linked Clinically Total 2014 2 2 0 0 2 0 0.2 ND 2015 ND 2 0 8 10 ND 1.4 ND 2016 ND 2 0 3 5 ND 0.7 ND 2017 0 2 0 3 5 0 0.7 ND 2018 ND 2 0 3 5 ND 0 ND 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 2014 ND ND ND ND ND ND ND ND 2015 ND ND ND ND ND ND ND ND 2016 ND ND ND ND 60 3.3% ND 100% 2017 ND ND ND ND 0 NA ND NA 2018 ND ND ND ND 0 0% ND 0% RVC comments, based on 2018 reporting The RVC commends Serbia on its efforts to control measles outbreaks and expand genotyping of confirmed cases. As there is continuous measles and rubella transmission, the RVC reiterates the need to include line-lists of suspected, confirmed and discarded cases linked with the results of laboratory investigation. The RVC urges national authorities to implement WHO strategies and recommendations to strengthen surveillance, and to include analysis of measles chains of transmission and genotyping of rubella cases in reports. As per WHO guidelines, immunization coverage should reach and be maintained at >95% with both doses of MRCV among all age groups at national and sub-national levels and SIAs should be considered to reach all susceptibles, close immunity gaps and prevent outbreaks. The RVC requests that the NVC strengthen cooperation with its secretariat and improve the quality and completeness of data in future ASUs. Data presented in the report should be checked for consistency of calculations. The RVC and WHO Secretariat are ready to provide support for these activities. Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC © World Health Organization 2020. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license. Document number: WHO/EURO:2020-1525-41275-56171 3