Measles-Rubella Bulletin 2022

Volume 16 • Issue 8 • August 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–31 July 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, February–July 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 August 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 0 0 0 0 1 1 0 0 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 1 2 0 0 0 0 0 0 0 27 China 32 46 30 44 32 43 64 98 41 82 35 69 China, Hong Kong SAR 0 0 0 0 0 0 0 0 1 1 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 0 0 0 0 0 0 0 0 2 2 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 12 12 13 13 18 18 32 33 21 22 15 16 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 2 12 2 47 6 43 4 52 8 67 9 90 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 0 0 0 0 1 1 1 0 0 Viet Nam 0 0 2 4 0 2 0 7 0 0 0 0 Pacific island countries and areas 0 0 0 0 0 0 0 0 0 0 0 0 Western Pacific Region 46 70 48 110 56 106 100 191 73 174 61 204 1 Reports only confirmed cases "-" No data MayApr 2022 JulyFeb Mar Country/area June Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 August 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 August 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l 2017 2018 2019 2020 2021 2022 N um be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 August 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 August 2022 Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 0 - - - - - 1 1 0 0 0 100.0% Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 1 0 0 0 1 0.0% China - 505 0 0 0 505 0.0% 277 0 0 0 277 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 0 - - - - - China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 2 0 0 0 2 0.0% Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 97 24 80.2% 131 2 0 99 30 77.1% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 32 0 0 29 3 90.6% Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 1 0 0 0 1 0.0% Viet Nam - 33 0 0 0 33 0.0% 2 0 0 0 2 0.0% Pacific island countries and areas - 2 0 0 0 2 0.0% 0 - - - - - Total 686 1 0 107 578 15.7% 447 3 0 128 316 29.3% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection Country/area Year verified 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 August 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 0 0.0 26.0 NA3 0 0 0 1 0 1 0.1 0 12-Jun-22 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 12 0 12 0 0 0 0 0.0 0 13-Sep-19 Cambodia 3 0.2 676 41.9 379 23.3 5 0.3 16.7 346 0 317 28 1 0 29 3.0 0 7-Mar-22 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1425.9 14 044 879 12 815 73 277 0 350 0.4 0 31-Jul-22 China, Hong Kong SAR 16 2.1 90 12.0 1 0.1 1 0.1 7.5 2 1 0 0 1 0 1 0.2 0 22-Jun-22 China, Macao SAR 3 4.7 37 56.3 0 0.0 0 0.0 0.7 5 0 5 0 0 0 0 0.0 0 6-May-19 Japan 284 2.2 763 6.1 12 0.1 6 0.0 124.3 49 2 45 0 2 0 2 0.0 0 25-Jul-22 Lao People's Democratic Republic 10 1.4 1 290 180.2 135 18.6 2 0.3 7.5 275 47 228 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 60.8 1 077 33.0 478 14.5 128 3.8 33.8 2 150 111 1 905 3 131 0 134 6.8 0 27-Jul-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 38 0 0 0 0 0.0 0 4-Mar-19 New Zealand 36 7.5 2 229 455.7 7 1.4 0 0.0 5.2 42 0 42 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.6 1 0.1 4 0.4 0 0.0 10.0 49 11 38 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 212.4 48 521 443.2 3 723 33.5 218 1.9 114.7 1 396 0 1 057 307 32 0 339 5.1 0 1-Aug-22 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.8 78 0 78 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.7 14 2.4 1 0.2 6.0 10 0 8 1 1 0 2 0.6 0 3-Jun-22 Viet Nam 1 247 13.2 5 723 60.0 713 7.4 163 1.7 97.8 209 86 110 11 2 0 13 0.2 0 16-May-22 Pacific island countries and areas4 0 0.0 6 346 1863.1 75 21.8 2 0.6 3.5 133 4 129 0 0 0 0 0.0 0 14-Nov-21 Western Pacific Region 30 575 16.0 64 177 33.4 6 370 3.3 1 080 0.6 1935.2 18 838 1 141 16 827 423 448 0 871 0.8 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 August 2022 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Country/area Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 August 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 4.6 Not applicable 100.0% 91.7% Cambodia 2.1 24.0% 96.3% 99.7% 3.3 40.0% 90.5% 99.4% China 2.0 0.0% 98.8% 97.9% 1.54 25.8% 98.1% 96.5% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable 50.0% 50.0% China, Macao SAR 3.4 Not applicable 91.3% 100.0% 1.2 Not applicable 100.0% 100.0% Japan 0.1 0.0% Insufficient data Insufficient data 0.1 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 5.2 55.6% 21.5% 5.5% Malaysia 6.1 62.5% 80.3% 96.8% 9.7 75.0% 84.3% 97.2% Mongolia 0.2 4.5% 100.0% 100.0% 1.9 13.6% 97.4% 100.0% New Zealand 1.4 15.0% Insufficient data Insufficient data 1.4 25.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.6 15.0% 82.0% 88.0% Philippines 0.6 0.0% 70.3% 72.8% 1.6 38.9% 68.6% 73.0% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.3 0.0% 48.4% 60.3% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 25.0% 10.0% Viet Nam 0.2 1.6% 38.9% 39.2% 0.2 1.6% 0.0% 41.4% Pacific island countries and areas4 2.5 0.0% 45.7% 95.7% 6.3 5.0% 97.0% 97.7% Western Pacific Region 1.7 6.9% 94.8% 95.4% 1.5 18.9% 91.1% 92.2% Green Yellow Red Substantially below target 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 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological bloc; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 August 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.0 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 12 4 8 0 0 0 0 0.0 - Cambodia 3 0.2 30 1.9 40 2.5 10 0.6 16.7 318 0 312 0 6 0 6 0.6 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 425.9 14 044 879 12 635 122 408 0 530 0.6 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.5 0 - - - - - - - - China, Macao SAR 1 1.6 79 120.2 3 4.5 0 0.0 0.7 5 0 5 0 0 0 0 0.0 - Japan 3 072 24.3 2 315 18.4 92 0.7 11 0.1 124.3 38 4 30 0 4 0 4 0.1 - Lao People's Democratic Republic 16 2.3 27 3.8 22 3.0 3 0.4 7.5 0 - - - - - - - - Malaysia 175 5.4 111 3.4 103 3.1 97 2.9 33.8 2 171 111 1 983 0 77 0 77 3.9 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 37 0 1 0 1 0.5 - New Zealand - - 1 0.2 - - 0 0.0 5.2 0 - - - - - - - - Papua New Guinea 3 0.3 5 0.5 2 0.2 0 0.0 10.0 49 11 35 0 3 0 3 0.5 - Philippines 152 1.4 198 1.8 404 3.6 36 0.3 114.7 1 396 0 1 368 0 28 0 28 0.4 - Republic of Korea 0 0.0 8 0.2 2 0.0 0 0.0 51.8 96 0 96 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 6.0 10 0 5 5 0 0 5 1.4 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 97.8 132 31 93 0 8 0 8 0.1 - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 133 4 128 0 1 0 1 0.5 - Western Pacific Region 7 487 3.9 35 484 18.5 3 019 1.6 1 046 0.5 1 935.2 18 442 1 044 16 735 127 536 0 663 0.6 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population "-" No data Red >= 10 confirmed cases / 1 000 000 population Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 August 2022 Gray No data Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Country/area 2019 Total confirmed and clinically compatible Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 August 2022 Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 August 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 2 2 2 0 - - - - 0 - - 0 - 2 1 1 0 - - - - Brunei Darussalam DLS 16 16 12 8 0 0% 0 0% 0 - 100.0 0 - 0 - 0 12 4 33% 0 0% Cambodia NIPH 317 317 317 317 1 0% 0 0% 0 - 90.7 0 - 0 - 1 318 6 2% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 155 155 133 128 3 2% 0 0% 0 - 95.2 0 - 28 0 3 56 0 0% 1 2% China, Macao SAR PHL 31 31 28 28 2 7% 0 0% 0 - 96.4 0 - 5 0 2 28 0 0% 0 0% Japan NIID 95 84 60 11 2 18% 4 36% 0 - - 2 2 31 1 2 8 4 50% 3 38% Lao People's Democratic Republic NCLE 1 1 1 0 - - - - 0 - - 0 - 0 - - 1 0 - 0 - Malaysia NPHL 3 708 3 708 2 319 2 246 179 8% 51 2% 0 - 98.8 721 0 561 0 179 2 166 164 8% 22 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 32 32 29 7 0 0% 0 0% 0 - 75.0 0 - 28 0 0 5 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 1 431 1 431 1 071 909 25 3% 7 1% 0 - 99.5 219 1 230 0 26 885 27 3% 8 1% Republic of Korea KCDC 221 221 139 61 8 13% 0 0% 0 - 89.9 0 - 61 3 0 81 59 73% 3 4% Singapore NPHL 115 115 115 1 0 - 0 - 0 - 100.0 0 - 115 0 0 1 0 - 0 - Viet Nam national lab (Northern) NIHE 29 29 29 29 0 - 0 - 0 - 100.0 0 - 0 - 0 29 2 - 1 - Viet Nam national lab (Southern) PI 18 18 18 9 0 0% 0 0% 0 - 100.0 0 - 0 - 0 29 2 7% 1 3% Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 348 338 338 342 19 6% 8 2% 0 - - 0 - 0 - 0 341 23 7% 7 2% Total 6 519 6 498 4 611 4 096 239 6% 70 2% 0 0 97.9 942 3 1 061 5 214 3 960 291 7% 46 1% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 August 2022 DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in August 2021 to July 2022, WHO Western Pacific Region 2021 2022 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia 1 Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 Lao People's Democratic Republic Malaysia 1 Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Jan 2022 Country/area Dec May Jun JulNovSep 2021 OctAug Feb Mar Apr Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 August 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in August 2021 to July 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 August 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas MayMarFebJan 2022 Country/area JulSep Oct Nov JunAprDec 2021 Aug 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Apr May Jun Jul Australia 100% 100% 11 Feb 07 Mar 04 Apr 09 May 08 Jun 06 Jul 04 Aug 100% 86% Brunei Darussalam 100% 92% 07 Feb 08 Mar 09 Apr 05 May 04 Jun 04 Jul 06 Aug 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% China 100% 50% 18 Feb 15 Mar 15 Apr 17 May 16 Jun 04 Jul 15 Aug 100% 57% China, Hong Kong SAR 100% 100% 08 Feb 02 Mar 04 Apr 09 May 06 Jun 05 Jul 03 Aug 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 07 Apr 03 May 08 Jun 07 Jul 04 Aug 100% 100% Japan 100% 100% 03 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 02 Jul 08 Aug 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 09 May 09 Jun 06 Jul 09 Aug 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 09 Apr 09 May 10 Jun 10 Jul 14 Aug 100% 86% Philippines 100% 100% 10 Feb 04 Mar 08 Apr 10 May 08 Jun 10 Jul 10 Aug 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 07 Jul 10 Aug 100% 100% Singapore 100% 100% 07 Feb 02 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Aug 86% 86% Completeness 99% 100% 100% 100% 94% 100% 100% 100% 99% Timeliness 95% 82% 100% 100% 88% 94% 100% 100% 95% 1 National measles surveillance monthly reports from July 2022. Legend: black = timely report; red = untimely report 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting th di id d b th b f t d t f th Country 2021 Australia 100% 100% 02 Feb 04 Mar 06 Apr 05 May 07 Jun 07 Jul 02 Aug 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 05 May 02 Feb 04 Jul 09 Aug 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% China 100% 100% 10 Feb 04 Mar 15 Apr 17 May 01 Jun 05 Jul 10 Aug 100% 86% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 04 Apr 04 May 07 Jun 06 Jul 05 Aug 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 10 Apr 06 May 10 Jun 10 Jul - 86% 100% Japan 100% 100% 07 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 09 Aug 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 10 May 09 Jun 06-Jul 09 Aug 100% 100% Papua New Guinea 0% 0% - - - - - - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 10 Apr 10 May 10 Jun 09 Jul 10 Aug 100% 100% Republic of Korea 100% 92% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 08 Jul 09 Aug 100% 100% Singapore 100% 100% 07 Feb 07 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 100% 100% Fiji 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Jul 86% 86% Completeness 95% 95% 95% 95% 90% 95% 95% 90% 94% Timeliness 94% 95% 95% 95% 85% 95% 100% 90% 94% 1 National measles laboratory monthly reports from July 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Completeness 2 Timeliness 3 2022 1 Jan Feb Mar Apr May Jun Jul Country/area Completeness 2 Timeliness 3 2021

Volume 16 • Issue 9 • September 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–31 August 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, March–August 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 September 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 0 0 1 1 0 0 0 0 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 0 0 0 0 0 0 1 1 1 1 China 30 44 32 43 64 98 41 82 35 69 33 85 China, Hong Kong SAR 0 0 0 0 0 0 1 1 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 0 0 1 1 0 0 2 2 2 2 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 13 13 18 18 32 33 21 22 19 19 34 37 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 2 47 6 43 4 52 8 67 9 75 5 60 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 0 0 1 1 1 0 0 1 1 Viet Nam 2 2 0 1 0 7 1 1 0 0 0 1 Pacific island countries and areas 0 0 0 0 0 0 0 0 0 0 0 0 Western Pacific Region 47 106 56 105 101 192 74 175 66 166 76 187 1 Reports only confirmed cases "-" No data 2022 AugMayAprMar Country/area JulJun Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 September 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 September 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g 2017 2018 2019 2020 2021 2022 N um be r o f m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 September 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 September 2022 Imported Import-related Endemic Unknow n/ not reported Imported Import-related Endemic Unknow n/ not reported Australia 2014 0 - - - - - 1 1 0 0 0 100.0% Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 2 0 0 0 2 0.0% China - 505 0 0 0 505 0.0% 323 0 0 0 323 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 1 0 0 0 1 0.0% China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 5 0 0 0 5 0.0% Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 97 24 80.2% 170 2 0 127 41 75.9% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 36 0 0 33 3 91.7% Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 2 0 0 0 2 0.0% Viet Nam - 33 0 0 0 33 0.0% 3 1 0 0 2 33.3% Pacific island countries and areas - 2 0 0 0 2 0.0% 0 - - - - - Total 686 1 0 107 578 15.7% 543 4 0 160 379 30.2% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% Country/area Year verified 2022 No. of confirme d cases Source of infection % of cases with known source of infection 2021 No. of confirme d cases Source of infection % of cases with known source of infection 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 September 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 0 0.0 26.0 NA3 0 0 0 1 0 1 0.1 0 12-Jun-22 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 12 0 12 0 0 0 0 0.0 0 13-Sep-19 Cambodia 3 0.2 676 41.9 379 23.3 5 0.3 16.7 439 120 317 0 2 0 2 0.2 0 22-Aug-22 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1425.9 16 922 1 023 15 478 98 323 0 421 0.4 0 31-Aug-22 China, Hong Kong SAR 16 2.1 90 12.0 1 0.1 1 0.1 7.5 3 1 1 0 1 0 1 0.2 0 22-Jun-22 China, Macao SAR 3 4.7 37 56.3 0 0.0 0 0.0 0.7 7 0 7 0 0 0 0 0.0 0 6-May-19 Japan 284 2.2 763 6.1 12 0.1 6 0.0 124.3 57 1 51 0 5 0 5 0.1 0 23-Aug-22 Lao People's Democratic Republic 10 1.4 1 290 180.2 135 18.6 2 0.3 7.5 283 55 228 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 60.8 1 077 33.0 478 14.5 128 3.8 33.8 2 625 172 2 277 6 170 0 176 7.8 0 1-Sep-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 38 0 0 0 0 0.0 0 4-Mar-19 New Zealand 36 7.5 2 229 455.7 7 1.4 0 0.0 5.2 60 0 60 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.6 1 0.1 4 0.4 0 0.0 10.0 49 11 38 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 212.4 48 521 443.2 3 723 33.5 218 1.9 114.7 1 606 0 1 236 334 36 0 370 4.8 0 31-Aug-22 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.8 86 0 86 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.7 14 2.4 1 0.2 6.0 11 0 8 1 2 0 3 0.8 0 9-Aug-22 Viet Nam 1 247 13.2 5 723 60.0 713 7.4 163 1.7 97.8 283 124 144 12 2 1 15 0.2 0 6-Jun-22 Pacific island countries and areas4 0 0.0 6 346 1863.1 75 21.8 2 0.6 3.5 226 6 220 0 0 0 0 0.0 0 14-Nov-21 Western Pacific Region 30 575 16.0 64 177 33.4 6 370 3.3 1 080 0.6 1935.2 22 707 1 513 20 201 451 542 1 994 0.8 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 September 2022 Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases Country/area 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 September 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 4.0 Not applicable 100.0% 91.7% Cambodia 2.1 24.0% 96.3% 99.7% 2.9 32.0% 79.0% 70.6% China 2.0 0.0% 98.8% 97.9% 1.63 25.8% 98.1% 96.4% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable 66.7% 66.7% China, Macao SAR 3.4 Not applicable 91.3% 100.0% 1.5 Not applicable 100.0% 100.0% Japan 0.1 0.0% Insufficient data Insufficient data 0.1 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 4.6 50.0% 5.3% 4.9% Malaysia 6.1 62.5% 80.3% 96.8% 10.1 81.3% 55.5% 64.7% Mongolia 0.2 4.5% 100.0% 100.0% 1.7 13.6% 97.4% 60.5% New Zealand 1.4 15.0% Insufficient data Insufficient data 1.7 35.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.6 10.0% 83.7% 89.8% Philippines 0.6 0.0% 70.3% 72.8% 1.6 38.9% 68.4% 73.0% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.2 0.0% 76.7% 96.5% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 36.4% 27.3% Viet Nam 0.2 1.6% 38.9% 39.2% 0.2 3.2% 0.0% 28.0% Pacific island countries and areas4 2.5 0.0% 45.7% 95.7% 9.4 5.0% 97.3% 98.2% Western Pacific Region 1.7 6.9% 94.8% 95.4% 1.6 18.9% 87.7% 88.0% Green Yellow Red Substantially below target 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 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 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological bloc; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 September 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.0 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 12 4 8 0 0 0 0 0.0 - Cambodia 3 0.2 30 1.9 40 2.5 10 0.6 16.7 319 0 313 0 6 0 6 0.5 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 425.9 16 922 1 023 15 270 166 463 0 629 0.7 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.5 0 - - - - - - - - China, Macao SAR 1 1.6 79 120.2 3 4.5 0 0.0 0.7 7 0 7 0 0 0 0 0.0 - Japan 3 072 24.3 2 315 18.4 92 0.7 11 0.1 124.3 45 4 35 1 5 0 6 0.1 - Lao People's Democratic Republic 16 2.3 27 3.8 22 3.0 3 0.4 7.5 0 - - - - - - - - Malaysia 175 5.4 111 3.4 103 3.1 97 2.9 33.8 2 648 172 2 391 0 85 0 85 3.8 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 37 0 1 0 1 0.4 - New Zealand - - 1 0.2 - - 0 0.0 5.2 0 - - - - - - - - Papua New Guinea 3 0.3 5 0.5 2 0.2 0 0.0 10.0 49 11 35 0 3 0 3 0.4 - Philippines 152 1.4 198 1.8 404 3.6 36 0.3 114.7 1 606 0 1 574 0 32 0 32 0.4 - Republic of Korea 0 0.0 8 0.2 2 0.0 0 0.0 51.8 115 0 115 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 6.0 11 0 5 6 0 0 6 1.5 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 97.8 169 35 123 0 11 0 11 0.2 - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 226 10 215 0 1 0 1 0.4 - Western Pacific Region 7 487 3.9 35 484 18.5 3 019 1.6 1 046 0.5 1 935.2 22 167 1 259 20 128 173 607 0 780 0.6 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population "-" No data Red >= 10 confirmed cases / 1 000 000 population Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 September 2022 Gray No data 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. Total confirmed and clinically compatible 2019 Country/area Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 September 2022 Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS)Serum Blood % of samples with results ≤4 days Measles IgM equiv 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 September 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 2 2 2 0 - - - - 0 - - 0 - 2 1 1 0 - - - - Brunei Darussalam DLS 16 16 12 8 0 0% 0 0% 0 - 100.0 0 - 0 - 0 12 4 33% 0 0% Cambodia NIPH 328 328 328 328 1 0% 0 0% 0 - 92.7 0 - 0 - 1 329 6 2% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 154 154 158 154 3 2% 0 0% 0 - 95.3 0 - 38 0 3 66 0 0% 1 2% China, Macao SAR PHL 39 39 36 36 3 8% 0 0% 0 - 97.2 0 - 6 0 3 36 1 3% 0 0% Japan NIID 111 97 70 15 4 27% 4 27% 0 - - 4 4 34 1 4 10 5 50% 4 40% Lao People's Democratic Republic NCLE 1 1 1 0 - - - - 0 - - 0 - 0 - - 1 0 - 0 - Malaysia NPHL 4 390 4 390 2 742 2 650 224 8% 57 2% 0 - 98.9 722 0 811 0 224 2 562 187 7% 27 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 39 39 36 5 0 0% 0 0% 0 - 60.0 0 - 28 0 0 5 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 1 747 1 747 1 358 1 167 31 3% 11 1% 0 - 99.2 267 1 292 0 32 1 140 36 3% 12 1% Republic of Korea KCDC 251 251 165 65 8 12% 0 0% 0 - 91.2 0 - 67 3 8 101 76 75% 4 4% Singapore NPHL 127 127 127 1 0 - 0 - 0 - 100.0 1 0 127 1 1 1 0 - 0 - Viet Nam national lab (Northern) NIHE 50 50 50 50 0 - 0 - 0 - 100.0 0 - 0 - 0 20 4 - 5 - Viet Nam national lab (Southern) PI 59 59 59 59 0 0% 0 0% 0 - 100.0 0 - 0 - 0 10 2 20% 1 10% Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 441 435 435 435 23 5% 13 3% 0 - - 0 - 19 0 23 434 30 7% 8 2% Total 7 755 7 735 5 579 4 973 297 6% 85 2% 0 0 98.0 994 5 1 424 6 300 4 727 351 7% 62 1% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 September 2022 Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS)Serum Blood Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in September 2021 to August 2022, WHO Western Pacific Region 2021 2022 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia 1 Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 1 1 Lao People's Democratic Republic Malaysia 1 2 Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore 1 Viet Nam Pacific island countries and areas Jan 2022 Country/area Dec 2021 Oct JulJun AugNovSep Feb Mar Apr May Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 September 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in September 2021 to August 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 September 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China 8 China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Country/area AugOct Nov JulJunAprDec 2021 Sep MayMarFebJan 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Apr May Jun Jul Aug Australia 100% 100% 11 Feb 07 Mar 04 Apr 09 May 08 Jun 06 Jul 04 Aug 06 Sep 100% 88% Brunei Darussalam 100% 92% 07 Feb 08 Mar 09 Apr 05 May 04 Jun 04 Jul 06 Aug 06 Sep 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% China 100% 50% 18 Feb 15 Mar 15 Apr 17 May 16 Jun 04 Jul 15 Aug 02 Sep 100% 63% China, Hong Kong SAR 100% 100% 08 Feb 02 Mar 04 Apr 09 May 06 Jun 05 Jul 03 Aug 08 Sep 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 07 Apr 03 May 08 Jun 07 Jul 04 Aug 07 Sep 100% 100% Japan 100% 100% 03 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 01 Sep 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 02 Jul 08 Aug 08-Sep 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 09 May 09 Jun 06 Jul 09 Aug 06 Sep 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 09 Apr 09 May 10 Jun 10 Jul 14 Aug 10 Sep 100% 88% Philippines 100% 100% 10 Feb 04 Mar 08 Apr 10 May 08 Jun 10 Jul 10 Aug 08 Sep 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 07 Jul 10 Aug 08 Sep 100% 100% Singapore 100% 100% 07 Feb 02 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 07 Sep 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Aug 16 Sep 88% 75% Completeness 99% 100% 100% 100% 94% 100% 100% 100% 100% 99% Timeliness 95% 82% 100% 100% 88% 94% 100% 100% 94% 95% 1 National measles surveillance monthly reports from August 2022. Legend: black = timely report; red = untimely report Country 2021 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 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. 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 Australia 100% 100% 02 Feb 04 Mar 06 Apr 05 May 07 Jun 07 Jul 02 Aug 01 Sep 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 05 May 02 Feb 04 Jul 09 Aug 05 Sep 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% China 100% 100% 10 Feb 04 Mar 15 Apr 17 May 01 Jun 05 Jul 10 Aug 05 Sep 100% 88% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 04 Apr 04 May 07 Jun 06 Jul 05 Aug 09 Sep 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 10 Apr 06 May 10 Jun 10 Jul - 08 Sep 88% 100% Japan 100% 100% 07 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 01 Sep 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 09 Aug 09 Sep 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 10 May 09 Jun 06-Jul 09 Aug 06 Sep 100% 100% Papua New Guinea 0% 0% - - - - - - - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 10 Apr 10 May 10 Jun 09 Jul 10 Aug 09 Sep 100% 100% Republic of Korea 100% 92% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 08 Jul 09 Aug 14 Sep 100% 100% Singapore 100% 100% 07 Feb 07 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 07 Sep 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 100% 100% Fiji 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Jul 16 Sep 88% 75% Completeness 95% 95% 95% 95% 90% 95% 95% 90% 95% 94% Timeliness 94% 95% 95% 95% 85% 95% 100% 90% 85% 93% 1 National measles laboratory monthly reports from August 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Completeness 2 Timeliness 3 2021 Country/area May Jun Jul Aug Completeness 2 Timeliness 3 2022 1 Jan Feb Mar Apr

Volume 16 • Issue 10 • October 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–30 September 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, April–September 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 October 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 1 1 0 0 0 0 2 2 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 0 0 0 0 0 0 1 1 4 4 China 32 43 64 98 41 82 35 69 33 85 25 59 China, Hong Kong SAR 0 0 0 0 1 1 0 0 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 0 0 0 0 2 2 2 2 1 1 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 17 17 28 28 18 18 20 20 39 40 25 28 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 6 43 4 52 8 70 9 75 4 53 1 49 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 1 1 1 0 0 1 1 0 0 Viet Nam 0 1 0 7 1 3 0 0 1 4 2 5 Pacific island countries and areas 0 0 0 0 0 0 0 0 0 0 0 0 Western Pacific Region 55 104 96 186 71 176 66 166 81 186 60 148 1 Reports only confirmed cases "-" No data 2022 Aug SepJulJunMayApr Country/area Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 October 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 October 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p 2017 2018 2019 2020 2021 2022 N um be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 October 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 October 2022 Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 0 - - - - - 3 3 0 0 0 100.0% Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 6 0 0 0 6 0.0% China - 505 0 0 0 505 0.0% 361 0 0 0 361 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 1 0 0 0 1 0.0% China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 5 0 0 0 5 0.0% Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 97 24 80.2% 192 2 0 150 40 79.2% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 36 0 0 33 3 91.7% Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 2 0 0 0 2 0.0% Viet Nam - 33 0 0 0 33 0.0% 6 0 0 0 6 0.0% Pacific island countries and areas - 2 0 0 0 2 0.0% 0 - - - - - Total 686 1 0 107 578 15.7% 612 5 0 183 424 30.7% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% Country/area Year verified 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 October 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 0 0.0 26.0 NA3 0 0 0 3 0 3 0.2 0 21-Sep-22 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 16 0 16 0 0 0 0 0.0 0 13-Sep-19 Cambodia 3 0.2 676 41.9 379 23.3 5 0.3 16.7 582 0 576 0 6 0 6 0.5 0 18-Sep-22 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1425.9 20 183 1 024 18 712 86 361 0 447 0.4 0 31-Aug-22 China, Hong Kong SAR 16 2.1 90 12.0 1 0.1 1 0.1 7.5 3 1 1 0 1 0 1 0.2 0 22-Jun-22 China, Macao SAR 3 4.7 37 56.3 0 0.0 0 0.0 0.7 8 0 8 0 0 0 0 0.0 0 6-May-19 Japan 284 2.2 763 6.1 12 0.1 6 0.0 124.3 61 0 56 0 5 0 5 0.1 0 26-Sep-22 Lao People's Democratic Republic 10 1.4 1 290 180.2 135 18.6 2 0.3 7.5 330 102 228 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 60.8 1 077 33.0 478 14.5 128 3.8 33.8 3 054 237 2 620 5 192 0 197 7.8 0 22-Sep-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 38 0 0 0 0 0.0 0 4-Mar-19 New Zealand 36 7.5 2 229 455.7 7 1.4 0 0.0 5.2 78 0 78 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.6 1 0.1 4 0.4 0 0.0 10.0 49 11 38 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 212.4 48 521 443.2 3 723 33.5 218 1.9 114.7 1 737 0 1 324 377 36 0 413 4.8 0 5-Sep-22 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.8 101 0 101 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.7 14 2.4 1 0.2 6.0 13 0 10 1 2 0 3 0.7 0 9-Aug-22 Viet Nam 1 247 13.2 5 723 60.0 713 7.4 163 1.7 97.8 416 140 251 19 5 1 25 0.3 0 23-Sep-22 Pacific island countries and areas4 0 0.0 6 346 1863.1 75 21.8 2 0.6 3.5 273 9 264 0 0 0 0 0.0 0 14-Nov-21 Western Pacific Region 30 575 16.0 64 177 33.4 6 370 3.3 1 080 0.6 1935.2 26 942 1 524 24 321 488 611 1 1 100 0.8 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 October 2022 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Country/area Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 October 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 4.8 Not applicable 100.0% 93.8% Cambodia 2.1 24.0% 96.3% 99.7% 4.6 56.0% 91.6% 99.5% China 2.0 0.0% 98.8% 97.9% 1.75 25.8% 98.4% 97.4% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable 66.7% 66.7% China, Macao SAR 3.4 Not applicable 91.3% 100.0% 1.5 Not applicable 100.0% 100.0% Japan 0.1 0.0% Insufficient data Insufficient data 0.1 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 4.1 44.4% 4.5% 4.5% Malaysia 6.1 62.5% 80.3% 96.8% 10.4 81.3% 83.7% 96.9% Mongolia 0.2 4.5% 100.0% 100.0% 1.5 13.6% 97.4% 60.5% New Zealand 1.4 15.0% Insufficient data Insufficient data 2.0 40.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.5 10.0% 83.7% 89.8% Philippines 0.6 0.0% 70.3% 72.8% 1.5 38.9% 68.0% 72.5% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.3 0.0% 77.2% 96.0% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 30.8% 23.1% Viet Nam 0.2 1.6% 38.9% 39.2% 0.3 3.2% 0.0% 35.7% Pacific island countries and areas4 2.5 0.0% 45.7% 95.7% 10.0 5.0% 97.4% 98.5% Western Pacific Region 1.7 6.9% 94.8% 95.4% 1.7 20.8% 91.4% 93.1% Green Yellow Red Substantially below target 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 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 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological bloc; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 October 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.0 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 16 4 12 0 0 0 0 0.0 - Cambodia 3 0.2 30 1.9 40 2.5 10 0.6 16.7 582 0 568 0 14 0 14 1.1 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 425.9 20 183 1 024 18 491 163 505 0 668 0.6 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.5 0 - - - - - - - - China, Macao SAR 1 1.6 79 120.2 3 4.5 0 0.0 0.7 8 0 8 0 0 0 0 0.0 - Japan 3 072 24.3 2 315 18.4 92 0.7 11 0.1 124.3 50 2 38 1 9 0 10 0.1 - Lao People's Democratic Republic 16 2.3 27 3.8 22 3.0 3 0.4 7.5 0 - - - - - - - - Malaysia 175 5.4 111 3.4 103 3.1 97 2.9 33.8 3 092 237 2 753 0 102 0 102 4.0 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 37 0 1 0 1 0.4 - New Zealand - - 1 0.2 - - 0 0.0 5.2 0 - - - - - - - - Papua New Guinea 3 0.3 5 0.5 2 0.2 0 0.0 10.0 49 11 35 0 3 0 3 0.4 - Philippines 152 1.4 198 1.8 404 3.6 36 0.3 114.7 1 737 0 1 700 0 37 0 37 0.4 - Republic of Korea 0 0.0 8 0.2 2 0.0 0 0.0 51.8 136 0 136 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 6.0 12 0 6 6 0 0 6 1.3 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 97.8 285 40 228 1 16 0 17 0.2 - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 273 13 259 0 1 0 1 0.4 - Western Pacific Region 7 487 3.9 35 484 18.5 3 019 1.6 1 046 0.5 1 935.2 26 461 1 331 24 271 171 688 0 859 0.6 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population "-" No data Red >= 10 confirmed cases / 1 000 000 population Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 October 2022 Gray No data 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. Total confirmed and clinically compatible 2019 Country/area Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 September 2022 Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS)Serum Blood % of samples with results ≤4 days Measles IgM equiv 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 October 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 4 4 4 0 - - - - 0 - - 0 - 4 3 3 0 - - - - Brunei Darussalam DLS 20 20 16 12 0 0% 0 0% 0 - 100.0 0 - 0 - 0 16 4 25% 0 0% Cambodia NIPH 580 580 580 580 6 1% 0 0% 0 - 94.8 0 - 0 - 6 580 15 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 224 224 224 179 4 2% 0 0% 0 - 95.3 0 - 42 0 4 80 0 0% 1 1% China, Macao SAR PHL 43 43 43 40 3 8% 0 0% 0 - 97.5 0 - 6 0 3 40 1 3% 0 0% Japan NIID 124 107 74 16 5 31% 4 25% 0 - - 5 5 39 1 8 14 9 64% 4 29% Lao People's Democratic Republic NCLE 1 1 1 0 - - - - 0 - - 0 - 0 - - 1 0 - 0 - Malaysia NPHL 5 156 5 156 3 219 3 111 274 9% 74 2% 0 - 98.9 722 0 1 082 0 274 3 014 231 8% 31 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 53 53 53 8 0 0% 0 0% 0 - 75.0 0 - 45 0 0 8 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 1 975 1 958 1 547 1 358 40 3% 15 1% 0 - 99.1 295 1 323 0 41 1 322 43 3% 17 1% Republic of Korea KCDC 289 289 195 74 8 11% 0 0% 0 - 90.3 0 - 80 3 8 118 89 75% 5 4% Singapore NPHL 135 135 135 1 0 - 0 - 0 - 100.0 1 0 135 1 1 1 0 - 0 - Viet Nam national lab (Northern) NIHE 54 54 54 54 0 - 0 - 0 - 100.0 0 - 0 - 0 54 6 - 6 - Viet Nam national lab (Southern) PI 59 59 59 59 0 0% 0 0% 0 - 100.0 0 - 0 - 0 64 8 13% 1 2% Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 499 486 486 486 31 6% 14 3% 0 - - 0 - 19 0 31 485 37 8% 10 2% Total 9 216 9 169 6 690 5 978 371 6% 107 2% 0 0 98.1 1 023 6 1 775 8 379 5 797 443 8% 75 1% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 October 2022 DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in October 2021 to September 2022, WHO Western Pacific Region 2021 2022 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia 1 2 Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 1 1 Lao People's Democratic Republic Malaysia 1 2 1 Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore 1 Viet Nam Pacific island countries and areas Jan 2022 Country/area Dec JulJun SepNov Feb Mar Apr May Aug 2021 Oct Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 October 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in October 2021 to September 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 October 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China 8 China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas JulJunAprDec 2021 MayMarFebJan 2022 Aug SepOct NovCountry/area 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Apr May Jun Jul Aug Sep Australia 100% 100% 11 Feb 07 Mar 04 Apr 09 May 08 Jun 06 Jul 04 Aug 06 Sep 10 Oct 100% 89% Brunei Darussalam 100% 92% 07 Feb 08 Mar 09 Apr 05 May 04 Jun 04 Jul 06 Aug 06 Sep 04 Oct 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% China 100% 50% 18 Feb 15 Mar 15 Apr 17 May 16 Jun 04 Jul 15 Aug 02 Sep 12 Oct 100% 67% China, Hong Kong SAR 100% 100% 08 Feb 02 Mar 04 Apr 09 May 06 Jun 05 Jul 03 Aug 08 Sep 07 Oct 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 07 Apr 03 May 08 Jun 07 Jul 04 Aug 07 Sep 06 Oct 100% 100% Japan 100% 100% 03 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 01 Sep 05 Oct 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 02 Jul 08 Aug 08-Sep 05 Oct 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 09 May 09 Jun 06 Jul 09 Aug 06 Sep 10 Oct 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 09 Apr 09 May 10 Jun 10 Jul 14 Aug 10 Sep - 89% 78% Philippines 100% 100% 10 Feb 04 Mar 08 Apr 10 May 08 Jun 10 Jul 10 Aug 08 Sep 06 Oct 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 07 Jul 10 Aug 08 Sep 06 Oct 100% 100% Singapore 100% 100% 07 Feb 02 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 07 Sep 06 Oct 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Aug 16 Sep 10 Oct 89% 78% Completeness 99% 100% 100% 100% 94% 100% 100% 100% 100% 94% 99% Timeliness 95% 82% 100% 100% 88% 94% 100% 100% 94% 94% 95% 1 National measles surveillance monthly reports from September 2022. Legend: black = timely report; red = untimely report 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting month di ided b the n mber of e pected reports for the ear Country 2021 Australia 100% 100% 02 Feb 04 Mar 06 Apr 05 May 07 Jun 07 Jul 02 Aug 01 Sep 04 Oct 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 05 May 02 Feb 04 Jul 09 Aug 05 Sep 03 Oct 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% China 100% 100% 10 Feb 04 Mar 15 Apr 17 May 01 Jun 05 Jul 10 Aug 05 Sep 11 Oct 100% 100% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 04 Apr 04 May 07 Jun 06 Jul 05 Aug 09 Sep 07 Oct 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 10 Apr 06 May 10 Jun 10 Jul - 08 Sep 09 Oct 89% 100% Japan 100% 100% 07 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 01 Sep 05 Oct 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 09 Aug 09 Sep 10 Oct 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 10 May 09 Jun 06-Jul 09 Aug 06 Sep 10 Oct 100% 100% Papua New Guinea 0% 0% - - - - - - - - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 10 Apr 10 May 10 Jun 09 Jul 10 Aug 09 Sep 26 Oct 100% 89% Republic of Korea 100% 92% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 08 Jul 09 Aug 14 Sep 11 Oct 100% 78% Singapore 100% 100% 07 Feb 07 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 07 Sep 06 Oct 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 100% 100% Fiji 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Jul 16 Sep 10 Oct 89% 78% Completeness 95% 95% 95% 95% 90% 95% 95% 90% 95% 95% 94% Timeliness 94% 95% 95% 95% 85% 95% 100% 90% 85% 80% 92% 1 National measles laboratory monthly reports from September 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Completeness 2 Timeliness 3 2021 Country/area May Jun Jul Aug Sep Completeness 2 Timeliness 3 2022 1 Jan Feb Mar Apr

Volume 16 • Issue 11 • November 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–31 October 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, May–October 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 November 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 1 1 0 0 0 0 2 2 0 0 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 0 0 0 0 1 1 4 4 1 1 China 64 98 41 82 35 69 33 85 25 59 39 99 China, Hong Kong SAR 0 0 1 1 0 0 0 0 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 0 0 2 2 2 2 1 1 1 1 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 18 18 18 18 11 12 23 24 13 15 19 22 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 4 50 7 65 11 64 6 53 5 50 3 61 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 1 1 1 0 0 1 1 0 0 1 1 Viet Nam 0 7 1 3 0 0 1 4 2 5 0 5 Pacific island countries and areas 0 0 0 0 0 0 0 0 0 0 0 0 Western Pacific Region 86 174 70 171 59 147 67 170 52 136 64 190 1 Reports only confirmed cases "-" No data Country/area 2022 Aug OctJulJunMay Sep Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 November 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 November 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t 2017 2018 2019 2020 2021 2022 N um be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 November 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 November 2022 Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 0 - - - - - 3 3 0 0 0 100.0% Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 7 0 0 0 7 0.0% China - 505 0 0 0 505 0.0% 411 0 0 0 411 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 1 0 0 0 1 0.0% China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 6 0 0 0 6 0.0% Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 97 24 80.2% 158 4 0 118 36 77.2% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 47 0 0 40 7 85.1% Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 3 0 0 0 3 0.0% Viet Nam - 33 0 0 0 33 0.0% 9 0 0 0 9 0.0% Pacific island countries and areas - 2 0 0 0 2 0.0% 0 - - - - - Total 686 1 0 107 578 15.7% 645 7 0 158 480 25.6% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection Country/area Year verified 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 November 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 0 0.0 26.0 NA3 0 0 0 3 0 3 0.1 0 21-Sep-22 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 16 0 16 0 0 0 0 0.0 0 13-Sep-19 Cambodia 3 0.2 676 41.9 379 23.3 5 0.3 16.7 738 0 731 0 7 0 7 0.5 0 13-Oct-22 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1425.9 23 824 1 456 21 835 122 411 0 533 0.4 0 31-Oct-22 China, Hong Kong SAR 16 2.1 90 12.0 1 0.1 1 0.1 7.5 4 0 2 1 1 0 2 0.3 0 22-Jun-22 China, Macao SAR 3 4.7 37 56.3 0 0.0 0 0.0 0.7 10 0 10 0 0 0 0 0.0 0 6-May-19 Japan 284 2.2 763 6.1 12 0.1 6 0.0 124.3 66 0 60 0 6 0 6 0.1 0 18-Oct-22 Lao People's Democratic Republic 10 1.4 1 290 180.2 135 18.6 2 0.3 7.5 400 172 228 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 60.8 1 077 33.0 478 14.5 128 3.8 33.8 3 597 109 3 321 9 158 0 167 5.9 0 31-Oct-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 38 0 0 0 0 0.0 0 4-Mar-19 New Zealand 36 7.5 2 229 455.7 7 1.4 0 0.0 5.2 89 0 89 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.6 1 0.1 4 0.4 0 0.0 10.0 49 11 38 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 212.4 48 521 443.2 3 723 33.5 218 1.9 114.7 2 004 0 1 509 448 47 0 495 5.2 0 4-Oct-22 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.8 109 0 109 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.7 14 2.4 1 0.2 6.0 14 0 10 1 3 0 4 0.8 0 27-Oct-22 Viet Nam 1 247 13.2 5 723 60.0 713 7.4 163 1.7 97.8 607 226 349 23 8 1 32 0.4 0 23-Sep-22 Pacific island countries and areas4 0 0.0 6 346 1863.1 75 21.8 2 0.6 3.5 319 13 306 0 0 0 0 0.0 0 14-Nov-21 Western Pacific Region 30 575 16.0 64 177 33.4 6 370 3.3 1 080 0.6 1935.2 31 884 1 987 28 651 604 644 1 1 249 0.8 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 November 2022 Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases Country/area 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 November 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 4.3 Not applicable 100.0% 93.8% Cambodia 2.1 24.0% 96.3% 99.7% 5.3 60.0% 91.2% 99.6% China 2.0 0.0% 98.8% 97.9% 1.84 38.7% 98.3% 96.8% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable 75.0% 75.0% China, Macao SAR 3.4 Not applicable 91.3% 100.0% 1.7 Not applicable 100.0% 100.0% Japan 0.1 0.0% Insufficient data Insufficient data 0.1 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 3.7 38.9% 3.8% 3.8% Malaysia 6.1 62.5% 80.3% 96.8% 11.8 81.3% 56.0% 71.4% Mongolia 0.2 4.5% 100.0% 100.0% 1.4 4.5% 97.4% 60.5% New Zealand 1.4 15.0% Insufficient data Insufficient data 2.1 40.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.5 10.0% 83.7% 89.8% Philippines 0.6 0.0% 70.3% 72.8% 1.6 33.3% 92.5% 74.5% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.3 0.0% 78.0% 98.2% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 35.7% 28.6% Viet Nam 0.2 1.6% 38.9% 39.2% 0.4 3.2% 0.0% 31.0% Pacific island countries and areas4 2.5 5.0% 45.7% 95.7% 10.5 10.0% 86.2% 82.4% Western Pacific Region 1.7 7.3% 94.8% 95.4% 1.8 21.5% 89.3% 89.5% Green Yellow Red Substantially below target 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 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological bloc; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 November 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.0 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 16 4 12 0 0 0 0 0.0 - Cambodia 3 0.2 30 1.9 40 2.5 10 0.6 16.7 738 0 721 0 17 0 17 1.2 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 425.9 23 824 1 456 21 614 201 553 0 754 0.6 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.5 0 - - - - - - - - China, Macao SAR 1 1.6 79 120.2 3 4.5 0 0.0 0.7 10 0 10 0 0 0 0 0.0 - Japan 3 072 24.3 2 315 18.4 92 0.7 11 0.1 124.3 56 1 45 1 9 0 10 0.1 - Lao People's Democratic Republic 16 2.3 27 3.8 22 3.0 3 0.4 7.5 0 - - - - - - - - Malaysia 175 5.4 111 3.4 103 3.1 97 2.9 33.8 3 664 109 3 481 0 74 0 74 2.6 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 37 0 1 0 1 0.4 - New Zealand - - 1 0.2 - - 0 0.0 5.2 0 - - - - - - - - Papua New Guinea 3 0.3 5 0.5 2 0.2 0 0.0 10.0 49 11 35 0 3 0 3 0.4 - Philippines 152 1.4 198 1.8 404 3.6 36 0.3 114.7 2 004 0 1 961 0 43 0 43 0.5 - Republic of Korea 0 0.0 8 0.2 2 0.0 0 0.0 51.8 152 2 150 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 6.0 13 0 6 7 0 0 7 1.4 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 97.8 372 30 322 0 20 0 20 0.2 - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 319 14 304 0 1 0 1 0.3 - Western Pacific Region 7 487 3.9 35 484 18.5 3 019 1.6 1 046 0.5 1 935.2 31 255 1 627 28 698 209 721 0 930 0.6 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population "-" No data Red >= 10 confirmed cases / 1 000 000 population Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 November 2022 Gray No data 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. Total confirmed and clinically compatible 2019 Country/area Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 November 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 4 4 4 0 - - - - 0 - - 0 - 4 3 3 0 - - - - Brunei Darussalam DLS 22 22 18 14 0 0% 0 0% 0 - 100.0 0 - 0 - 0 18 4 22% 0 0% Cambodia NIPH 738 738 738 736 7 1% 0 0% 0 - 89.8 0 - 0 - 7 736 18 2% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 248 248 224 195 4 2% 0 0% 0 - 95.7 0 - 46 1 5 88 0 0% 1 1% China, Macao SAR PHL 48 48 45 45 3 7% 0 0% 0 - 97.8 0 - 6 0 3 45 1 2% 0 0% Japan NIID 132 117 85 17 5 29% 5 29% 0 - - 5 5 42 1 9 16 9 56% 6 38% Lao People's Democratic Republic NCLE 1 1 1 0 - - - - 0 - - 0 - 0 - - 1 0 - 0 - Malaysia NPHL 6 040 6 040 3 754 3 622 325 9% 98 3% 0 - 99.0 725 0 1 413 0 325 3 512 265 8% 33 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 65 65 59 10 0 0% 0 0% 0 - 80.0 0 - 45 0 0 9 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 2 178 2 178 1 734 1 523 43 3% 17 1% 3 0 98.8 344 1 359 0 44 1 486 46 3% 20 1% Republic of Korea KCDC 322 322 220 78 8 10% 0 0% 0 - 91.1 0 - 85 3 8 139 109 78% 5 4% Singapore NPHL 145 145 145 1 0 - 0 - 0 - 100.0 2 0 145 2 2 1 0 - 0 - Viet Nam national lab (Northern) NIHE 118 118 118 118 10 - 8 - 0 - 99.1 0 - 0 - 0 118 10 - 8 - Viet Nam national lab (Southern) PI 10 10 10 10 2 20% 1 10% 0 - 100.0 0 - 0 - 0 10 2 20% 1 10% Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 524 524 511 511 33 6% 16 3% 0 - - 0 - 33 0 31 510 38 7% 10 2% Total 10 595 10 580 7 666 6 880 440 6% 145 2% 3 0 97.6 1 076 6 2 178 10 437 6 689 502 8% 84 1% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 November 2022 Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in November 2021 to October 2022, WHO Western Pacific Region 2021 2022 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia 1 2 Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 1 1 Lao People's Democratic Republic Malaysia 1 2 1 Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore 1 1 Viet Nam Pacific island countries and areas JulJun OctNov Feb Mar Apr May Aug 2021 SepDecCountry/area Jan 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 November 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in November 2021 to October 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 November 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China 8 China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas JulJunAprDec 2021 MayMarFebJan 2022 Aug OctNovCountry/area Sep 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Apr May Jun Jul Aug Sep Oct Australia 100% 100% 11 Feb 07 Mar 04 Apr 09 May 08 Jun 06 Jul 04 Aug 06 Sep 10 Oct 10 Nov 100% 90% Brunei Darussalam 100% 92% 07 Feb 08 Mar 09 Apr 05 May 04 Jun 04 Jul 06 Aug 06 Sep 04 Oct - 90% 90% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% China 100% 50% 18 Feb 15 Mar 15 Apr 17 May 16 Jun 04 Jul 15 Aug 02 Sep 12 Oct 03 Nov 100% 70% China, Hong Kong SAR 100% 100% 08 Feb 02 Mar 04 Apr 09 May 06 Jun 05 Jul 03 Aug 08 Sep 07 Oct 08 Nov 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 07 Apr 03 May 08 Jun 07 Jul 04 Aug 07 Sep 06 Oct 07 Nov 100% 100% Japan 100% 100% 03 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 01 Sep 05 Oct 01 Nov 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 02 Jul 08 Aug 08-Sep 05 Oct 08 Nov 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 09 May 09 Jun 06 Jul 09 Aug 06 Sep 10 Oct 10 Nov 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 09 Apr 09 May 10 Jun 10 Jul 14 Aug 10 Sep - - 80% 70% Philippines 100% 100% 10 Feb 04 Mar 08 Apr 10 May 08 Jun 10 Jul 10 Aug 08 Sep 06 Oct 10 Nov 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 07 Jul 10 Aug 08 Sep 06 Oct 08 Nov 100% 100% Singapore 100% 100% 07 Feb 02 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 07 Sep 06 Oct 07 Nov 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Aug 16 Sep 10 Oct 15 Nov 90% 80% Completeness 99% 100% 100% 100% 94% 100% 100% 100% 100% 94% 88% 98% Timeliness 95% 82% 100% 100% 88% 94% 100% 100% 94% 94% 88% 94% 1 National measles surveillance monthly reports from October 2022. Legend: black = timely report; red = untimely report Country 2021 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting th di id d b th b f t d t f th 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 Australia 100% 100% 02 Feb 04 Mar 06 Apr 05 May 07 Jun 07 Jul 02 Aug 01 Sep 04 Oct 08 Nov 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 05 May 02 Feb 04 Jul 09 Aug 05 Sep 03 Oct 02 Nov 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% China 100% 100% 10 Feb 04 Mar 15 Apr 17 May 01 Jun 05 Jul 10 Aug 05 Sep 11 Oct 05 Nov 100% 100% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 04 Apr 04 May 07 Jun 06 Jul 05 Aug 09 Sep 07 Oct 07 Nov 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 10 Apr 06 May 10 Jun 10 Jul - 08 Sep 09 Oct 09 Nov 90% 90% Japan 100% 100% 07 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 01 Sep 05 Oct 01 Nov 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 09 Aug 09 Sep 10 Oct 09 Nov 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 10 May 09 Jun 06-Jul 09 Aug 06 Sep 10 Oct 04 Nov 100% 100% Papua New Guinea 0% 0% - - - - - - - - - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 10 Apr 10 May 10 Jun 09 Jul 10 Aug 09 Sep 26 Oct 10 Nov 100% 90% Republic of Korea 100% 92% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 08 Jul 09 Aug 14 Sep 11 Oct 10 Nov 100% 80% Singapore 100% 100% 07 Feb 07 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 07 Sep 06 Oct 07 Nov 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 100% 100% Fiji 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Jul 16 Sep 10 Oct 15 Nov 90% 80% Completeness 95% 95% 95% 95% 90% 95% 95% 90% 95% 95% 95% 94% Timeliness 94% 95% 95% 95% 85% 95% 100% 90% 85% 80% 95% 92% 1 National measles laboratory monthly reports from October 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Oct Completeness 2 Timeliness 3 2022 1 Jan Feb Mar Apr SepMay Jun Jul Aug Country/area Completeness 2 Timeliness 3 2021

Volume 16 • Issue 12 •December 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–30 November 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, June–November 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 December 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 1 1 0 0 0 0 2 2 0 0 3 3 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 0 0 1 1 4 4 1 1 0 6 China 41 82 35 69 33 85 25 59 39 99 23 66 China, Hong Kong SAR 1 1 0 0 0 0 0 0 0 0 1 1 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 2 2 1 2 1 1 1 1 0 0 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 13 13 10 10 28 28 20 20 32 33 23 23 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 8 69 11 73 6 58 6 69 5 62 3 24 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 1 1 0 0 1 1 0 0 1 1 0 0 Viet Nam 2 19 0 17 2 18 2 16 0 13 0 4 Pacific island countries and areas 0 0 0 0 0 0 0 0 0 0 0 2 Western Pacific Region 67 186 58 171 72 193 60 171 79 210 53 129 1 Reports only confirmed cases "-" No data Sep 2022 Aug NovJulJun Oct Country/area Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 December 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 December 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v 2017 2018 2019 2020 2021 2022 N um be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 December 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 December 2022 Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 0 - - - - - 6 6 0 0 0 100.0% Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 13 0 0 0 13 0.0% China - 505 0 0 0 505 0.0% 441 0 0 0 441 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 2 0 0 0 2 0.0% China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 5 0 0 0 5 0.0% Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 97 24 80.2% 184 5 0 137 42 77.2% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 53 0 0 46 7 86.8% Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 3 0 0 0 3 0.0% Viet Nam - 33 0 0 0 33 0.0% 10 0 0 0 10 0.0% Pacific island countries and areas - 2 0 0 0 2 0.0% 0 - - - - - Total 686 1 0 107 578 15.7% 717 11 0 183 523 27.1% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% Country/area Year verified 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 December 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 0 0.0 26.0 NA3 0 0 0 6 0 6 0.3 0 15-Nov-22 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 19 0 19 0 0 0 0 0.0 0 13-Sep-19 Cambodia 3 0.2 676 41.9 379 23.3 5 0.3 16.7 882 48 821 0 13 0 13 0.9 0 27-Nov-22 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1425.9 27 255 1 462 25 231 121 441 0 562 0.4 0 30-Nov-22 China, Hong Kong SAR 16 2.1 90 12.0 1 0.1 1 0.1 7.5 5 0 2 1 2 0 3 0.4 0 18-Nov-22 China, Macao SAR 3 4.7 37 56.3 0 0.0 0 0.0 0.7 11 0 11 0 0 0 0 0.0 0 6-May-19 Japan 284 2.2 763 6.1 12 0.1 6 0.0 124.3 75 0 69 1 5 0 6 0.1 0 18-Oct-22 Lao People's Democratic Republic 10 1.4 1 290 180.2 135 18.6 2 0.3 7.5 409 181 228 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 60.8 1 077 33.0 478 14.5 128 3.8 33.8 4 035 83 3 761 7 184 0 191 6.2 0 4-Dec-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 38 0 0 0 0 0.0 0 4-Mar-19 New Zealand 36 7.5 2 229 455.7 7 1.4 0 0.0 5.2 101 0 101 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.6 1 0.1 4 0.4 0 0.0 10.0 59 19 40 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 212.4 48 521 443.2 3 723 33.5 218 1.9 114.7 2 162 0 1 638 471 53 0 524 5.0 0 5-Nov-22 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.8 133 0 133 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.7 14 2.4 1 0.2 6.0 16 0 12 1 3 0 4 0.7 0 27-Oct-22 Viet Nam 1 247 13.2 5 723 60.0 713 7.4 163 1.7 97.8 791 290 375 116 9 1 126 1.4 1 23-Sep-22 Pacific island countries and areas4 0 0.0 6 346 1863.1 75 21.8 2 0.6 3.5 332 14 316 2 0 0 2 0.6 0 14-Nov-21 Western Pacific Region 30 575 16.0 64 177 33.4 6 370 3.3 1 080 0.6 1935.2 36 323 2 097 32 795 720 716 1 1 437 0.8 1 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 November 2022 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Country/area Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 December 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 4.6 Not applicable 100.0% 94.7% Cambodia 2.1 24.0% 96.3% 99.7% 5.4 60.0% 90.6% 99.5% China 2.0 0.0% 98.8% 97.9% 1.93 35.5% 98.5% 97.3% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable 80.0% 80.0% China, Macao SAR 3.4 Not applicable 91.3% 100.0% 1.7 Not applicable 100.0% 100.0% Japan 0.1 0.0% Insufficient data Insufficient data 0.1 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 3.3 27.8% 3.7% 3.7% Malaysia 6.1 62.5% 80.3% 96.8% 12.2 81.3% 81.3% 98.6% Mongolia 0.2 4.5% 100.0% 100.0% 1.2 4.5% 97.4% 60.5% New Zealand 1.4 15.0% Insufficient data Insufficient data 2.1 35.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.4 5.0% 81.4% 88.1% Philippines 0.6 0.0% 70.3% 72.8% 1.6 38.9% 85.7% 72.7% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.3 0.0% 68.4% 98.5% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 31.3% 37.5% Viet Nam 0.2 1.6% 38.9% 39.2% 0.4 6.3% 0.0% 34.7% Pacific island countries and areas4 2.5 5.0% 45.7% 95.7% 9.8 10.0% 97.6% 98.2% Western Pacific Region 1.7 7.3% 94.8% 95.4% 1.8 20.8% 91.8% 93.1% Green Yellow Red Substantially below target 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 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 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological bloc; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 December 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.0 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 19 4 15 0 0 0 0 0.0 - Cambodia 3 0.2 30 1.9 40 2.5 10 0.6 16.7 830 0 813 0 17 0 17 1.1 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 425.9 27 255 1 462 24 969 217 605 2 824 0.6 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.5 2 0 1 0 1 0 1 0.1 - China, Macao SAR 1 1.6 79 120.2 3 4.5 0 0.0 0.7 11 0 11 0 0 0 0 0.0 - Japan 3 072 24.3 2 315 18.4 92 0.7 11 0.1 124.3 68 0 54 1 13 0 14 0.1 - Lao People's Democratic Republic 16 2.3 27 3.8 22 3.0 3 0.4 7.5 228 0 228 0 0 0 0 0.0 - Malaysia 175 5.4 111 3.4 103 3.1 97 2.9 33.8 4 101 83 3 939 0 79 0 79 2.6 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 37 0 1 0 1 0.3 - New Zealand - - 1 0.2 - - 0 0.0 5.2 0 - - - - - - - - Papua New Guinea 3 0.3 5 0.5 2 0.2 0 0.0 10.0 59 19 37 0 3 0 3 0.3 - Philippines 152 1.4 198 1.8 404 3.6 36 0.3 114.7 2 162 0 2 114 0 48 0 48 0.5 - Republic of Korea 0 0.0 8 0.2 2 0.0 0 0.0 51.8 183 0 183 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 6.0 14 0 7 7 0 0 7 1.3 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 97.8 412 51 332 8 21 0 29 0.3 - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 332 14 317 0 1 0 1 0.3 - Western Pacific Region 7 487 3.9 35 484 18.5 3 019 1.6 1 046 0.5 1 935.2 35 714 1 633 33 057 233 789 2 1 024 0.6 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2022 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population "-" No data Red >= 10 confirmed cases / 1 000 000 population Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 December 2022 Gray No data 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. Total confirmed and clinically compatible 2019 Country/area Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 December 2022 Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 December 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 4 4 4 0 - - - - 0 - - 0 - 4 3 3 0 - - - - Brunei Darussalam DLS 23 23 19 15 0 0% 0 0% 0 - 100.0 0 - 0 - 0 19 4 21% 0 0% Cambodia NIPH 828 828 828 828 9 1% 0 0% 0 - 91.0 0 - 0 - 7 827 18 2% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 273 273 224 217 5 2% 0 0% 0 - 96.2 0 - 50 1 6 97 0 0% 1 1% China, Macao SAR PHL 49 49 46 46 3 7% 0 0% 0 - 97.8 0 - 6 0 3 46 1 2% 0 0% Japan NIID 156 141 102 20 5 25% 6 30% 0 - - 5 5 47 1 9 24 13 54% 8 33% Lao People's Democratic Republic NCLE 1 1 1 0 - - - - 0 - - 0 - 0 - - 1 0 - 0 - Malaysia NPHL 6 809 6 809 4 223 4 061 376 9% 115 3% 0 - 99.0 726 0 1 702 0 376 3 938 294 7% 38 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 72 72 64 10 0 0% 0 0% 0 - 80.0 1 0 61 0 0 10 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 2 179 2 162 1 734 1 668 43 3% 20 1% 3 0 98.8 341 1 387 0 44 1 628 56 3% 18 1% Republic of Korea KCDC 380 380 234 93 9 10% 0 0% 0 - 91.8 0 - 106 3 9 159 122 77% 8 5% Singapore NPHL 159 159 159 3 1 - 0 - 0 - 100.0 2 1 159 2 2 3 1 - 0 - Viet Nam national lab (Northern) NIHE 178 178 178 178 4 - 6 - 0 - 99.1 0 - 0 - 4 176 14 - 10 - Viet Nam national lab (Southern) PI 10 10 10 10 2 20% 1 10% 0 - 100.0 0 - 0 - 0 10 2 20% 1 10% Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 549 536 536 536 33 6% 19 4% 0 - - 0 - 19 0 33 535 38 7% 11 2% Total 11 670 11 625 8 362 7 685 490 6% 167 2% 3 0 97.6 1 075 7 2 541 10 496 7 473 563 8% 95 1% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 December 2022 Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in December 2021 to November 2022, WHO Western Pacific Region 2021 2022 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia 1 2 3 Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 1 1 Lao People's Democratic Republic Malaysia 1 2 1 Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore 1 1 Viet Nam Pacific island countries and areas JulJun NovFeb Mar Apr May Aug 2021 SepDecCountry/area OctJan 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 December 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in December 2021 to November 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 December 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China 8 China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas JulJunAprDec 2021 MayMarFebJan 2022 Aug NovCountry/area OctSep 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Australia 100% 100% 11 Feb 07 Mar 04 Apr 09 May 08 Jun 06 Jul 04 Aug 06 Sep 10 Oct 10 Nov 09 Dec 100% 91% Brunei Darussalam 100% 92% 07 Feb 08 Mar 09 Apr 05 May 04 Jun 04 Jul 06 Aug 06 Sep 04 Oct - 06 Dec 91% 91% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% China 100% 50% 18 Feb 15 Mar 15 Apr 17 May 16 Jun 04 Jul 15 Aug 02 Sep 12 Oct 03 Nov 02 Dec 100% 73% China, Hong Kong SAR 100% 100% 08 Feb 02 Mar 04 Apr 09 May 06 Jun 05 Jul 03 Aug 08 Sep 07 Oct 08 Nov 09 Dec 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 07 Apr 03 May 08 Jun 07 Jul 04 Aug 07 Sep 06 Oct 07 Nov 09 Dec 100% 100% Japan 100% 100% 03 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 01 Sep 05 Oct 01 Nov 06 Dec 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 02 Jul 08 Aug 08-Sep 05 Oct 08 Nov 09 Dec 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 09 May 09 Jun 06 Jul 09 Aug 06 Sep 10 Oct 10 Nov 07 Dec 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 09 Apr 09 May 10 Jun 10 Jul 14 Aug 10 Sep - - 13 Dec 82% 64% Philippines 100% 100% 10 Feb 04 Mar 08 Apr 10 May 08 Jun 10 Jul 10 Aug 08 Sep 06 Oct 10 Nov 02 Dec 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 07 Jul 10 Aug 08 Sep 06 Oct 08 Nov 09 Dec 100% 100% Singapore 100% 100% 07 Feb 02 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 07 Sep 06 Oct 07 Nov 07 Dec 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Aug 16 Sep 10 Oct 15 Nov 15 Dec 91% 82% Completeness 99% 100% 100% 100% 94% 100% 100% 100% 100% 94% 88% 100% 98% Timeliness 95% 82% 100% 100% 88% 94% 100% 100% 94% 94% 88% 94% 94% 1 National measles surveillance monthly reports from December 2022. Legend: black = timely report; red = untimely report Country 2021 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting th di id d b th b f t d t f th 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 Australia 100% 100% 02 Feb 04 Mar 06 Apr 05 May 07 Jun 07 Jul 02 Aug 01 Sep 04 Oct 08 Nov 02 Dec 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 05 May 02 Feb 04 Jul 09 Aug 05 Sep 03 Oct 02 Nov 06 Dec 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% China 100% 100% 10 Feb 04 Mar 15 Apr 17 May 01 Jun 05 Jul 10 Aug 05 Sep 11 Oct 05 Nov 09 Dec 100% 100% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 04 Apr 04 May 07 Jun 06 Jul 05 Aug 09 Sep 07 Oct 07 Nov 07 Dec 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 10 Apr 06 May 10 Jun 10 Jul - 08 Sep 09 Oct 09 Nov 10 Dec 91% 91% Japan 100% 100% 07 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 01 Aug 01 Sep 05 Oct 01 Nov 06 Dec 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 09 Aug 09 Sep 10 Oct 09 Nov 10 Dec 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 10 May 09 Jun 06-Jul 09 Aug 06 Sep 10 Oct 04 Nov 07 Dec 100% 100% Papua New Guinea 0% 0% - - - - - - - - - - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 10 Apr 10 May 10 Jun 09 Jul 10 Aug 09 Sep 26 Oct 10 Nov 06 Dec 100% 91% Republic of Korea 100% 92% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 08 Jul 09 Aug 14 Sep 11 Oct 10 Nov 10 Dec 100% 82% Singapore 100% 100% 07 Feb 07 Mar 04 Apr 06 May 03 Jun 07 Jul 03 Aug 07 Sep 06 Oct 07 Nov 07 Dec 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 100% 100% Fiji 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 15 Jul 16 Sep 10 Oct 15 Nov 15 Dec 91% 82% Completeness 95% 95% 95% 95% 90% 95% 95% 90% 95% 95% 95% 95% 94% Timeliness 94% 95% 95% 95% 85% 95% 100% 90% 85% 80% 95% 95% 92% 1 National measles laboratory monthly reports from December 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Oct Nov Completeness 2 Timeliness 3 2022 1 Jan Feb Mar Apr SepMay Jun Jul Aug Country/area Completeness 2 Timeliness 3 2021

Volume 16 • Issue 1 • January 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–31 December 2021, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, July–December 2021, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 January 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 0 0 0 0 0 0 0 0 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 0 0 0 0 0 0 1 1 0 0 China 40 53 42 51 35 69 32 54 43 85 - - China, Hong Kong SAR 0 0 1 1 0 0 0 1 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 0 0 0 0 1 1 0 0 1 1 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 5 5 4 6 3 4 7 7 11 11 6 10 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 2 11 0 15 0 10 0 19 0 24 0 20 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 0 0 0 0 0 0 0 0 0 Viet Nam 0 5 0 7 0 6 0 3 0 2 0 4 Pacific island countries and areas 0 0 0 0 0 0 0 0 3 3 0 0 Western Pacific Region 47 74 47 80 38 89 40 85 58 126 7 35 1 Reports only confirmed cases "-" No data Dec Country/area 2021 OctJul Aug Sep Nov Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 January 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2016–2021 as of 20 January 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c 2016 2017 2018 2019 2020 2021 N um be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 January 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 January 2022 Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 25 12 4 0 9 64.0% 0 - - - - - Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 379 0 0 0 379 0.0% 5 0 0 0 5 0.0% China - 829 0 0 0 829 0.0% 439 0 0 0 439 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 1 0 0 0 1 0.0% China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 11 3 1 0 7 36.4% 5 1 0 0 4 20.0% Lao People's Democratic Republic - 132 0 0 0 132 0.0% 2 0 0 0 2 0.0% Malaysia - 473 1 0 416 56 88.2% 107 0 0 87 20 81.3% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 7 1 3 0 3 57.1% 0 - - - - - Papua New Guinea - 3 0 0 0 3 0.0% 0 - - - - - Philippines - 955 54 0 664 237 75.2% 12 0 0 10 2 83.3% Republic of Korea 2014 6 6 0 0 0 100.0% 0 - - - - - Singapore 2018 12 2 0 0 10 16.7% 0 - - - - - Viet Nam - 342 0 0 0 342 0.0% 33 0 0 0 33 0.0% Pacific island countries and areas - 75 0 0 0 72 0.0% 3 0 0 0 3 0.0% Total 3 250 79 8 1 080 2 080 35.9% 607 1 0 97 509 16.1% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% Country/area Year verified 2021 No. of confirmed cases Source of infection % of cases with known source of infection 2020 No. of confirmed cases Source of infection % of cases with known source of infection 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2017—2021 as of 20 January 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 81 3.3 101 4.1 285 11.3 25 1.0 25.8 NA3 - - - - - - - - 26-Feb-20 Brunei Darussalam 0 0.0 1 2.3 1 2.3 0 0.0 0.4 18 0 18 0 0 0 0 0.0 0 13-Sep-19 Cambodia 10 0.6 3 0.2 676 41.0 379 22.7 16.9 355 3 347 0 5 0 5 0.3 0 28-Nov-21 China 5 993 4.2 3 975 2.8 3 098 2.2 867 0.6 1444.2 25 138 1 787 22 802 110 438 1 549 0.4 0 30-Nov-21 China, Hong Kong SAR 4 0.5 16 2.2 90 12.1 1 0.1 7.6 1 0 0 0 1 0 1 0.1 0 19-Aug-21 China, Macao SAR 2 3.2 3 4.7 36 56.2 0 0.0 0.7 23 0 23 0 0 0 0 0.0 0 6-May-19 Japan 188 1.5 279 2.2 761 6.0 12 0.1 126.1 110 1 103 1 5 0 6 0.0 0 7-Dec-21 Lao People's Democratic Republic 3 0.4 10 1.4 1 119 156.1 135 18.6 7.4 45 3 40 0 2 0 2 0.3 0 5-Feb-21 Malaysia 1 693 54.4 1 958 62.1 1 077 33.7 478 14.8 32.8 2 152 111 1 922 12 107 0 119 3.6 0 28-Dec-21 Mongolia 9 2.9 1 0.3 2 0.6 0 0.0 3.3 6 1 5 0 0 0 0 0.0 0 4-Mar-19 New Zealand 15 3.2 36 7.6 2 229 466.0 7 1.5 4.9 72 1 71 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 7 0.8 15 1.7 1 0.1 4 0.4 9.1 8 0 8 0 0 0 0 0.0 0 7-Sep-20 Philippines 2 432 23.1 22 869 214.4 48 521 448.8 3 832 35.0 111.0 879 0 661 206 12 0 218 2.0 0 25-Jul-21 Republic of Korea 7 0.1 19 0.4 191 3.7 6 0.1 51.3 211 0 211 0 0 0 0 0.0 0 10-Feb-20 Singapore 81 14.2 37 6.4 162 27.9 14 2.4 5.9 8 0 7 1 0 0 1 0.2 0 9-Oct-20 Viet Nam 592 6.3 1 249 13.1 5 004 51.9 713 7.3 98.2 701 362 166 130 33 0 163 1.7 0 19-Jun-21 Pacific island countries and areas4 2 0.6 0 0.0 6 346 1885.5 75 22.0 3.5 94 5 85 0 3 0 3 0.9 0 14-Nov-21 American Samoa - - - - 31 560.5 2 36.2 0.1 0 - - - - - - - - 19-Jan-20 Fiji 1 1.1 0 0.0 31 34.8 3 3.3 0.9 94 5 85 0 3 0 3 3.3 0 14-Nov-21 Kiribati - - - - - - 1 8.4 0.1 0 - - - - - - - - 3-Jan-20 New Caledonia 1 3.6 0 0.0 0 0.0 - - 0.3 0 - - - - - - - - 10-Jan-17 Samoa - - - - 5 689 28864.5 18 90.7 0.2 0 - - - - - - - - 13-Jan-20 Solomon Islands 0 0.0 0 0.0 - - - - 0.7 0 - - - - - - - - 21-Jan-16 Tonga - - - - 608 5818.3 51 482.5 0.1 0 - - - - - - - - 13-Feb-20 Western Pacific Region 11 119 5.8 30 572 15.9 63 284 32.8 6 479 3.3 1949.0 29 821 2 274 26 469 460 606 1 1 067 0.5 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. 2021 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases Pending classification Discarded cases3 Measles cases Deaths due to measles 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 20182017 Country/area Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2020—2021 as of 20 January 2022 Discarded non-measles rate per 100 000 pop Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.3 Not applicable 94.7% 68.4% 4.1 Not applicable 100.0% 100.0% Cambodia 14.8 100.0% 93.2% 98.5% 2.0 24.0% 96.3% 99.7% China 2.0 32.3% 101.5% 96.1% 1.6 0.0% 98.0% 96.2% China, Hong Kong SAR 0.1 Not applicable 100.0% 85.7% 0.0 Not applicable 100.0% 100.0% China, Macao SAR 1.5 Not applicable 100.0% 100.0% 3.5 Not applicable 91.3% 100.0% Japan 0.2 0.0% Insufficient data Insufficient data 0.1 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 4.7 61.1% 68.6% 70.1% 0.5 5.6% 46.7% 77.8% Malaysia 15.2 87.5% 88.7% 97.4% 5.9 62.5% 80.9% 97.5% Mongolia 3.0 22.7% 100.0% 100.0% 0.2 4.5% 100.0% 100.0% New Zealand 5.0 60.0% Insufficient data Insufficient data 1.5 15.0% Insufficient data Insufficient data Papua New Guinea 1.4 20.0% 83.3% 94.7% 0.1 0.0% 100.0% 87.5% Philippines 1.0 11.1% 43.3% 49.2% 0.6 0.0% 70.3% 72.8% Republic of Korea 0.6 0.0% 61.5% 95.7% 0.4 0.0% 92.9% 94.8% Singapore 0.3 Not applicable 61.8% 76.5% 0.1 Not applicable 25.0% 25.0% Viet Nam 0.4 6.3% 30.1% 43.1% 0.2 1.6% 38.9% 39.2% Pacific island countries and areas4 5.0 5.0% Insufficient data Insufficient data 2.5 0.0% Insufficient data Insufficient data Western Pacific Region 2.0 27.8% 87.4% 87.2% 1.4 6.9% 93.5% 93.3% Green Reached or surpassed target Yellow 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 Red Substantially below target Country/area 2020 Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% ≥ 80% 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological block; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2017–2021 as of 20 January 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 25.8 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 18 0 18 0 0 0 0 0.0 - Cambodia 7 0.4 3 0.2 30 1.8 40 2.4 16.9 355 0 342 0 10 0 10 0.6 - China 1 601 1.1 3 935 2.8 32 568 22.9 2 202 1.5 1 444.2 25 138 1 787 22 571 179 533 68 780 0.5 - China, Hong Kong SAR 1 0.1 11 1.5 48 6.4 4 0.5 7.6 3 0 0 0 2 0 2 0.3 - China, Macao SAR 0 0.0 1 1.6 78 121.5 3 4.6 0.7 23 0 23 0 0 0 0 0.0 - Japan3 5 0.0 68 0.5 2 394 18.9 99 0.8 126.1 162 0 70 0 11 0 11 0.1 - Lao People's Democratic Republic 12 1.7 15 2.1 11 1.6 22 3.1 7.4 45 3 39 0 3 0 3 0.4 - Malaysia 113 3.6 175 5.6 111 3.4 103 3.1 32.8 2 183 111 1 980 0 92 0 92 2.8 - Mongolia 13 4.2 1 0.3 2 0.6 0 0.0 3.3 6 0 5 0 0 0 0 0.0 - New Zealand - - - - 1 0.2 - - 4.9 0 0 5 0 0 0 0 0.0 - Papua New Guinea 1 0.1 1 0.1 5 0.6 2 0.2 9.1 8 0 8 0 0 0 0 0.0 - Philippines 448 4.3 152 1.4 198 1.8 382 3.5 111.0 879 0 843 0 36 0 36 0.3 - Republic of Korea 2 0.0 0 0.00 8 0.2 2 0.0 51.3 358 1 179 0 0 0 0 0.0 - Singapore 3 0.5 16 2.8 7 1.2 10 1.7 5.9 15 0 2 0 0 0 0 0.0 - Viet Nam 126 1.3 102 1.1 85 0.9 135 1.4 98.2 701 59 106 33 5 0 38 0.4 - Pacific island countries and areas2 4 1.2 0 0.0 0 0.0 0 0.0 3.5 94 3 86 0 4 0 4 1.2 - Fiji 4 4.6 0 0.0 0 0.0 0 0.0 0.9 94 3 86 0 4 0 4 4.4 - Kiribati - - - - - - 0 0.0 0.1 0 - - - - - - - - New Caledonia 0 0.0 0 0.0 0 0.0 - - 0.3 0 - - - - - - - - Solomon Islands 0 0.0 - - - - - - 0.7 0 - - - - - - - - Vanuatu - - - - - - - - 0.0 0 - - - - - - - - Western Pacific Region 2 336 1.2 4 480 2.3 35 546 18.5 3 004 1.6 1 949.0 29 988 1 964 26 277 212 696 68 976 0.5 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Rubella cases are cases reported as suspected measles cases that were identified as rubella laboratory confirmed cases during the investigation. This represents a small proportion of a large number of rubella cases occurring in Japan during 2018 Red >= 10 confirmed cases / 1 000 000 population "-" No data Gray No data 2021 Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases Total confirmed and clinically compatible Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. Total confirmed and clinically compatible Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2019 Country/area Total confirmed and clinically compatible 20202017 Rubella incidence per 1 million pop. 2018 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2020 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 21 21 20 0 - - - - 0 - - 3 0 21 20 20 0 - - - - Brunei Darussalam DLS 19 19 19 19 0 0% 0 0% 0 - 95.8 0 - 0 - 0 19 0 0% 0 0% Cambodia NIPH 2 595 2 595 2 595 2 564 369 14% 0 0% 31 1 94.2 0 - 0 - 362 2 077 18 1% 0 0% China CCDC - - - - - - - - 0 - 95.8 - - - - - - - - - - China, Hong Kong SAR PHLC 427 427 369 332 3 1% 3 1% 0 - 96.3 0 - 111 0 3 196 6 3% 2 1% China, Macao SAR PHL 82 82 70 70 5 7% 1 1% 0 - 100.0 2 0 19 0 5 70 2 3% 0 0% Japan NIID 835 811 511 76 10 13% 26 34% 0 - - 0 - 253 4 11 118 63 53% 22 19% Lao People's Democratic Republic NCLE 271 271 271 271 37 14% 14 5% 0 - 70.6 0 - 0 - 36 270 15 6% 9 3% Malaysia NPHL 10 456 10 456 6 900 6 374 625 10% 145 2% 0 - 88.2 2 913 0 0 - 625 5 416 301 6% 99 2% Mongolia NCCD 97 97 97 97 0 0% 0 0% 0 - 100.0 0 - 0 - 0 97 0 0% 0 0% New Zealand CHL 126 126 117 19 1 5% 1 5% 0 - 94.7 0 - 107 7 7 11 0 0% 0 0% Papua New Guinea CPHL 135 135 134 134 7 5% 1 1% 0 - 66.4 0 - 0 - 7 134 2 1% 3 2% Philippines RITM 2 787 2 579 2 538 2 569 1 064 41% 69 3% 8 1 95.5 0 - 185 54 1 108 1 514 417 28% 35 2% Republic of Korea KCDC 705 705 465 315 24 8% 14 4% 0 - 88.8 0 - 293 14 31 185 64 35% 8 4% Singapore NPHL 344 344 332 23 2 9% 1 4% 0 - 87.0 12 1 294 10 13 23 0 0% 0 0% Viet Nam national lab (Northern) NIHE 99 99 99 99 58 - 0 - 0 - - 0 - 0 - 58 34 3 - 2 - Viet Nam national lab (Southern) PI 760 760 760 760 462 61% 7 1% 0 - - 0 - 0 - 462 255 26 10% 5 2% Viet Nam subnational lab (Central) PI 30 30 30 30 19 - 0 - 0 - - 0 - 0 - 19 28 1 - 0 0% Viet Nam subnational lab (Highland) IHE 1 1 1 1 1 100% 0 0% 0 - - 0 - 0 - 1 0 - - - - Fiji FCCDC 214 202 202 201 5 2% 10 5% 0 - - 0 - 2 0 5 112 0 0% 3 3% Total 20 004 19 760 15 530 13 954 2 692 19% 292 2% 39 2 90.8 2 930 1 1 285 109 2 773 10 559 918 9% 188 2% "-" No data DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 as of 20 January 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - - - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 818 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 564 564 358 176 11 6% 3 2% - 87.9 0 - 182 13 22 165 88 53% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 - 0 - 0 - - 0 - 0 - 4 6 0 - 0 - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 414 7 267 5 442 4 629 244 5% 97 2% 1 0 93.4 838 8 689 21 270 4 390 406 9% 96 2% "-" No data Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv 8Figure 3. Measles genotype distribution of cases with rash onset in 2020 and 2021, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in January to December 2021, WHO Western Pacific Region 2020 2021 B3 D8 D9 H1 B3 D8 D9 H1 B3 D4 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia 1 Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas NovSepJulJan 2021 Feb Mar Apr May Jun DecCountry/area OctAug Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 January 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2020 and 2021, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in January to December 2021, WHO Western Pacific Region 2020 2021 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 January 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China 7 2 1 China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Jan 2021 Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecCountry/area 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2020—2021 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2020—2021 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Australia 100% 92% 03 Feb 03 Mar 07 Apr 06 May 08 Jun 05 Jul 05 Aug 07 Sep 08 Oct 05 Nov 10 Dec 10 Jan 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 10 May 05 Jun 08 Jul 05 Aug 06 Sep 07 Oct 01 Nov 03 Dec 15 Jan 100% 92% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 20 Dec 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% China 100% 100% 18 Feb 22 Mar 20 Apr 22 May 29 Jul 13 Jul 09 Aug 15 Sep 12 Oct 08 Nov 16 Dec 17 Jan 100% 50% China, Hong Kong SAR 100% 100% 05 Feb 09 Mar 08 Apr 07 May 07 Jun 07 Jul 04 Aug 06 Sep 07 Oct 04 Nov 07 Dec 07 Jan 100% 100% China, Macao SAR 100% 100% 08 Feb 03 Mar 31 Mar 07 May 04 Jun 07 Jul 07 Aug 06 Sep 07 Oct 05 Nov 09 Dec 04 Jan 100% 100% Japan 92% 25% 07 Feb 07 Mar 08 Apr 06 May 07 Jun 06 Jul 10 Aug 02 Sep 04 Oct 02 Nov 03 Dec 07 Jan 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% Malaysia 100% 92% 09 Feb 10 Mar 10 Apr 10 May 10 Jun 06 Jul 10 Aug 10-Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 05 Nov 10 Dec 10 Jan 100% 100% New Zealand 100% 100% 05 Feb 02 Mar 09 Apr 08 May 09 Jun 08 Jul 10 Aug 03 Sep 10 Oct 08 Nov 09 Dec 07 Jan 100% 100% Papua New Guinea 100% 83% 10 Feb - - 10 May 08 Jun 09 Jul 10 Aug 10 Sep 10 Oct 09 Nov 10 Dec 10 Jan 83% 83% Philippines 100% 75% 08 Feb 08 Mar 07 Apr 30 Apr 08 Jun 10 Jul 10 Aug 08 Sep 02 Oct 01 Nov 01 Dec 04 Jan 100% 100% Republic of Korea 100% 100% 10 Feb 09 Mar 08 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% Singapore 100% 100% 06 Feb 04 Mar 07 Apr 06 May 03 Jun 05 Jul 05 Aug 08 Sep 06 Oct 08 Nov 07 Dec 07 Jan 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% Pacific island countries and areas 100% 100% 15 Feb 15 Mar 15 Apr 15 May 15 Jun - 15 Aug 15 Sep 15 Oct 15 Nov 15 Dec 14 Jan 92% 92% Completeness 100% 100% 94% 94% 100% 100% 94% 100% 100% 100% 100% 100% 100% 99% Timeliness 92% 94% 88% 88% 94% 94% 94% 100% 100% 100% 100% 94% 88% 95% 1 National measles surveillance monthly reports from December 2021. Legend: black = timely report; red = untimely report Country 2020 Completeness 2 Timeliness 3 2021 1 Completeness 2 Timeliness 3 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 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. Australia 100% 100% 03 Feb 03 Mar 08 Apr 07 May 08 Jun 06 Jul 10 Aug 03 Sep 07 Oct 04 Nov 01 Dec 10 Jan 100% 100% Brunei Darussalam 100% 100% 02 Feb 06 Mar 06 Apr 04 May 01 Jun 06 Jul 02 Aug 31 Aug 05 Oct 01 Nov 03 Dec 05 Jan 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% China 100% 100% 02 Feb 04 Mar 07 Apr 06 May 03 Jun 08 Jul 09 Aug 08 Sep 08 Oct 09 Nov 07 Dec 11 Jan 100% 100% China, Hong Kong SAR 100% 100% 10 Feb 09 Mar 07 Apr 07 May 07 Jun 07 Jul 04 Aug 06 Sep 07 Oct 04 Nov 07 Dec 06 Jan 100% 100% China, Macao SAR 100% 100% 08 Feb 08 Mar 09 Apr 10 May 09 Jun 08 Jul 10 Aug 09 Sep 07 Oct 05 Nov 10 Dec 10 Jan 100% 100% Japan 92% 25% 07 Feb 07 Mar 08 Apr 06 May 07 Jun 06 Jul 10 Aug 02 Sep 04 Oct 02 Nov 03 Dec 07 Jan 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 02 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% Malaysia 100% 83% 09 Feb 10 Mar 08 Apr 10 May 09 Jun 07 Jul 09 Aug 07 Sep 08 Oct 10 Nov 10 Dec 10 Jan 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% New Zealand 100% 100% 10 Feb 08 Mar 09 Apr 10 May 09 Jun 08-Jul 10 Aug 03 Sep 07 Oct 09 Nov 09 Dec 07 Jan 100% 100% Papua New Guinea 42% 42% - - - - - - - - - - - - 0% 0% Philippines 100% 92% 10 Feb 08 Mar 09 Apr 09 May 06 Jun 09 Jul 10 Aug 09 Sep 09 Oct 08 Nov 10 Dec 10 Jan 100% 100% Republic of Korea 100% 92% 10 Feb 10 Mar 09 Apr 11 May 10 Jun 09 Jul 09 Aug 10 Sep 09 Oct 10 Nov 10 Dec 10 Jan 100% 92% Singapore 100% 100% 06 Feb 04 Mar 07 Apr 06 May 03 Jun 05 Jul 05 Aug 08 Sep 06 Oct 08 Nov 07 Dec 07 Jan 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10 Oct 10 Nov 10 Dec 10 Jan 100% 100% Fiji 100% 100% 15 Feb 15 Mar 15 Apr 15 May 15 Jun - 15 Aug 15 Sep 15 Oct 15 Nov 15 Dec 14 Jan 92% 92% Completeness 97% 95% 95% 95% 95% 95% 90% 95% 95% 95% 95% 95% 95% 95% Timeliness 92% 95% 95% 95% 90% 95% 90% 95% 95% 95% 95% 95% 95% 94% 1 National measles laboratory monthly reports from December 2021. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Oct Nov Dec Completeness 2 Timeliness 3 2021 1 Jan Feb Mar Apr May Jun Jul Aug Sep 2020 Country/area Completeness 2 Timeliness 3

Volume 16 • Issue 4 • April 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–31 March 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, October 2021–March 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 April 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 0 0 0 0 0 0 0 0 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 1 1 0 0 0 0 0 0 1 1 China 32 54 43 85 47 57 15 27 32 46 30 44 China, Hong Kong SAR 0 1 0 0 0 0 0 0 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 1 1 0 0 1 1 0 0 0 0 0 0 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 10 11 13 13 9 10 18 18 11 14 10 14 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 0 19 0 24 0 20 0 11 2 9 0 23 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 0 0 0 0 0 0 0 0 0 Viet Nam 0 3 0 2 0 4 0 0 0 0 0 0 Pacific island countries and areas 0 0 3 3 0 0 0 0 0 0 0 0 Western Pacific Region 43 89 60 128 57 92 33 56 45 69 41 82 1 Reports only confirmed cases "-" No data 2021 Oct Nov DecCountry/area 2022 MarJan Feb Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 April 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 April 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar 2017 2018 2019 2020 2021 2022 Nu mb er of m ea sle s c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 April 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 April 2022 Imported Import-related Endemic Unknown / not reported Imported Import-related Endemic Unknown / not reported Australia 2014 0 - - - - - 0 - - - - - Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 1 0 0 0 1 0.0% China - 505 0 0 0 505 0.0% 87 0 0 0 87 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 0 - - - - - China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 0 - - - - - Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 87 20 71.9% 39 0 0 33 6 84.6% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 2 0 0 2 0 100.0% Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 0 - - - - - Viet Nam - 33 0 0 0 33 0.0% 0 - - - - - Pacific island countries and areas - 3 0 0 0 3 0.0% 0 - - - - - Total 687 1 0 97 575 14.3% 129 0 0 35 94 27.1% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection Country/area Year verified 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 April 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 - - 26.1 NA3 - - - - - - - - 26-Feb-20 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 5 0 5 0 0 0 0 0.0 0 13-Sep-19 Cambodia 3 0.2 676 41.0 379 22.7 5 0.3 17.2 113 32 80 0 1 0 1 0.2 0 7-Mar-22 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1448.5 3 150 287 2 746 30 87 0 117 0.3 0 31-Mar-22 China, Hong Kong SAR 16 2.2 90 12.1 1 0.1 1 0.1 7.6 0 - - - - - - - - 19-Aug-21 China, Macao SAR 3 4.7 36 56.2 0 0.0 0 0.0 0.7 0 - - - - - - - - 6-May-19 Japan 279 2.2 761 6.0 12 0.1 6 0.0 125.6 13 0 13 0 0 0 0 0.0 0 7-Dec-21 Lao People's Democratic Republic 10 1.4 1 119 156.1 135 18.6 2 0.3 7.5 0 - - - - - - - 0 5-Feb-21 Malaysia 1 958 62.1 1 077 33.7 478 14.8 128 3.9 33.2 684 174 458 7 39 0 46 5.5 0 24-Mar-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 16 0 16 0 0 0 0 0.0 0 4-Mar-19 New Zealand 36 7.6 2 229 466.0 7 1.5 0 0.0 4.9 11 1 10 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.7 1 0.1 4 0.4 0 0.0 9.3 16 0 16 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 214.4 48 521 448.8 3 832 35.0 218 2.0 112.5 137 0 92 43 2 0 45 1.6 10 26-Feb-22 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.3 40 0 20 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.9 14 2.4 1 0.2 5.9 5 0 3 0 0 0 0 0.0 0 9-Oct-20 Viet Nam 1 249 13.1 5 004 51.9 713 7.3 163 1.7 99.0 5 5 0 0 0 0 0 0.0 0 19-Jun-21 Pacific island countries and areas4 0 0.0 6 346 1885.5 75 22.0 2 0.6 3.5 32 1 31 0 0 0 0 0.0 0 14-Nov-21 American Samoa - - 31 560.5 2 36.2 - - 0.1 0 - - - - - - - - 19-Jan-20 Fiji 0 0.0 31 34.8 3 3.3 2 2.2 0.9 31 1 30 0 0 0 0 0.0 0 14-Nov-21 Kiribati - - - - 1 8.4 - - 0.1 1 0 1 0 0 0 0 0.0 0 3-Jan-20 New Caledonia 0 0.0 0 0.0 - - - - 0.3 0 - - - - - - - - 10-Jan-17 Samoa - - 5 689 28864.5 18 90.7 - - 0.2 0 - - - - - - - - 13-Jan-20 Solomon Islands 0 0.0 - - - - - - 0.7 0 - - - - - - - - 21-Jan-16 Tonga - - 608 5818.3 51 482.5 - - 0.1 0 - - - - - - - - 13-Feb-20 Western Pacific Region 30 572 15.9 63 284 32.8 6 479 3.3 1 080 0.6 1956.5 4 227 500 3 490 80 129 0 209 0.4 10 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases Country/area 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 April 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 4.5 Not applicable 100.0% 100.0% Cambodia 2.0 24.0% 96.3% 99.7% 1.9 16.0% 94.7% 100.0% China 1.98 0.0% 98.8% 97.9% 0.8 0.0% 97.3% 95.2% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable Not applicable Not applicable China, Macao SAR 3.5 Not applicable 91.3% 100.0% 0.0 Not applicable Not applicable Not applicable Japan 0.1 0.0% Insufficient data Insufficient data 0.0 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 0.0 0.0% Not applicable Not applicable Malaysia 6.2 62.5% 80.3% 96.8% 5.5 62.5% 79.2% 95.2% Mongolia 0.2 4.5% 100.0% 100.0% 1.9 9.1% 93.8% 100.0% New Zealand 1.5 15.0% Insufficient data Insufficient data 0.8 10.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.7 10.0% 81.3% 100.0% Philippines 0.6 0.0% 70.3% 72.8% 0.3 0.0% 86.9% 70.1% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.2 0.0% 0.0% 50.0% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 40.0% 20.0% Viet Nam 0.2 1.6% 38.9% 39.2% 0.0 0.0% 0.0% 100.0% Pacific island countries and areas4 2.5 0.0% 45.7% 95.7% 3.5 10.0% 93.8% 96.9% Western Pacific Region 1.7 6.9% 94.8% 95.4% 0.7 6.9% 92.3% 93.5% Green Reached or surpassed target Yellow 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 Red Substantially below target 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological block; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 April 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.1 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 5 0 5 0 0 0 0 0.0 - Cambodia 3 0.2 30 1.8 40 2.4 10 0.6 17.2 113 0 78 0 3 0 3 0.7 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 448.5 3 150 287 2 698 55 110 0 165 0.5 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.6 0 - - - - - - - - China, Macao SAR 1 1.6 78 121.5 3 4.6 0 0.0 0.7 0 - - - - - - - - Japan3 68 0.5 2 394 18.9 99 0.8 11 0.1 125.6 21 0 8 0 0 0 0 0.0 - Lao People's Democratic Republic 15 2.1 11 1.6 22 3.1 3 0.4 7.5 0 - - - - - - - - Malaysia 175 5.6 111 3.4 103 3.1 97 3.0 33.2 684 174 492 0 18 0 18 2.2 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 16 0 16 0 0 0 0 0.0 - New Zealand - - 1 0.2 - - 0 0.0 4.9 0 - - - - - - - - Papua New Guinea 1 0.1 5 0.6 2 0.2 0 0.0 9.3 16 0 15 0 1 0 1 0.4 - Philippines 152 1.4 198 1.8 382 3.5 36 0.3 112.5 137 0 133 0 4 0 4 0.1 - Republic of Korea 0 0.00 8 0.2 2 0.0 0 0.0 51.3 40 0 22 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 5.9 5 0 1 1 0 0 1 0.7 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 99.0 0 - - - - - - - - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 32 1 31 0 0 0 0 0.0 - Fiji 0 0.0 0 0.0 0 0.0 4 4.4 0.9 31 1 30 0 0 0 0 0.0 - Kiribati - - - - 0 0.0 - - 0.1 1 0 1 0 0 0 0 0.0 - New Caledonia 0 0.0 0 0.0 - - - - 0.3 0 - - - - - - - - Western Pacific Region 4 480 2.3 35 546 18.5 3 004 1.6 1 046 0.5 1 956.5 4 219 462 3 499 56 136 0 192 0.4 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Rubella cases are cases reported as suspected measles cases that were identified as rubella laboratory confirmed cases during the investigation. This represents a small proportion of a large number of rubella cases occurring in Japan during 2018 Red >= 10 confirmed cases / 1 000 000 population "-" No data Gray No data Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Country/area 2019 Total confirmed and clinically compatible Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 April 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 0 1 0 - - - - Brunei Darussalam DLS 5 5 5 5 0 0% 0 0% 0 - 100.0 0 - 0 - 0 5 0 0% 0 0% Cambodia NIPH 81 81 81 81 1 1% 0 0% 0 - 100.0 0 - 0 - 1 81 3 4% 78 96% China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 50 50 50 41 0 0% 0 0% 0 - 90.0 0 - 9 0 0 17 0 0% 1 6% China, Macao SAR PHL 11 11 11 11 0 0% 0 0% 0 - 100.0 0 - 0 - 0 11 0 0% 0 0% Japan NIID 19 17 13 1 0 0% 0 0% 0 - - 1 1 5 0 1 1 0 0% 1 100% Lao People's Democratic Republic NCLE 0 - - 0 - - - - 0 - - 0 - 0 - - 0 - - - - Malaysia NPHL 1 259 1 259 813 775 64 8% 17 2% 0 - 95.3 272 0 0 - 64 722 57 8% 6 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 13 13 13 2 0 0% 0 0% 0 - 100.0 0 - 11 0 0 2 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 156 156 152 131 5 4% 0 0% 0 - 100.0 0 - 19 0 5 126 5 4% 2 2% Republic of Korea KCDC 64 64 43 20 3 15% 0 0% 0 - 71.4 0 - 12 1 3 23 20 87% 0 0% Singapore NPHL 49 49 49 0 - - - - 0 - - 0 - 49 0 0 0 - - - - Viet Nam national lab (Northern) NIHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam national lab (Southern) PI 4 4 4 4 0 0% 0 0% 0 - 100.0 0 - 0 - 0 4 0 0% 0 0% Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 32 32 32 32 0 0% 0 0% 0 - - 0 - 0 - 0 31 0 0% 0 0% Total 1 744 1 742 1 267 1 103 73 7% 17 2% 0 0 96.0 273 1 106 1 75 1 023 85 8% 88 9% "-" No data Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in April 2021 to March 2022, WHO Western Pacific Region 2021 2022 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas MarNovSepJul 2021 Apr May Jun OctAug FebDecCountry/area Jan 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 April 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in April 2021 to March 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 April 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China 7 2 1 China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Dec 2021 Apr May Jun Jul Aug Sep Oct Nov MarCountry/area FebJan 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Australia 100% 100% 11 Feb 07 Mar 04 Apr 100% 67% Brunei Darussalam 100% 92% 07 Feb 08 Mar 09 Apr 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% China 100% 50% 18 Feb 15 Mar 15 Apr 100% 67% China, Hong Kong SAR 100% 100% 08 Feb - 04 Apr 67% 67% China, Macao SAR 100% 100% 10 Feb - - 33% 33% Japan 100% 100% 03 Feb 02 Mar 03 Apr 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 08 Apr 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 09 Apr 100% 67% Philippines 100% 100% 10 Feb 04 Mar 08 Apr 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 08 Apr 100% 100% Singapore 100% 100% 07 Feb 02 Mar 04 Apr 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 15 Apr 100% 100% Completeness 99% 100% 88% 94% 94% Timeliness 95% 82% 88% 94% 88% 1 National measles surveillance monthly reports from March 2022. Legend: black = timely report; red = untimely report 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting th di id d b th b f t d t f th Country 2021 Australia 100% 100% 02 Feb 04 Mar 06 Apr 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% China 100% 100% 10 Feb 04 Mar 15 Apr 100% 100% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 04 Apr 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 10 Apr 100% 100% Japan 100% 100% 07 Feb 02 Mar 03 Apr 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 10 Apr 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 100% 100% Papua New Guinea 0% 0% - - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 10 Apr 100% 100% Republic of Korea 100% 92% 10 Feb 10 Mar 08 Apr 100% 100% Singapore 100% 100% 07 Feb 07 Mar 04 Apr 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 100% 100% Fiji 92% 92% 15 Feb 15 Mar 15 Apr 100% 100% Completeness 95% 95% 95% 95% 95% Timeliness 94% 95% 95% 95% 95% 1 National measles laboratory monthly reports from March 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Completeness 2 Timeliness 3 2022 1 Jan Feb Mar Country/area Completeness 2 Timeliness 3 2021

Volume 16 • Issue 2 • February 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–31 January 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, August 2021–January 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 February 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 0 0 0 0 0 0 0 0 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 0 0 0 0 1 1 0 0 0 0 China 42 51 35 69 32 54 43 85 47 57 15 27 China, Hong Kong SAR 1 1 0 0 0 1 0 0 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 0 0 1 1 0 0 1 1 0 0 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 4 6 3 4 7 7 11 11 6 10 10 14 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 0 15 0 10 0 19 0 24 0 20 0 12 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 0 0 0 0 0 0 0 0 0 Viet Nam 0 7 0 6 0 3 0 2 0 4 0 0 Pacific island countries and areas 0 0 0 0 0 0 3 3 0 0 0 0 Western Pacific Region 47 80 38 89 40 85 58 126 54 92 25 53 1 Reports only confirmed cases "-" No data Jan 2022 Country/area 2021 OctAug Sep Nov Dec Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 February 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 February 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n 2017 2018 2019 2020 2021 2022 N um be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 February 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 February 2022 Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 0 - - - - - 0 - - - - - Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 0 - - - - - China - 505 0 0 0 505 0.0% 15 0 0 0 15 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 0 - - - - - China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 0 - - - - - Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 107 0 0 87 20 81.3% 10 0 0 10 0 100.0% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 0 - - - - - Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 0 - - - - - Viet Nam - 33 0 0 0 33 0.0% 0 - - - - - Pacific island countries and areas - 3 0 0 0 3 0.0% 0 - - - - - Total 673 1 0 97 575 14.6% 25 0 0 10 15 40.0% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% Country/area Year verified 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 February 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 - - 26.1 NA3 - - - - - - - - 26-Feb-20 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 0 - - - - - - - - 13-Sep-19 Cambodia 3 0.2 676 41.0 379 22.7 5 0.3 17.2 40 40 0 0 0 0 0 0.0 0 28-Nov-21 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1448.5 566 153 386 12 15 0 27 0.2 0 31-Jan-22 China, Hong Kong SAR 16 2.2 90 12.1 1 0.1 1 0.1 7.6 0 - - - - - - - - 19-Aug-21 China, Macao SAR 3 4.7 36 56.2 0 0.0 0 0.0 0.7 0 - - - - - - - - 6-May-19 Japan 279 2.2 761 6.0 12 0.1 6 0.0 125.6 2 1 1 0 0 0 0 0.0 0 7-Dec-21 Lao People's Democratic Republic 10 1.4 1 119 156.1 135 18.6 2 0.3 7.5 1 0 1 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 62.1 1 077 33.7 478 14.8 119 3.6 33.2 235 155 65 4 10 0 14 5.1 0 28-Dec-21 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 0 - - - - - - - - 4-Mar-19 New Zealand 36 7.6 2 229 466.0 7 1.5 0 0.0 4.9 6 1 5 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.7 1 0.1 4 0.4 0 0.0 9.3 1 0 1 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 214.4 48 521 448.8 3 832 35.0 218 2.0 112.5 40 0 27 13 0 0 13 1.4 0 25-Jul-21 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.3 17 0 11 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.9 14 2.4 1 0.2 5.9 2 0 1 0 0 0 0 0.0 0 9-Oct-20 Viet Nam 1 249 13.1 5 004 51.9 713 7.3 163 1.7 99.0 0 - - - - - - - - 19-Jun-21 Pacific island countries and areas4 0 0.0 6 346 1885.5 75 22.0 3 0.9 3.5 1 0 1 0 0 0 0 0.0 0 14-Nov-21 American Samoa - - 31 560.5 2 36.2 - - 0.1 0 - - - - - - - - 19-Jan-20 Fiji 0 0.0 31 34.8 3 3.3 3 3.3 0.9 1 0 1 0 0 0 0 0.0 0 14-Nov-21 Kiribati - - - - 1 8.4 - - 0.1 0 - - - - - - - - 3-Jan-20 New Caledonia 0 0.0 0 0.0 - - - - 0.3 0 - - - - - - - - 10-Jan-17 Samoa - - 5 689 28864.5 18 90.7 - - 0.2 0 - - - - - - - - 13-Jan-20 Solomon Islands 0 0.0 - - - - - - 0.7 0 - - - - - - - - 21-Jan-16 Tonga - - 608 5818.3 51 482.5 - - 0.1 0 - - - - - - - - 13-Feb-20 Western Pacific Region 30 572 15.9 63 284 32.8 6 479 3.3 1 072 0.6 1956.5 911 350 499 29 25 0 54 0.3 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. Pending classification Discarded cases3 2018 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Country/area Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 February 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 0.0 Not applicable Not applicable Not applicable Cambodia 2.0 24.0% 96.3% 99.7% 0.0 0.0% 95.0% 100.0% China 2.0 0.0% 98.8% 97.9% 0.3 0.0% 92.8% 88.7% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable Not applicable Not applicable China, Macao SAR 3.5 Not applicable 91.3% 100.0% 0.0 Not applicable Not applicable Not applicable Japan 0.1 0.0% Insufficient data Insufficient data 0.0 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 0.2 5.6% 0.0% 0.0% Malaysia 5.9 62.5% 80.9% 97.5% 2.4 50.0% 75.7% 94.5% Mongolia 0.2 4.5% 100.0% 100.0% 0.0 0.0% Not applicable Not applicable New Zealand 1.5 15.0% Insufficient data Insufficient data 1.2 25.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.1 5.0% 100.0% 100.0% Philippines 0.6 0.0% 70.3% 72.8% 0.3 0.0% 92.5% 70.0% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.3 0.0% 0.0% 64.7% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 100.0% 0.0% Viet Nam 0.2 1.6% 38.9% 39.2% 0.0 0.0% Not applicable Not applicable Pacific island countries and areas4 2.5 0.0% Insufficient data Insufficient data 0.3 0.0% Insufficient data Insufficient data Western Pacific Region 1.7 6.9% 94.7% 95.2% 0.3 4.7% 85.7% 88.3% Green Reached or surpassed target Yellow 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 Red Substantially below target 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological block; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 February 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.1 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 0 - - - - - - - - Cambodia 3 0.2 30 1.8 40 2.4 10 0.6 17.2 40 0 0 0 0 0 0 0.0 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 448.5 566 153 372 16 25 0 41 0.3 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.6 0 - - - - - - - - China, Macao SAR 1 1.6 78 121.5 3 4.6 0 0.0 0.7 0 - - - - - - - - Japan3 68 0.5 2 394 18.9 99 0.8 11 0.1 125.6 4 0 2 0 0 0 0 0.0 - Lao People's Democratic Republic 15 2.1 11 1.6 22 3.1 3 0.4 7.5 1 0 1 0 0 0 0 0.0 - Malaysia 175 5.6 111 3.4 103 3.1 92 2.8 33.2 235 155 77 0 3 0 3 1.1 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 0 - - - - - - - - New Zealand - - 1 0.2 - - 0 0.0 4.9 0 - - - - - - - - Papua New Guinea 1 0.1 5 0.6 2 0.2 0 0.0 9.3 1 0 1 0 0 0 0 0.0 - Philippines 152 1.4 198 1.8 382 3.5 36 0.3 112.5 40 0 39 0 1 0 1 0.1 - Republic of Korea 0 0.00 8 0.2 2 0.0 0 0.0 51.3 17 0 8 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 5.9 2 0 0 1 0 0 1 2.0 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 99.0 0 - - - - - - - - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 1 0 1 0 0 0 0 0.0 - Fiji 0 0.0 0 0.0 0 0.0 4 4.4 0.9 1 0 1 0 0 0 0 0.0 - Kiribati - - - - 0 0.0 - - 0.1 0 - - - - - - - - New Caledonia 0 0.0 0 0.0 - - - - 0.3 0 - - - - - - - - Solomon Islands - - - - - - - - 0.7 0 - - - - - - - - Vanuatu - - - - - - - - 0.0 0 - - - - - - - - Western Pacific Region 4 480 2.3 35 546 18.5 3 004 18.7 1 041 0.5 1 956.5 907 308 501 17 29 0 46 0.3 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Rubella cases are cases reported as suspected measles cases that were identified as rubella laboratory confirmed cases during the investigation. This represents a small proportion of a large number of rubella cases occurring in Japan during 2018 Red >= 10 confirmed cases / 1 000 000 population "-" No data Gray No data Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Country/area 2019 Total confirmed and clinically compatible Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 February 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Brunei Darussalam DLS 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Cambodia NIPH 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 31 31 26 22 0 0% 0 0% 0 - 90.9 0 - 9 0 0 8 0 0% 1 13% China, Macao SAR PHL 7 7 7 7 0 0% 0 0% 0 - 100.0 0 - 0 - 0 7 0 0% 0 0% Japan NIID 4 3 3 0 - - - - 0 - - 1 1 1 0 1 1 0 0% 1 100% Lao People's Democratic Republic NCLE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Malaysia NPHL 440 440 284 268 19 7% 6 2% 0 - 93.0 60 0 0 - 19 240 16 7% 0 0% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 3 3 2 1 0 0% 0 0% 0 - 100.0 0 - 2 0 1 1 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 48 48 37 33 2 6% 0 0% 0 - 100.0 0 - 4 0 2 38 1 3% 1 3% Republic of Korea KCDC 26 26 17 11 2 18% 0 0% 0 - 50.0 0 - 5 1 2 6 5 83% 0 0% Singapore NPHL 24 24 24 0 - - - - 0 - 100.0 0 - 24 0 0 0 - - - - Viet Nam national lab (Northern) NIHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam national lab (Southern) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 1 1 1 1 0 0% 0 0% 0 - - 0 - 1 0 0 1 0 0% 0 0% Total 584 583 401 343 23 7% 6 2% 0 0 93.1 61 1 46 1 25 302 22 7% 3 1% "-" No data Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 8Figure 3. Measles genotype distribution of cases with rash onset in 2020 and 2021, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in February 2021 to January 2022, WHO Western Pacific Region 2020 2021 B3 D8 D9 H1 B3 D4 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia 1 Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Jan 2022 NovSepJul 2021 Feb Mar Apr May Jun DecCountry/area OctAug Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 February 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2020 and 2021, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in February 2021 to January 2022, WHO Western Pacific Region 2020 2021 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 February 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China 7 2 1 China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Dec 2021 2022 Feb Mar Apr May Jun Jul Aug Sep Oct Nov JanCountry/area 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Australia 100% 100% 11 Feb 100% 0% Brunei Darussalam 100% 92% 07 Feb 100% 100% Cambodia 100% 100% 10 Feb 100% 100% China 100% 50% 18 Feb 100% 0% China, Hong Kong SAR 100% 100% 08 Feb 100% 100% China, Macao SAR 100% 100% 10 Feb 100% 100% Japan 100% 100% 03 Feb 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 100% 100% Malaysia 100% 100% 10 Feb 100% 100% Mongolia 100% 100% 10 Feb 100% 100% New Zealand 100% 100% 09 Feb 100% 100% Papua New Guinea 83% 83% 11 Feb 100% 0% Philippines 100% 100% 10 Feb 100% 100% Republic of Korea 100% 100% 10 Feb 100% 100% Singapore 100% 100% 07 Feb 100% 100% Viet Nam 100% 100% 10 Feb 100% 100% Pacific island countries and areas 92% 92% 15 Feb 100% 100% Completeness 99% 100% 100% Timeliness 95% 82% 82% 1 National measles surveillance monthly reports from January 2022. Legend: black = timely report; red = untimely report 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting th di id d b th b f t d t f th 2021 Completeness 2 Timeliness 3 2022 1 Completeness 2 Timeliness 3 Country Australia 100% 100% 02 Feb 100% 100% Brunei Darussalam 100% 100% 06 Feb 100% 100% Cambodia 100% 100% 10 Feb 100% 100% China 100% 100% 10 Feb 100% 100% China, Hong Kong SAR 100% 100% 09 Feb 100% 100% China, Macao SAR 100% 100% 10 Feb 100% 100% Japan 100% 100% 07 Feb 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 100% 100% Malaysia 100% 100% 07 Feb 100% 100% Mongolia 100% 100% 10 Feb 100% 100% New Zealand 100% 100% 09 Feb 100% 100% Papua New Guinea 0% 0% - 0% 0% Philippines 100% 100% 08 Feb 100% 100% Republic of Korea 100% 92% 10 Feb 100% 100% Singapore 100% 100% 07 Feb 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 100% 100% Fiji 92% 92% 15 Feb 100% 100% Completeness 95% 95% 100% Timeliness 94% 95% 95% 1 National measles laboratory monthly reports from January 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Completeness 2 Timeliness 3 2021 Country/area Completeness 2 Timeliness 3 2022 1 Jan

Volume 16 • Issue 3 • March 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–28 February 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, September 2021–February 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 March 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 0 0 0 0 0 0 0 0 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 0 0 1 1 0 0 0 0 0 0 China 35 69 32 54 43 85 47 57 15 27 32 46 China, Hong Kong SAR 0 0 0 1 0 0 0 0 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 1 1 0 0 1 1 0 0 0 0 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 3 3 10 11 13 13 9 10 16 18 5 10 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 0 10 0 19 0 24 0 20 0 11 0 1 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 0 0 0 0 0 0 0 0 0 Viet Nam 0 6 0 3 0 2 0 4 0 0 0 0 Pacific island countries and areas 0 0 0 0 3 3 0 0 0 0 0 0 Western Pacific Region 38 88 43 89 60 128 57 92 31 56 37 57 1 Reports only confirmed cases "-" No data 2022 FebJanCountry/area 2021 OctSep Nov Dec Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 March 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 March 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b 2017 2018 2019 2020 2021 2022 Nu mb er of m ea sle s c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 March 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 March 2022 Imported Import-related Endemic Unknown / not reported Imported Import-related Endemic Unknown / not reported Australia 2014 0 - - - - - 0 - - - - - Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 0 - - - - - China - 505 0 0 0 505 0.0% 49 0 0 0 49 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 0 - - - - - China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 0 - - - - - Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 87 20 71.9% 21 0 0 20 1 95.2% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 0 - - - - - Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 0 - - - - - Viet Nam - 33 0 0 0 33 0.0% 0 - - - - - Pacific island countries and areas - 3 0 0 0 3 0.0% 0 - - - - - Total 687 1 0 97 575 14.3% 70 0 0 20 50 28.6% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection Country/area Year verified 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 March 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 - - 26.1 NA3 - - - - - - - - 26-Feb-20 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 0 - - - - - - - - 13-Sep-19 Cambodia 3 0.2 676 41.0 379 22.7 5 0.3 17.2 60 60 0 0 0 0 0 0.0 0 28-Nov-21 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1448.5 1 398 270 1 053 26 49 0 75 0.3 0 28-Feb-22 China, Hong Kong SAR 16 2.2 90 12.1 1 0.1 1 0.1 7.6 0 - - - - - - - - 19-Aug-21 China, Macao SAR 3 4.7 36 56.2 0 0.0 0 0.0 0.7 0 - - - - - - - - 6-May-19 Japan 279 2.2 761 6.0 12 0.1 6 0.0 125.6 6 0 6 0 0 0 0 0.0 0 7-Dec-21 Lao People's Democratic Republic 10 1.4 1 119 156.1 135 18.6 2 0.3 7.5 1 0 1 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 62.1 1 077 33.7 478 14.8 128 3.9 33.2 447 191 224 7 21 0 28 5.1 0 16-Feb-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 0 - - - - - - - - 4-Mar-19 New Zealand 36 7.6 2 229 466.0 7 1.5 0 0.0 4.9 11 0 11 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.7 1 0.1 4 0.4 0 0.0 9.3 6 0 6 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 214.4 48 521 448.8 3 832 35.0 218 2.0 112.5 55 0 43 12 0 0 12 0.6 0 25-Jul-21 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.3 29 0 15 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.9 14 2.4 1 0.2 5.9 3 0 2 0 0 0 0 0.0 0 9-Oct-20 Viet Nam 1 249 13.1 5 004 51.9 713 7.3 163 1.7 99.0 0 - - - - - - - - 19-Jun-21 Pacific island countries and areas4 0 0.0 6 346 1885.5 75 22.0 3 0.9 3.5 25 0 25 0 0 0 0 0.0 0 14-Nov-21 American Samoa - - 31 560.5 2 36.2 - - 0.1 0 - - - - - - - - 19-Jan-20 Fiji 0 0.0 31 34.8 3 3.3 3 3.3 0.9 24 0 24 0 0 0 0 0.0 0 14-Nov-21 Kiribati - - - - 1 8.4 - - 0.1 1 0 1 0 0 0 0 0.0 0 3-Jan-20 New Caledonia 0 0.0 0 0.0 - - - - 0.3 0 - - - - - - - - 10-Jan-17 Samoa - - 5 689 28864.5 18 90.7 - - 0.2 0 - - - - - - - - 13-Jan-20 Solomon Islands 0 0.0 - - - - - - 0.7 0 - - - - - - - - 21-Jan-16 Tonga - - 608 5818.3 51 482.5 - - 0.1 0 - - - - - - - - 13-Feb-20 Western Pacific Region 30 572 15.9 63 284 32.8 6 479 3.3 1 081 0.6 1956.5 2 041 521 1 386 45 70 0 115 0.4 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Country/area Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 March 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 0.0 Not applicable Not applicable Not applicable Cambodia 2.0 24.0% 96.3% 99.7% 0.0 0.0% 90.0% 100.0% China 1.98 0.0% 98.8% 97.9% 0.4 0.0% 91.2% 86.8% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable Not applicable Not applicable China, Macao SAR 3.5 Not applicable 91.3% 100.0% 0.0 Not applicable Not applicable Not applicable Japan 0.1 0.0% Insufficient data Insufficient data 0.0 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 0.1 5.6% 0.0% 0.0% Malaysia 6.2 62.5% 80.3% 96.8% 4.1 56.3% 38.0% 93.1% Mongolia 0.2 4.5% 100.0% 100.0% 0.0 0.0% Not applicable Not applicable New Zealand 1.5 15.0% Insufficient data Insufficient data 1.3 15.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.4 10.0% 83.3% 100.0% Philippines 0.6 0.0% 70.3% 72.8% 0.2 0.0% 67.3% 78.2% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.2 0.0% 0.0% 41.4% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 100.0% 33.3% Viet Nam 0.2 1.6% 38.9% 39.2% 0.0 0.0% Not applicable Not applicable Pacific island countries and areas4 2.5 0.0% 45.7% 95.7% 4.3 10.0% 92.0% 96.0% Western Pacific Region 1.7 6.9% 94.8% 95.4% 0.4 5.4% 76.8% 87.0% Green Reached or surpassed target Yellow 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 Red Substantially below target 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological block; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 March 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.1 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 0 - - - - - - - - Cambodia 3 0.2 30 1.8 40 2.4 10 0.6 17.2 60 60 0 0 0 0 0 0.0 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 448.5 566 153 372 16 25 0 41 0.2 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.6 0 - - - - - - - - China, Macao SAR 1 1.6 78 121.5 3 4.6 0 0.0 0.7 0 - - - - - - - - Japan3 68 0.5 2 394 18.9 99 0.8 11 0.1 125.6 12 1 5 0 0 0 0 0.0 - Lao People's Democratic Republic 15 2.1 11 1.6 22 3.1 3 0.4 7.5 1 0 1 0 0 0 0 0.0 - Malaysia 175 5.6 111 3.4 103 3.1 97 3.0 33.2 447 191 243 0 13 0 13 2.4 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 0 - - - - - - - - New Zealand - - 1 0.2 - - 0 0.0 4.9 0 - - - - - - - - Papua New Guinea 1 0.1 5 0.6 2 0.2 0 0.0 9.3 6 0 5 0 1 0 1 0.6 - Philippines 152 1.4 198 1.8 382 3.5 36 0.3 112.5 55 0 54 0 1 0 1 0.1 - Republic of Korea 0 0.00 8 0.2 2 0.0 0 0.0 51.3 29 0 16 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 5.9 3 0 0 1 0 0 1 1.0 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 99.0 0 - - - - - - - - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 25 0 25 0 0 0 0 0.0 - Fiji 0 0.0 0 0.0 0 0.0 4 4.4 0.9 24 0 24 0 0 0 0 0.0 - Kiribati - - - - 0 0.0 - - 0.1 1 0 1 0 0 0 0 0.0 - New Caledonia 0 0.0 0 0.0 - - - - 0.3 0 - - - - - - - - Western Pacific Region 4 480 2.3 35 546 18.5 3 004 1.6 1 046 0.5 1 956.5 1 204 405 721 17 40 0 57 0.2 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Rubella cases are cases reported as suspected measles cases that were identified as rubella laboratory confirmed cases during the investigation. This represents a small proportion of a large number of rubella cases occurring in Japan during 2018 Red >= 10 confirmed cases / 1 000 000 population "-" No data Gray No data Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Country/area 2019 Total confirmed and clinically compatible Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 March 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Brunei Darussalam DLS 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Cambodia NIPH 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 45 45 39 36 0 0% 0 0% 0 - 94.3 0 - 9 0 0 14 0 0% 1 7% China, Macao SAR PHL 9 9 9 9 0 0% 0 0% 0 - 100.0 0 - 0 - 0 9 0 0% 0 0% Japan NIID 10 4 6 2 0 - 1 - 0 - - 1 1 3 0 1 1 0 0% 1 100% Lao People's Democratic Republic NCLE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Malaysia NPHL 825 825 528 502 38 8% 13 3% 0 - 94.8 156 0 0 - 38 461 37 8% 2 0% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 4 4 3 1 0 0% 0 0% 0 - 100.0 0 - 3 0 0 1 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 77 77 77 70 3 4% 0 0% 0 - 100.0 0 - 8 0 3 68 3 4% 1 1% Republic of Korea KCDC 44 44 30 14 2 14% 0 0% 0 - 63.6 0 - 9 1 2 15 13 87% 0 0% Singapore NPHL 38 38 38 0 - - - - 0 - 100.0 0 - 38 0 0 0 - - - - Viet Nam national lab (Northern) NIHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam national lab (Southern) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 25 25 25 25 0 0% 0 0% 0 - - 0 - 0 - 0 25 0 0% 0 0% Total 1 077 1 071 755 659 43 7% 14 2% 0 0 94.8 157 1 70 1 44 594 53 9% 5 1% "-" No data DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in March 2021 to February 2022, WHO Western Pacific Region 2021 2022 B3 D4 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia 1 Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Jan 2022 Country/area Dec FebNovSepJul 2021 Mar Apr May Jun OctAug Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 March 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in March 2021 to February 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 March 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China 7 2 1 China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Jan 2022 Country/area FebOct Nov Dec 2021 Mar Apr May Jun Jul Aug Sep 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Australia 100% 100% 11 Feb 07 Mar 100% 50% Brunei Darussalam 100% 92% 07 Feb 08 Mar 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 100% 100% China 100% 50% 18 Feb 15 Mar 100% 50% China, Hong Kong SAR 100% 100% 08 Feb - 50% 50% China, Macao SAR 100% 100% 10 Feb - 50% 50% Japan 100% 100% 03 Feb 02 Mar 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 100% 50% Philippines 100% 100% 10 Feb 04 Mar 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 100% 100% Singapore 100% 100% 07 Feb 02 Mar 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 100% 100% Completeness 99% 100% 88% 94% Timeliness 95% 82% 88% 85% 1 National measles surveillance monthly reports from February 2022. Legend: black = timely report; red = untimely report Country 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting th di id d b th b f t d t f th 2021 Australia 100% 100% 02 Feb 04 Mar 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 100% 100% China 100% 100% 10 Feb 04 Mar 100% 100% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 100% 100% Japan 100% 100% 07 Feb 02 Mar 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 100% 100% Papua New Guinea 0% 0% - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 100% 100% Republic of Korea 100% 92% 10 Feb 10 Mar 100% 100% Singapore 100% 100% 07 Feb 07 Mar 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 100% 100% Fiji 92% 92% 15 Feb 15 Mar 100% 100% Completeness 95% 95% 95% 95% Timeliness 94% 95% 95% 95% 1 National measles laboratory monthly reports from February 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Completeness 2 Timeliness 3 2022 1 Jan Feb Country/area Completeness 2 Timeliness 3 2021

Volume 16 • Issue 5 • May 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–30 April 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, November 2021–April 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 May 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 0 0 0 0 0 0 0 0 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 1 1 0 0 0 0 0 0 1 1 0 0 China 43 85 47 57 15 27 32 46 30 44 32 43 China, Hong Kong SAR 0 0 0 0 0 0 0 0 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 1 1 0 0 0 0 0 0 0 0 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 13 13 9 10 19 19 12 15 14 16 11 12 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 0 24 0 20 0 13 2 11 2 49 4 52 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 0 0 0 0 0 0 0 0 0 Viet Nam 0 2 0 4 0 0 0 0 0 1 0 0 Pacific island countries and areas 3 3 0 0 0 0 0 0 0 0 0 0 Western Pacific Region 60 128 57 92 34 59 46 72 47 111 47 107 1 Reports only confirmed cases "-" No data 2022 AprJan Feb Mar Country/area 2021 Nov Dec Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 May 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 May 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r 2017 2018 2019 2020 2021 2022 N um be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 May 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 May 2022 Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 0 - - - - - 0 - - - - - Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 1 0 0 0 1 0.0% China - 505 0 0 0 505 0.0% 116 0 0 0 116 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 0 - - - - - China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 0 - - - - - Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 97 24 80.2% 56 0 0 47 9 83.9% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 8 0 0 8 0 100.0% Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 0 - - - - - Viet Nam - 33 0 0 0 33 0.0% 0 - - - - - Pacific island countries and areas - 2 0 0 0 2 0.0% 0 - - - - - Total 686 1 0 107 578 15.7% 181 0 0 55 126 30.4% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% Country/area Year verified 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 May 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 0 0.0 26.1 NA3 0 0 0 0 0 0 0.0 - 26-Feb-20 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 7 0 7 0 0 0 0 0.0 0 13-Sep-19 Cambodia 3 0.2 676 41.0 379 22.7 5 0.3 17.2 122 0 121 0 1 0 1 0.2 0 7-Mar-22 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1448.5 4 906 382 4 375 33 116 0 149 0.3 0 30-Apr-22 China, Hong Kong SAR 16 2.2 90 12.1 1 0.1 1 0.1 7.6 1 1 0 0 0 0 0 0.0 0 19-Aug-21 China, Macao SAR 3 4.7 37 57.8 0 0.0 0 0.0 0.7 1 0 1 0 0 0 0 0.0 0 6-May-19 Japan 284 2.2 763 6.0 12 0.1 6 0.0 125.6 25 2 23 0 0 0 0 0.0 0 7-Dec-21 Lao People's Democratic Republic 10 1.4 1 290 179.9 135 18.6 2 0.3 7.5 7 7 0 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 62.1 1 077 33.7 478 14.8 128 3.9 33.2 1 005 221 711 6 56 0 62 5.6 0 22-Apr-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 29 0 29 0 0 0 0 0.0 0 4-Mar-19 New Zealand 36 7.6 2 229 466.0 7 1.5 0 0.0 4.9 19 0 19 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.7 1 0.1 4 0.4 0 0.0 9.3 28 0 28 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 214.4 48 521 448.8 3 723 34.0 218 2.0 112.5 355 0 230 117 8 0 125 3.3 0 18-Apr-22 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.3 49 0 20 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.9 14 2.4 1 0.2 5.9 9 0 3 0 0 0 0 0.0 0 9-Oct-20 Viet Nam 1 247 13.1 5 723 59.3 713 7.3 163 1.7 99.0 15 8 6 1 0 0 1 0.0 0 19-Jun-21 Pacific island countries and areas4 0 0.0 6 346 1885.5 75 22.0 2 0.6 3.5 32 1 31 0 0 0 0 0.0 0 14-Nov-21 Western Pacific Region 30 575 15.9 64 177 33.2 6 370 3.3 1 080 0.6 1956.5 6 610 622 5 604 157 181 0 338 0.5 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Country/area Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 May 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 4.7 Not applicable 100.0% 100.0% Cambodia 2.0 24.0% 96.3% 99.7% 2.1 24.0% 95.1% 100.0% China 1.98 0.0% 98.8% 97.9% 0.9 0.0% 98.1% 96.8% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable 0.0% 0.0% China, Macao SAR 3.5 Not applicable 91.3% 100.0% 0.4 Not applicable 100.0% 100.0% Japan 0.1 0.0% Insufficient data Insufficient data 0.1 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 0.0 0.0% 100.0% 100.0% Malaysia 6.2 62.5% 80.3% 96.8% 6.4 62.5% 79.9% 94.8% Mongolia 0.2 4.5% 100.0% 100.0% 2.6 9.1% 96.6% 100.0% New Zealand 1.5 15.0% Insufficient data Insufficient data 1.2 20.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.9 20.0% 96.4% 100.0% Philippines 0.6 0.0% 70.3% 72.8% 0.6 0.0% 69.6% 73.5% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.1 0.0% Insufficient data 34.7% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 11.1% 22.2% Viet Nam 0.2 1.6% 38.9% 39.2% 0.0 0.0% 0.0% 60.0% Pacific island countries and areas4 2.5 0.0% 45.7% 95.7% 2.7 10.0% 93.8% 96.9% Western Pacific Region 1.7 6.9% 94.8% 95.4% 0.9 8.8% 92.1% 94.1% Green Yellow Red Substantially below target 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 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological block; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 May 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.1 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 7 0 7 0 0 0 0 0.0 - Cambodia 3 0.2 30 1.8 40 2.4 10 0.6 17.2 122 0 119 0 3 0 3 0.5 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 448.5 4 906 382 4 312 62 150 0 212 0.4 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.6 0 - - - - - - - - China, Macao SAR 1 1.6 79 123.0 3 4.6 0 0.0 0.7 1 0 1 0 0 0 0 0.0 - Japan3 3 072 24.2 2 315 18.2 92 0.7 11 0.1 125.6 16 1 14 0 1 0 1 0.0 - Lao People's Democratic Republic 16 2.3 27 3.8 22 3.1 3 0.4 7.5 0 - - - - - - - - Malaysia 175 5.6 111 3.4 103 3.1 97 3.0 33.2 1 005 221 759 0 25 0 25 2.3 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 29 0 28 0 1 0 1 0.9 - New Zealand - - 1 0.2 - - 0 0.0 4.9 0 - - - - - - - - Papua New Guinea 3 0.3 5 0.6 2 0.2 0 0.0 9.3 28 0 26 0 2 0 2 0.6 - Philippines 152 1.4 198 1.8 404 3.7 36 0.3 112.5 355 0 347 0 8 0 8 0.2 - Republic of Korea 0 0.00 8 0.2 2 0.0 0 0.0 51.3 31 0 31 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 5.9 6 1 1 4 0 0 4 2.0 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 99.0 6 0 6 0 0 0 0 0.0 - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 32 1 31 0 0 0 0 0.0 - Western Pacific Region 7 487 3.9 35 484 18.5 3 019 1.6 1 046 0.5 1 956.5 6 544 606 5 682 66 190 0 256 0.4 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population Red >= 10 confirmed cases / 1 000 000 population number of rubella cases occurring in Japan during 2018 Gray No data "-" No data 3 Rubella cases are cases reported as suspected measles cases that were identified as rubella laboratory confirmed cases during the investigation. This represents a small proportion of a large Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Country/area 2019 Total confirmed and clinically compatible Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 May 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 0 1 0 - - - - Brunei Darussalam DLS 7 7 7 7 0 0% 0 0% 0 - 100.0 0 - 0 - 0 7 0 0% 0 0% Cambodia NIPH 122 122 122 122 1 1% 0 0% 0 - 100.0 0 - 0 - 1 122 3 2% 119 98% China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 74 74 66 62 1 2% 0 0% 0 - 90.2 0 - 12 0 1 26 0 0% 1 4% China, Macao SAR PHL 14 14 14 14 0 0% 0 0% 0 - 100.0 0 - 0 - 0 14 0 0% 0 0% Japan NIID 43 37 31 4 0 0% 1 25% 0 - - 2 2 15 0 2 1 0 0% 1 100% Lao People's Democratic Republic NCLE 0 - - 0 - - - - 0 - - 0 - 0 - - 0 - - - - Malaysia NPHL 1 804 1 804 1 142 1 098 92 8% 21 2% 0 - 96.2 382 0 0 - 92 1 036 84 8% 11 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 15 15 13 2 0 0% 0 0% 0 - 100.0 0 - 13 0 0 2 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 306 306 286 242 8 3% 2 1% 0 - 100.0 0 - 45 0 8 235 8 3% 2 1% Republic of Korea KCDC 91 91 59 23 4 17% 0 0% 0 - 81.8 0 - 19 2 4 32 27 84% 0 0% Singapore NPHL 63 63 63 0 - - - - 0 - - 0 - 63 0 0 0 - - - - Viet Nam national lab (Northern) NIHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam national lab (Southern) PI 4 4 4 4 0 0% 0 0% 0 - 100.0 0 - 0 - 0 4 0 0% 0 0% Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 32 32 32 32 0 0% 0 0% 0 - - 0 - 0 - 0 31 0 0% 0 0% Total 2 576 2 570 1 840 1 610 106 7% 24 1% 0 0 96.5 384 2 168 2 109 1 510 122 8% 134 9% "-" No data Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in May 2021 to April 2022, WHO Western Pacific Region 2021 2022 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Jan 2022 Country/area Dec AprNovSepJul 2021 May Jun OctAug Feb Mar Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 May 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in May 2021 to April 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 May 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China 2 1 China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas MarFebJan 2022 Country/area AprOct Nov Dec 2021 May Jun Jul Aug Sep 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Apr Australia 100% 100% 11 Feb 07 Mar 04 Apr 09 May 100% 75% Brunei Darussalam 100% 92% 07 Feb 08 Mar 09 Apr 05 May 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% China 100% 50% 18 Feb 15 Mar 15 Apr 17 May 100% 50% China, Hong Kong SAR 100% 100% 08 Feb 02 Mar 04 Apr 09 May 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 07 Apr 03 May 100% 100% Japan 100% 100% 03 Feb 02 Mar 03 Apr 02 May 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 08 Apr 10 May 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 09 May 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 09 Apr 09 May 100% 75% Philippines 100% 100% 10 Feb 04 Mar 08 Apr 10 May 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 08 Apr 10 May 100% 100% Singapore 100% 100% 07 Feb 02 Mar 04 Apr 06 May 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 15 Apr - 75% 100% Completeness 99% 100% 100% 100% 94% 99% Timeliness 95% 82% 100% 100% 88% 94% 1 National measles surveillance monthly reports from April 2022. Legend: black = timely report; red = untimely report 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting th di id d b th b f t d t f th Country 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 2021 Australia 100% 100% 02 Feb 04 Mar 06 Apr 05 May 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 05 May 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% China 100% 100% 10 Feb 04 Mar 15 Apr 17 May 100% 75% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 04 Apr 04 May 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 10 Apr 06 May 100% 100% Japan 100% 100% 07 Feb 02 Mar 03 Apr 02 May 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 10 Apr 10 May 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 10 May 100% 100% Papua New Guinea 0% 0% - - - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 10 Apr 10 May 100% 100% Republic of Korea 100% 92% 10 Feb 10 Mar 08 Apr 10 May 100% 100% Singapore 100% 100% 07 Feb 07 Mar 04 Apr 06 May 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 100% 100% Fiji 92% 92% 15 Feb 15 Mar 15 Apr - 75% 75% Completeness 95% 95% 95% 95% 90% 94% Timeliness 94% 95% 95% 95% 85% 93% 1 National measles laboratory monthly reports from April 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Completeness 2 Timeliness 3 2022 1 Jan Feb Mar Apr Country/area Completeness 2 Timeliness 3 2021

Volume 16 • Issue 6 • June 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–31 May 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, December 2021–May 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 June 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 0 0 0 0 0 0 0 0 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 0 0 0 0 1 1 0 0 0 0 China 47 57 15 27 32 46 30 44 32 43 64 98 China, Hong Kong SAR 0 0 0 0 0 0 0 0 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 1 1 0 0 0 0 0 0 0 0 0 0 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 9 10 20 20 12 13 14 15 21 21 21 24 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 0 20 0 12 2 10 2 51 6 40 0 57 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 0 0 0 0 0 0 0 0 1 Viet Nam 0 4 0 1 0 0 2 3 0 0 0 0 Pacific island countries and areas 0 0 0 0 0 0 0 0 0 0 0 0 Western Pacific Region 57 92 35 60 46 69 49 114 59 104 85 180 1 Reports only confirmed cases "-" No data 2021 Dec Country/area Apr 2022 MayJan Feb Mar Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 June 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 June 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay 2017 2018 2019 2020 2021 2022 N um be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 June 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 June 2022 Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 0 - - - - - 0 - - - - - Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 1 0 0 0 1 0.0% China - 505 0 0 0 505 0.0% 185 0 0 0 185 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 0 - - - - - China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 0 - - - - - Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 97 24 80.2% 88 0 0 71 17 80.7% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 10 0 0 10 0 100.0% Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 0 - - - - - Viet Nam - 33 0 0 0 33 0.0% 2 0 0 0 2 0.0% Pacific island countries and areas - 2 0 0 0 2 0.0% 0 - - - - - Total 686 1 0 107 578 15.7% 286 0 0 81 205 28.3% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection Country/area Year verified 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 June 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 0 0.0 26.1 NA3 0 0 0 0 0 0 0.0 - 26-Feb-20 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 11 0 11 0 0 0 0 0.0 0 13-Sep-19 Cambodia 3 0.2 676 41.0 379 22.7 5 0.3 17.2 176 34 141 0 1 0 1 0.1 0 7-Mar-22 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1448.5 7 853 771 6 837 60 185 0 245 0.4 0 31-May-22 China, Hong Kong SAR 16 2.2 90 12.1 1 0.1 1 0.1 7.6 1 1 0 0 0 0 0 0.0 0 19-Aug-21 China, Macao SAR 3 4.7 37 57.8 0 0.0 0 0.0 0.7 4 0 4 0 0 0 0 0.0 0 6-May-19 Japan 284 2.2 763 6.0 12 0.1 6 0.0 125.6 28 0 28 0 0 0 0 0.0 0 7-Dec-21 Lao People's Democratic Republic 10 1.4 1 290 179.9 135 18.6 2 0.3 7.5 167 14 153 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 62.1 1 077 33.7 478 14.8 128 3.9 33.2 1 394 133 1 153 5 88 0 93 6.7 0 29-May-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 36 0 36 0 0 0 0 0.0 0 4-Mar-19 New Zealand 36 7.6 2 229 466.0 7 1.5 0 0.0 4.9 26 0 26 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.7 1 0.1 4 0.4 0 0.0 9.3 37 8 29 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 214.4 48 521 448.8 3 723 34.0 218 2.0 112.5 522 0 351 161 10 0 171 3.6 0 16-Apr-22 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.3 76 0 33 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.9 14 2.4 1 0.2 5.9 15 0 6 1 0 0 1 0.4 0 9-Oct-20 Viet Nam 1 247 13.1 5 723 59.3 713 7.3 163 1.7 99.0 70 33 33 2 2 0 4 0.1 0 29-Mar-22 Pacific island countries and areas4 0 0.0 6 346 1885.5 75 22.0 2 0.6 3.5 46 0 46 0 0 0 0 0.0 0 14-Nov-21 Western Pacific Region 30 575 15.9 64 177 33.2 6 370 3.3 1 080 0.6 1956.5 10 462 994 8 887 229 286 0 515 0.6 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases Country/area 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 June 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 5.9 Not applicable 100.0% 100.0% Cambodia 2.0 24.0% 96.3% 99.7% 2.0 20.0% 96.6% 100.0% China 1.98 0.0% 98.8% 97.9% 1.13 0.0% 97.8% 96.0% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable 0.0% 0.0% China, Macao SAR 3.5 Not applicable 91.3% 100.0% 1.4 Not applicable 100.0% 100.0% Japan 0.1 0.0% Insufficient data Insufficient data 0.1 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 4.9 55.6% 8.4% 8.4% Malaysia 6.2 62.5% 80.3% 96.8% 8.3 68.8% 82.9% 96.9% Mongolia 0.2 4.5% 100.0% 100.0% 2.6 13.6% 97.2% 100.0% New Zealand 1.5 15.0% Insufficient data Insufficient data 1.3 25.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.7 15.0% 83.8% 86.5% Philippines 0.6 0.0% 70.3% 72.8% 0.7 11.1% 69.7% 73.9% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.2 0.0% 13.2% 39.5% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 6.7% 13.3% Viet Nam 0.2 1.6% 38.9% 39.2% 0.1 0.0% 0.0% 40.0% Pacific island countries and areas4 2.5 0.0% 45.7% 95.7% 3.2 5.0% 93.5% 97.8% Western Pacific Region 1.7 6.9% 94.8% 95.4% 1.1 12.6% 91.1% 92.3% Green Yellow Red Substantially below target 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 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological block; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 June 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.1 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 11 4 7 0 0 0 0 0.0 - Cambodia 3 0.2 30 1.8 40 2.4 10 0.6 17.2 142 0 139 0 3 0 3 0.4 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 448.5 7 853 771 6 729 89 264 0 353 0.6 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.6 0 - - - - - - - - China, Macao SAR 1 1.6 79 123.0 3 4.6 0 0.0 0.7 4 0 4 0 0 0 0 0.0 - Japan3 3 072 24.2 2 315 18.2 92 0.7 11 0.1 125.6 22 0 20 0 2 0 2 0.0 - Lao People's Democratic Republic 16 2.3 27 3.8 22 3.1 3 0.4 7.5 0 - - - - - - - - Malaysia 175 5.6 111 3.4 103 3.1 97 3.0 33.2 1 394 133 1 213 0 48 0 48 3.5 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 36 0 35 0 1 0 1 0.7 - New Zealand - - 1 0.2 - - 0 0.0 4.9 0 - - - - - - - - Papua New Guinea 3 0.3 5 0.6 2 0.2 0 0.0 9.3 37 8 27 0 2 0 2 0.5 - Philippines 152 1.4 198 1.8 404 3.7 36 0.3 112.5 361 0 351 0 10 0 10 0.2 - Republic of Korea 0 0.00 8 0.2 2 0.0 0 0.0 51.3 45 0 45 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 5.9 8 1 2 5 0 0 5 2.0 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 99.0 35 2 33 0 0 0 0 0.0 - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 46 0 45 0 1 0 1 0.7 - Western Pacific Region 7 487 3.9 35 484 18.5 3 019 1.6 1 046 0.5 1 956.5 9 994 919 8 650 94 331 0 425 0.5 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population Red >= 10 confirmed cases / 1 000 000 population number of rubella cases occurring in Japan during 2018 Gray No data "-" No data 3 Rubella cases are cases reported as suspected measles cases that were identified as rubella laboratory confirmed cases during the investigation. This represents a small proportion of a large Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Country/area 2019 Total confirmed and clinically compatible Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 June 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 0 1 0 - - - - Brunei Darussalam DLS 7 7 7 7 0 0% 0 0% 0 - 100.0 0 - 0 - 0 11 4 36% 0 0% Cambodia NIPH 142 142 142 142 1 1% 0 0% 0 - 89.8 0 - 0 - 1 142 3 2% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 96 96 96 81 1 1% 0 0% 0 - 92.5 0 - 15 0 1 32 0 0% 1 3% China, Macao SAR PHL 25 25 25 23 2 9% 0 0% 0 - 95.7 0 - 4 0 2 23 0 0% 0 0% Japan NIID 57 52 37 6 0 0% 1 17% 0 - - 2 2 20 0 2 5 2 40% 2 40% Lao People's Democratic Republic NCLE 1 1 1 0 - - - - 0 - - 0 - 0 - - 1 0 - 0 - Malaysia NPHL 2 422 2 422 1 516 1 465 123 8% 27 2% 0 - 98.4 720 0 126 0 123 1 400 114 8% 15 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 20 20 20 2 0 0% 0 0% 0 - 100.0 0 - 18 0 0 2 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 461 461 286 362 10 3% 4 1% 0 - 99.2 68 1 77 0 11 355 10 3% 2 1% Republic of Korea KCDC 140 140 86 36 5 14% 0 0% 0 - 91.3 0 - 31 2 5 48 38 79% 0 0% Singapore NPHL 78 78 78 1 0 - 0 - 0 - 100.0 0 - 78 0 0 1 0 - 0 - Viet Nam national lab (Northern) NIHE 10 10 10 10 0 - 0 - 0 - 100.0 0 - 0 - 0 10 1 - 0 - Viet Nam national lab (Southern) PI 18 18 18 18 0 0% 0 0% 0 - 100.0 0 - 0 - 0 18 1 6% 0 0% Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 46 46 46 45 0 0% 0 0% 0 - 100.0 0 - 0 - 0 44 0 0% 0 0% Total 3 524 3 519 2 369 2 198 142 6% 32 1% 0 0 97.5 790 3 370 2 146 2 092 173 8% 20 1% "-" No data DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in June 2021 to May 2022, WHO Western Pacific Region 2021 2022 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas Jan 2022 Country/area Dec MayNovSepJul 2021 Jun OctAug Feb Mar Apr Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 June 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in June 2021 to May 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 June 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas MarFebJan 2022 Country/area MayOct Nov AprDec 2021 Jun Jul Aug Sep 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Apr May Australia 100% 100% 11 Feb 07 Mar 04 Apr 09 May 08 Jun 100% 80% Brunei Darussalam 100% 92% 07 Feb 08 Mar 09 Apr 05 May 04 Jun 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% China 100% 50% 18 Feb 15 Mar 15 Apr 17 May 16 Jun 100% 40% China, Hong Kong SAR 100% 100% 08 Feb 02 Mar 04 Apr 09 May 06 Jun 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 07 Apr 03 May 08 Jun 100% 100% Japan 100% 100% 03 Feb 02 Mar 03 Apr 02 May 02 Jun 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 09 May 09 Jun 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 09 Apr 09 May 10 Jun 100% 80% Philippines 100% 100% 10 Feb 04 Mar 08 Apr 10 May 08 Jun 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 100% 100% Singapore 100% 100% 07 Feb 02 Mar 04 Apr 06 May 03 Jun 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 80% 100% Completeness 99% 100% 100% 100% 94% 100% 99% Timeliness 95% 82% 100% 100% 88% 94% 94% 1 National measles surveillance monthly reports from May 2022. Legend: black = timely report; red = untimely report 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting th di id d b th b f t d t f th Country 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 2021 Australia 100% 100% 02 Feb 04 Mar 06 Apr 05 May 07 Jun 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 05 May 02 Feb 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% China 100% 100% 10 Feb 04 Mar 15 Apr 17 May 01 Jun 100% 80% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 04 Apr 04 May 07 Jun 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 10 Apr 06 May 10 Jun 100% 100% Japan 100% 100% 07 Feb 02 Mar 03 Apr 02 May 02 Jun 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 10 May 09 Jun 100% 100% Papua New Guinea 0% 0% - - - - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% Republic of Korea 100% 92% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 100% 100% Singapore 100% 100% 07 Feb 07 Mar 04 Apr 06 May 03 Jun 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 100% 100% Fiji 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 80% 80% Completeness 95% 95% 95% 95% 90% 95% 94% Timeliness 94% 95% 95% 95% 85% 95% 93% 1 National measles laboratory monthly reports from May 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Completeness 2 Timeliness 3 2022 1 Jan Feb Mar Apr May Country/area Completeness 2 Timeliness 3 2021

Volume 16 • Issue 7 • July 2022 ISSN 1814 3601 Figure 1. Incidence rate of measles cases with rash onset 1–30 June 2022, WHO Western Pacific Region Pacific island countries and areas DISCLAIMER: The boundaries and names shown and the designations used on this map 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved *Map of Australia is from the Australian Bureau of Statistics Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, January–June 2022, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 July 2022 No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases No. of confirmed Total no. of cases Australia1 0 0 0 0 0 0 0 0 0 0 1 1 Brunei Darussalam 0 0 0 0 0 0 0 0 0 0 0 0 Cambodia 0 0 0 0 1 1 0 0 0 0 0 0 China 15 27 32 46 30 44 32 43 64 98 41 82 China, Hong Kong SAR 0 0 0 0 0 0 0 0 0 0 0 0 China, Macao SAR 0 0 0 0 0 0 0 0 0 0 0 0 Japan 0 0 0 0 0 0 0 0 0 0 0 0 Lao People's Democratic Republic 0 0 0 0 0 0 0 0 0 0 0 0 Malaysia 20 20 12 13 13 13 18 18 30 32 10 15 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 0 0 0 0 0 0 0 0 0 0 0 0 Papua New Guinea 0 0 0 0 0 0 0 0 0 0 0 0 Philippines 0 9 2 12 2 47 6 43 4 48 3 37 Republic of Korea 0 0 0 0 0 0 0 0 0 0 0 0 Singapore 0 0 0 0 0 0 0 0 0 1 1 1 Viet Nam 0 1 0 1 2 4 0 0 0 3 1 1 Pacific island countries and areas 0 0 0 0 0 0 0 0 0 0 0 0 Western Pacific Region 35 57 46 72 48 109 56 104 98 182 57 137 1 Reports only confirmed cases "-" No data Mar Country/area MayApr 2022 JuneJan Feb Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 July 2022 Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2017–2022 as of 20 July 2022 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p Oc t No v De c Ja n Fe b M ar Ap r M ay Ju n 2017 2018 2019 2020 2021 2022 N um be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Source: Measles and rubella monthly country reports to WHO by 20 July 2022 Table 2. Status of verification of measles elimination, WHO Western Pacific Region Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 July 2022 Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 0 - - - - - 1 1 0 0 0 100.0% Brunei Darussalam 2015 0 - - - - - 0 - - - - - Cambodia - 5 0 0 0 5 0.0% 1 0 0 0 1 0.0% China - 505 0 0 0 505 0.0% 229 0 0 0 229 0.0% China, Hong Kong SAR 2016 1 0 0 0 1 0.0% 0 - - - - - China, Macao SAR 2014 0 - - - - - 0 - - - - - Japan 2015 5 1 0 0 4 20.0% 0 - - - - - Lao People's Democratic Republic - 2 0 0 0 2 0.0% 0 - - - - - Malaysia - 121 0 0 97 24 80.2% 103 2 0 79 22 78.6% Mongolia - 0 - - - - - 0 - - - - - New Zealand 2017 0 - - - - - 0 - - - - - Papua New Guinea - 0 - - - - - 0 - - - - - Philippines - 12 0 0 10 2 83.3% 17 0 0 16 1 94.1% Republic of Korea 2014 0 - - - - - 0 - - - - - Singapore 2018 0 - - - - - 1 0 0 0 1 0.0% Viet Nam - 33 0 0 0 33 0.0% 3 0 0 0 3 0.0% Pacific island countries and areas - 2 0 0 0 2 0.0% 0 - - - - - Total 686 1 0 107 578 15.7% 355 3 0 95 257 27.6% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% 2022 No. of confirmed cases Source of infection % of cases with known source of infection 2021 No. of confirmed cases Source of infection % of cases with known source of infection Country/area Year verified 2 3Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2018—2022 as of 20 July 2022 Clinically compatible Lab Epi-linked Total confirmed and clinically compatible1 Annualized measles incidence per 1 million pop. Australia 101 4.1 285 11.3 25 1.0 0 0.0 26.1 NA3 0 0 0 1 0 1 0.1 0 12-Jun-22 Brunei Darussalam 1 2.3 1 2.3 0 0.0 0 0.0 0.4 11 0 11 0 0 0 0 0.0 0 13-Sep-19 Cambodia 3 0.2 676 41.0 379 22.7 5 0.3 17.2 261 3 257 0 1 0 1 0.1 0 7-Mar-22 China 3 975 2.8 3 098 2.2 867 0.6 554 0.4 1448.5 11 226 1 075 9 852 70 229 0 299 0.4 0 30-Jun-22 China, Hong Kong SAR 16 2.2 90 12.1 1 0.1 1 0.1 7.6 1 1 0 0 0 0 0 0.0 0 19-Aug-21 China, Macao SAR 3 4.7 37 57.8 0 0.0 0 0.0 0.7 5 0 5 0 0 0 0 0.0 0 6-May-19 Japan 284 2.2 763 6.0 12 0.1 6 0.0 125.6 40 1 39 0 0 0 0 0.0 0 7-Dec-21 Lao People's Democratic Republic 10 1.4 1 290 179.9 135 18.6 2 0.3 7.5 259 37 222 0 0 0 0 0.0 0 5-Feb-21 Malaysia 1 958 62.1 1 077 33.7 478 14.8 128 3.9 33.2 1 816 195 1 492 8 103 0 111 6.7 0 25-Jun-22 Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 38 0 0 0 0 0.0 0 4-Mar-19 New Zealand 36 7.6 2 229 466.0 7 1.5 0 0.0 4.9 32 0 32 0 0 0 0 0.0 0 29-Jan-20 Papua New Guinea 15 1.7 1 0.1 4 0.4 0 0.0 9.3 42 11 31 0 0 0 0 0.0 0 7-Sep-20 Philippines 22 869 214.4 48 521 448.8 3 723 34.0 218 2.0 112.5 814 0 616 181 17 0 198 3.5 0 14-Jun-22 Republic of Korea 19 0.4 191 3.7 6 0.1 0 0.0 51.3 94 0 43 0 0 0 0 0.0 0 10-Feb-20 Singapore 37 6.4 162 27.9 14 2.4 1 0.2 5.9 18 0 7 1 1 0 2 0.7 0 9-Oct-20 Viet Nam 1 247 13.1 5 723 59.3 713 7.3 163 1.7 99.0 111 46 55 7 3 0 10 0.2 0 13-Jun-22 Pacific island countries and areas4 0 0.0 6 346 1885.5 75 22.0 2 0.6 3.5 46 0 46 0 0 0 0 0.0 0 14-Nov-21 Western Pacific Region 30 575 15.9 64 177 33.2 6 370 3.3 1 080 0.6 1956.5 14 814 1 369 12 746 267 355 0 622 0.6 0 1 Includes clinically compatible, laboratory confirmed and epi-linked confirmed cases Green <1 confirmed measles case / 1 000 000 population 2 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision. Yellow 1–9.9 confirmed measles case / 1 000 000 population 3 Australia reports confirmed cases only. Red >= 10 confirmed cases / 1 000 000 population 4 Classification is provisional based on laboratory data only. Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 July 2022 Measles cases Deaths due to measles 2021 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 2020 2022 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases Country/area 2018 Pending classification Discarded cases3 2019 Total confirmed and clinically compatible1 Measles incidence per 1 million pop. Total confirmed and clinically compatible1 Measles incidence per 1 million pop. 4Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2021—2022 as of 20 July 2022 Discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 Annualized discarded non-measles rate per 100 000 pop Second level units with ≥ 2 discarded cases per 100 000 pop [annualized]1 ≥ 2 ≥ 80% ≥ 2 ≥ 80% Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.1 Not applicable 100.0% 100.0% 4.9 Not applicable 100.0% 100.0% Cambodia 2.0 24.0% 96.3% 99.7% 3.0 36.0% 96.2% 100.0% China 1.98 0.0% 98.8% 97.9% 1.36 12.9% 97.6% 95.7% China, Hong Kong SAR 0.0 Not applicable 100.0% 100.0% 0.0 Not applicable 0.0% 0.0% China, Macao SAR 3.5 Not applicable 91.3% 100.0% 1.5 Not applicable 100.0% 100.0% Japan 0.1 0.0% Insufficient data Insufficient data 0.1 0.0% Insufficient data Insufficient data Lao People's Democratic Republic 0.5 5.6% 46.7% 77.8% 5.9 55.6% 5.8% 5.8% Malaysia 6.2 62.5% 80.3% 96.8% 9.0 68.8% 81.7% 95.8% Mongolia 0.2 4.5% 100.0% 100.0% 2.2 13.6% 97.4% 100.0% New Zealand 1.5 15.0% Insufficient data Insufficient data 1.3 15.0% Insufficient data Insufficient data Papua New Guinea 0.1 0.0% 100.0% 87.5% 0.7 15.0% 85.7% 88.1% Philippines 0.6 0.0% 70.3% 72.8% 1.1 16.7% 71.4% 74.2% Republic of Korea 0.4 0.0% 92.9% 94.8% 0.2 0.0% 31.9% 44.7% Singapore 0.1 Not applicable 25.0% 25.0% 0.2 Not applicable 16.7% 11.1% Viet Nam 0.2 1.6% 38.9% 39.2% 0.1 0.0% 0.0% 41.4% Pacific island countries and areas4 2.5 0.0% 45.7% 95.7% 2.6 5.0% 93.5% 97.8% Western Pacific Region 1.7 6.9% 94.8% 95.4% 1.3 14.8% 90.9% 91.7% Green Yellow Red Substantially below target 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 2022 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% Country/area 2021 Suspected cases with adequate investigation Suspected cases with adequate specimens for laboratory confirmation 2 ≥ 80% ≥ 80% 1 This indicator is not applicable for countries which have no second-level administrative units 2 Adequate specimen defined as blood specimen collected within 28 days of rash onset or other specimen (throat swab, nasopharyngeal swab, cerebrospinal fluid, urine) collected within 5 days of rash onset; excludes epidemiologically-linked cases. 3 Reports only confirmed cases 4 Surveillance performance indicators refer to all the Pacific island countries and areas as one epidemiological block; each country is considered as second level unit 5Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2018–2022 as of 20 July 2022 Clinically compatible cases Lab Epi-linked Australia - - - - - - - - 26.1 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.4 11 4 7 0 0 0 0 0.0 - Cambodia 3 0.2 30 1.8 40 2.4 10 0.6 17.2 258 0 253 0 5 0 5 0.6 - China 3 935 2.8 32 568 22.9 2 202 1.5 845 0.6 1 448.5 11 226 1 075 9 674 126 351 0 477 0.7 - China, Hong Kong SAR 11 1.5 48 6.4 4 0.5 2 0.3 7.6 0 - - - - - - - - China, Macao SAR 1 1.6 79 123.0 3 4.6 0 0.0 0.7 5 0 5 0 0 0 0 0.0 - Japan 3 072 24.2 2 315 18.2 92 0.7 11 0.1 125.6 30 1 26 0 3 0 3 0.0 - Lao People's Democratic Republic 16 2.3 27 3.8 22 3.1 3 0.4 7.5 0 - - - - - - - - Malaysia 175 5.6 111 3.4 103 3.1 97 3.0 33.2 1 816 195 1 558 0 63 0 63 3.8 - Mongolia 1 0.3 2 0.6 0 0.0 0 0.0 3.4 38 0 37 0 1 0 1 0.6 - New Zealand - - 1 0.2 - - 0 0.0 4.9 0 - - - - - - - - Papua New Guinea 3 0.3 5 0.6 2 0.2 0 0.0 9.3 42 11 29 0 2 0 2 0.4 - Philippines 152 1.4 198 1.8 404 3.7 36 0.3 112.5 814 0 793 0 21 0 21 0.4 - Republic of Korea 0 0.00 8 0.2 2 0.0 0 0.0 51.3 55 0 55 0 0 0 0 0.0 - Singapore 16 2.8 7 1.2 10 1.7 0 0.0 5.9 9 0 4 5 0 0 5 1.7 - Viet Nam 102 1.1 85 0.9 135 1.4 38 0.4 99.0 69 17 50 0 2 0 2 0.0 - Pacific island countries and areas2 0 0.0 0 0.0 0 0.0 4 1.2 3.5 46 0 45 0 1 0 1 0.6 - Western Pacific Region 7 487 3.9 35 484 18.5 3 019 1.6 1 046 0.5 1 956.5 14 419 1 303 12 536 131 449 0 580 0.6 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2019 revision Green <1 confirmed measles case / 1 000 000 population 2 Classification is provisional based on laboratory data only. Yellow 1–9.9 confirmed measles case / 1 000 000 population "-" No data Red >= 10 confirmed cases / 1 000 000 population Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 July 2022 Gray No data 2020 2021 Total confirmed and clinically compatible Rubella incidence per 1 million pop. Total confirmed and clinically compatible Rubella incidence per 1 million pop. Rubella incidence per 1 million pop. Total confirmed and clinically compatible 2019 Country/area Total confirmed and clinically compatible Rubella incidence per 1 million pop. 2018 Total confirmed and clinically compatible Annualized Rubella incidence per 1 million pop. Congenital rubella syndrome Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Rubella cases 2022 6Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2021 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 1 1 1 0 - - - - 0 - - 0 - 1 1 1 0 - - - - Brunei Darussalam DLS 20 20 19 19 1 5% 0 0% 0 - 100.0 0 - 0 - 1 19 0 0% 0 0% Cambodia NIPH 351 351 351 351 5 1% 0 0% 0 - 95.7 0 - 0 - 5 351 10 3% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 335 335 271 262 3 1% 2 1% 0 - 96.8 0 - 64 0 3 152 2 1% 2 1% China, Macao SAR PHL 69 69 64 64 0 0% 1 2% 0 - 98.4 1 0 5 0 0 64 3 5% 1 2% Japan NIID 227 199 134 25 4 16% 16 64% 0 - - 8 8 55 1 12 32 11 34% 15 47% Lao People's Democratic Republic NCLE 32 32 32 32 2 6% 2 6% 0 - 75.0 0 - 0 - 2 32 3 9% 0 0% Malaysia NPHL 4 450 4 450 2 990 2 730 172 6% 63 2% 0 - 91.9 1 187 0 0 - 172 2 644 247 9% 39 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 69 69 56 14 1 7% 1 7% 0 - 78.6 0 - 54 0 1 12 0 0% 1 8% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 788 675 665 674 12 2% 2 0% 1 0 98.9 0 - 107 1 13 663 27 4% 12 2% Republic of Korea KCDC 567 567 359 176 11 6% 3 2% 0 - 88.0 0 - 183 13 22 166 89 54% 17 10% Singapore NPHL 228 228 227 8 0 0% 0 0% 0 - 88.9 11 0 218 5 5 8 0 0% 2 25% Viet Nam national lab (Northern) NIHE 56 56 56 56 22 39% 2 4% 0 - - 0 - 0 - 22 34 4 12% 0 0% Viet Nam national lab (Southern) PI 118 118 118 118 4 3% 2 2% 0 - - 0 - 0 - 4 118 6 5% 5 4% Viet Nam subnational lab (Central) PI 9 9 9 9 4 44% 0 0% 0 - - 0 - 0 - 4 6 0 0% 0 0% Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 97 91 91 91 3 3% 3 3% 0 - - 0 - 3 0 3 90 5 6% 2 2% Total 7 417 7 270 5 443 4 629 244 5% 97 2% 1 0 93.4 1 207 8 690 21 270 4 391 407 9% 96 2% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 July 2022 Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % of samples with results ≤4 days Measles IgM equiv 7Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2022 as of 20 July 2022 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 2 2 2 0 - - - - 0 - - 0 - 2 1 1 0 - - - - Brunei Darussalam DLS 7 7 7 7 0 0% 0 0% 0 - 100.0 0 - 0 - 0 11 4 36% 0 0% Cambodia NIPH 258 258 258 258 1 0% 0 0% 0 - 92.0 0 - 0 - 1 258 5 2% 0 0% China CCDC - - - - - - - - - - - - - - - - - - - - - China, Hong Kong SAR PHLC 127 127 110 105 1 1% 0 0% 0 - 94.2 0 - 21 0 1 46 0 0% 1 2% China, Macao SAR PHL 31 31 28 28 2 7% 0 0% 0 - 96.4 0 - 5 0 2 28 0 0% 0 0% Japan NIID 112 102 48 8 0 0% 3 38% 0 - - 2 2 27 0 2 7 3 43% 3 43% Lao People's Democratic Republic NCLE 1 1 1 0 - - - - 0 - - 0 - 0 - - 1 0 - 0 - Malaysia NPHL 3 138 3 138 1 965 1 913 155 8% 41 2% 0 - 98.6 720 0 353 0 155 1 836 148 8% 18 1% Mongolia NCCD 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - New Zealand CHL 27 27 24 3 0 0% 0 0% 0 - 66.7 0 - 24 0 0 3 0 0% 0 0% Papua New Guinea CPHL - - - - - - - - - - - - - - - - - - - - - Philippines RITM 844 844 740 631 18 3% 5 1% 0 - 99.2 147 1 155 0 19 620 19 3% 7 1% Republic of Korea KCDC 174 174 108 45 8 18% 0 0% 0 - 89.7 0 - 47 3 0 58 45 78% 0 0% Singapore NPHL 95 95 95 1 0 - 0 - 0 - 100.0 0 - 95 0 0 1 0 - 0 - Viet Nam national lab (Northern) NIHE 12 12 12 12 0 - 0 - 0 - 100.0 0 - 0 - 0 11 1 - 0 - Viet Nam national lab (Southern) PI 18 18 18 8 0 0% 0 0% 0 - 100.0 0 - 0 - 0 18 2 11% 0 0% Viet Nam subnational lab (Central) PI 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Viet Nam subnational lab (Highland) IHE 0 - - 0 - - - - 0 - - 0 - 0 - 0 0 - - - - Fiji FCCDC 46 46 46 45 0 0% 0 0% 0 - 100.0 0 - 0 - 0 44 0 0% 0 0% Total 4 892 4 882 3 462 3 064 185 6% 49 2% 0 0 97.7 869 3 729 4 181 2 942 227 8% 29 1% "-" No data Source: Measles and rubella monthly laboratory reports to the Western Pacific Regional Office by 20 July 2022 DBS samples Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv % of samples with results ≤4 days Measles Virus isolation/ detection (swab, urine and others) Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Rubella Serology Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood 8Figure 3. Measles genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in July 2021 to June 2022, WHO Western Pacific Region 2021 2022 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 B3 D8 D9 H1 Australia 1 Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan 1 Lao People's Democratic Republic Malaysia 1 Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas JunNovSepJul 2021 OctAug Feb Mar Apr MayDecCountry/area Jan 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 July 2022 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2022. All rights reserved. 9Figure 4. Rubella genotype distribution of cases with rash onset in 2021 and 2022, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in July 2021 to June 2022, WHO Western Pacific Region 2021 2022 Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 July 2022 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J 2B 1E 1J Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Japan Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines Republic of Korea Singapore Viet Nam Pacific island countries and areas MayMarFebJan 2022 Country/area JunOct Nov AprDec 2021 Jul Aug Sep 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 lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO Regional Office for the Western Pacific 2021. All rights reserved. Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2021—2022 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2021—2022 Vaccine-Preventable Diseases and Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 85288001 Fax No. (63 2) 85211036, 85260279 Please send your comments and monthly data before the 10th of the month to: WPROEPIdata@who.int More detailed information available in the Regional and country profile of measles elimination Jan Feb Mar Apr May Jun Australia 100% 100% 11 Feb 07 Mar 04 Apr 09 May 08 Jun 06 Jul 100% 83% Brunei Darussalam 100% 92% 07 Feb 08 Mar 09 Apr 05 May 04 Jun 04 Jul 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% China 100% 50% 18 Feb 15 Mar 15 Apr 17 May 16 Jun 04 Jul 100% 50% China, Hong Kong SAR 100% 100% 08 Feb 02 Mar 04 Apr 09 May 06 Jun 05 Jul 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 07 Apr 03 May 08 Jun 07 Jul 100% 100% Japan 100% 100% 03 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% Malaysia 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 02 Jul 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 09 May 09 Jun 06 Jul 100% 100% Papua New Guinea 83% 83% 11 Feb 10 Mar 09 Apr 09 May 10 Jun 10 Jul 100% 83% Philippines 100% 100% 10 Feb 04 Mar 08 Apr 10 May 08 Jun 10 Jul 100% 100% Republic of Korea 100% 100% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 07 Jul 100% 100% Singapore 100% 100% 07 Feb 02 Mar 04 Apr 06 May 03 Jun 07 Jul 100% 100% Viet Nam 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% Pacific island countries and areas 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 83% 83% Completeness 99% 100% 100% 100% 94% 100% 100% 99% Timeliness 95% 82% 100% 100% 88% 94% 100% 94% 1 National measles surveillance monthly reports from June 2022. Legend: black = timely report; red = untimely report Country 2021 3 Countries and areas should submit reports by the 10th (or the next working day) of the following month; Pacific island countries and areas and China may report to the Regional Office by the 15th (or the next working day) of the following month. 2 Completeness is defined as the number of reports received by the end of the reporting th di id d b th b f t d t f th 2022 1 Completeness 2 Timeliness 3Completeness 2 Timeliness 3 Australia 100% 100% 02 Feb 04 Mar 06 Apr 05 May 07 Jun 07 Jul 100% 100% Brunei Darussalam 100% 100% 06 Feb 08 Mar 07 Apr 05 May 02 Feb 04 Jul 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% China 100% 100% 10 Feb 04 Mar 15 Apr 17 May 01 Jun 05 Jul 100% 83% China, Hong Kong SAR 100% 100% 09 Feb 07 Mar 04 Apr 04 May 07 Jun 06 Jul 100% 100% China, Macao SAR 100% 100% 10 Feb 07 Mar 10 Apr 06 May 10 Jun 10 Jul 100% 100% Japan 100% 100% 07 Feb 02 Mar 03 Apr 02 May 02 Jun 02 Jul 100% 100% Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% Malaysia 100% 100% 07 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% Mongolia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% New Zealand 100% 100% 09 Feb 09 Mar 10 Apr 10 May 09 Jun 06-Jul 100% 100% Papua New Guinea 0% 0% - - - - - - 0% 0% Philippines 100% 100% 08 Feb 10 Mar 10 Apr 10 May 10 Jun 09 Jul 100% 100% Republic of Korea 100% 92% 10 Feb 10 Mar 08 Apr 10 May 10 Jun 08 Jul 100% 100% Singapore 100% 100% 07 Feb 07 Mar 04 Apr 06 May 03 Jun 07 Jul 100% 100% Viet Nam national lab (Northern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% Viet Nam national lab (Southern) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% Viet Nam subnational lab (Central) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% Viet Nam subnational lab (Highland) 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% Fiji 92% 92% 15 Feb 15 Mar 15 Apr - 15 Jun 15 Jul 83% 83% Completeness 95% 95% 95% 95% 90% 95% 95% 94% Timeliness 94% 95% 95% 95% 85% 95% 100% 93% 1 National measles laboratory monthly reports from June 2022. 2 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. 3 National measles and rubella laboratories should submit monthly reports by the 10th (or the next working day) of the following month. Completeness 2 Timeliness 3 2022 1 Jan Feb Mar Apr May Jun Country/area Completeness 2 Timeliness 3 2021