Measles and rubella elimination country profile: San Marino

Measles elimination status Rubella elimination status Total population 33 401 < 1 year old 277 < 5 years old 1385 Demographic information, 2017 Source: World Population Prospects: The 2017 Revision, New York, United Nations Measles and rubella surveillance National case-based surveillance for measles, rubella and CRS Lab confirmation for diagnosis of measles, rubella and CRS Source: WHO/UNICEF Joint Reporting Form on Immunization, 2017 Measles and rubella elimination country profile San Marino Measles and rubella immunization schedule, 2017 Source: Immunization schedule, WHO, Data and Statistics, Immunization Monitoring and Surveillance (http://www.who.int/immunization/monitoring_surveillance/data/en/) MMR = measles-mumps-rubella vaccine; MCV1 = first dose measles-containing vaccine; MCV2 = second dose measles-containing vaccine; RCV = rubella-containing vaccine Measles and rubella cases and immunization coverage, 2008–2017 Source: Disease incidence and immunization coverage (WUENIC), WHO, Data and Statistics, Immunization Monitoring and Surveillance (http://www.who.int/immunization/monitoring_surveillance/data/en/) MCV1 = first dose of measles-containing vaccine MCV2= second dose of measles-containing vaccine Definition used for an outbreak Source: Measles and rubella elimination Annual Status Update report, 2017 ND = Data not available ND 2016 ND 2017 eliminated Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thrvc ND = Data not available 2016 ND 2017 eliminated Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thrvc ND = Data not available Vaccine Schedule MCV1 MMR 15 months MCV2 MMR 10 years Year of introduction MCV2 2001 RCV 1995 Measles vaccination in school No Information on CRS, 2017 ND Source: Measles and rubella elimination Annual Status Update report, 2017 CRS = congenital rubella syndrome ND = Data not available 0 10 20 30 40 50 60 70 80 90 100 0 10 20 30 40 50 60 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 % co ve ra ge Nu m be r o f c as es Year Measles Rubella MCV1 coverage MCV2 coverage Suspected measles cases Confirmed measles cases Discarded as non- measles Measles incidence Genotypes detected Laboratory Epi- linked Clinically Total 2013 ND ND ND ND ND ND ND ND 2014 ND ND ND ND ND ND ND ND 2015 ND ND ND ND ND ND ND ND 2016 ND ND ND ND ND ND ND ND 2017 0 0 0 0 0 0 0 NA Measles incidence, epidemiologic and virologic characteristics, 2013-2017 Measles surveillance and laboratory performance indicators, 2013-2017 Source: Measles and rubella elimination Annual Status Update report, 2013-2017 Incidence calculated per 1 million population ND = Data not available; NA= Not applicable Source: ASU 2013-2017 ND = Data not available; NA= Not applicable A proficient laboratory is WHO accredited and/or has an established quality assurance programme with oversight by a WHO accredited laboratory Rubella incidence, epidemiologic and virologic characteristics, 2013-2017 Rubella surveillance and laboratory performance indicators, 2013-2017 Source: Measles and rubella elimination Annual Status Update report, 2013-2017 Incidence calculated per 1 million population ND = Data not available; NA= Not applicable Source: ASU 2013-2017 ND = Data not available; NA= Not applicable A proficient laboratory is WHO accredited and/or has an established quality assurance programme with oversight by a WHO accredited laboratory Surveillance performance indicators and targets a. Rate of discarded cases: at least 2 discarded measles or rubella cases per 100 000 population b. % cases with adequate laboratory investigation: ≥ 80% c. % origin of infection known: ≥ 80% d. Rate of viral detection: ≥ 80% Measles and rubella elimination country profile San Marino Discarded non- measles rate % 1st sub- national unit with ≥ 2 discarded cases % cases with adequate laboratory investigation % origin of infection known # specimen tested for measles % positive for measles Rate of viral detection % WHO and proficient labs 2013 ND ND ND ND ND ND ND ND 2014 ND ND ND ND ND ND ND ND 2015 ND ND ND ND ND ND ND ND 2016 ND ND ND ND ND ND ND ND 2017 ND ND ND ND ND 0% ND ND Suspected rubella cases Confirmed rubella cases Discarded as non- rubella Rubella incidence Genotypes detected Laboratory Epi- linked Clinically Total 2013 ND ND ND ND ND ND ND ND 2014 ND ND ND ND ND ND ND ND 2015 ND ND ND ND ND ND ND ND 2016 ND ND ND ND ND ND ND ND 2017 0 0 0 0 0 0 0 NA Discarded non- rubella rate % 1st sub- national unit with ≥ 2 discarded cases % cases with adequate laboratory investigtion % origin of infection known # specimen tested for rubella % positive for rubella Rate of viral detection % WHO and proficient labs 2013 ND ND ND ND ND ND ND ND 2014 ND ND ND ND ND ND ND ND 2015 ND ND ND ND ND ND ND ND 2016 ND ND ND ND ND ND ND ND 2017 ND ND ND ND ND 0% ND ND RVC comments, based on 2017 reporting The Regional Verification Commission for Measles and Rubella Elimination (RVC) congratulates San Marino on providing an ASU for the first time and greatly appreciates the efforts taken. Based on received data and considering population size, the RVC concluded that endemic transmission of both measles and rubella has been interrupted in San Marino for a period of 3 years, and verified that measles and rubella have been eliminated. The RVC commends the national health authorities and public health system on this achievement. Source: Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report (www.euro.who.int/7thrvc) ©WHO 2019