Measles and rubella elimination country profile: Ukraine

Measles elimination status Rubella elimination status Total population 44 222 947 < 1 year old 429 937 < 5 years old 2 303 013 Demographic information, 2017 Source: World Population Prospects: The 2017 Revision, New York, United Nations Measles and rubella surveillance National case-based surveillance for measles Lab confirmation for diagnosis of measles, rubella and CRS Source: WHO/UNICEF Joint Reporting Form on Immunization, 2017 Measles and rubella elimination country profile Ukraine 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 Several cases (3 and more) that are epidemiologically linked between each other by infection source Confirmed measles cases by month of onset, 2013-2017 Source: CISID 2017 Vaccine Schedule MCV1 MMR 12 months MCV2 MMR 6 years Year of introduction MCV2 2001 RCV 2003 Measles vaccination in school No 2016 endemic 2017 endemic 2016 endemic 2017 endemic 0 10 20 30 40 50 60 70 80 90 100 0 2000 4000 6000 8000 10000 12000 14000 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 0 200 400 600 800 1000 1200 1400 1600 J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D 2013 2014 2015 2016 2017 N u m b e r o f ca se s Month and year Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thrvc Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thrvc Measles and rubella elimination country profile Ukraine ©WHO 2019 Information on CRS, 2017 No cases reported Source: Measles and rubella elimination Annual Status Update report, 2017 CRS = congenital rubella syndrome Measles cases by first subnational level, 2017 Source: Measles and rubella elimination Annual Status Update report, 2017 Measles genotypes by first subnational level, 2017 Source: MeaNS 2017 Note: The dots in the maps are placed randomly within the administrative regions. Map disclaimer: The boundaries and names shown and the designations used on the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Sources of infection, 2017 Measles Rubella Imported 1 0 Import-related 0 0 Unknown/ Not reported 0 0 Endemic 4781 160 Source: Measles and rubella elimination Annual Status Update report, 2017 Measles cases by age group and vaccination status, 2017 Source: Measles and rubella elimination Annual Status Update report, 2017 Note: Excludes imported cases Supplementary immunization activities Year Target age Vaccine used % Coverage 2017 1-9Y MMR 57% 2017 6-9Y MMR 67% Source: Supplementary immunization activities, WHO, Data and Statistics, Immunization Monitoring and Surveillance (http://www.who.int/immunization/monitoring_surveillance/data/en/) MMR = measles-mumps-rubella vaccine ND = Data not available 1dot=1case •B3 •D8 •H1 •D4 0 20 40 60 80 100 < 1 1-4 5-9 10-14 15-19 20-29 30 + % o f c as es Age group (years) 0 doses 1 dose 2 or more doses Unknown Suspected measles cases Confirmed measles cases Discarded as non- measles Measles incidence Genotypes detected Laboratory Epi- linked Clinically Total 2013 3978 1300 0 2009 3309 669 72.8 D4,D8 2014 2800 857 520 939 2326 474 50.8 D4,D8 2015 235 35 0 70 105 130 2.4 ND 2016 638 47 21 34 102 536 2.4 D8 2017 5410 1984 926 1872 4782 628 112.3 D8 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 Ukraine 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 1.5 ND 39.3% ND 1 007 61.9% 14 100% 2014 1.1 ND 51.4% ND 517 39.9% 4 100% 2015 7.8 ND 82.3% 1.9% 326 10.7% 0 100% 2016 1.3 ND 100% 39.2% 638 7.4% 0 100% 2017 1.5 12% 50.1% 100% 2712 73.2% 24.2% 62.1% Suspected rubella cases Confirmed rubella cases Discarded as non- rubella Rubella incidence Genotypes detected Laboratory Epi- linked Clinically Total 2013 2193 362 0 909 1271 922 28 2B 2014 2013 304 122 915 1341 672 29 ND 2015 600 15 0 232 247 353 5.8 ND 2016 330 2 0 146 150 180 3.5 ND 2017 350 7 12 141 160 190 3.8 ND Discarded non- rubella rate % 1st sub- national unit with ≥ 2 discarded cases % cases with adequate laboratory investigtion % origin of infection known # specimen tested for rubella % positive for rubella Rate of viral detection % WHO and proficient labs 2013 2 ND 28.5% ND 478 29.7% ND 100% 2014 1.5 ND 42.2% ND 450 30% ND 100% 2015 0.8 ND 56.3% ND 338 4.4% ND 100% 2016 0.5 ND 100% ND 632 0.3% ND 100% 2017 0.4 ND 19.4% 100% 68 10.3% ND 80.9% RVC comments, based on 2017 reporting The Regional Verification Commission for Measles and Rubella Elimination (RVC) commends Ukraine on efforts to increase immunization coverage, but with ongoing measles outbreak still urges further steps to achieve and maintain universal high vaccination coverage with 2 doses of MRCV. Surveillance sensitivity, laboratory testing and genotyping needs to be strengthened and better documented in ASU. Source: Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report (www.euro.who.int/7thrvc) ©WHO 2019