Measles and rubella elimination country profile: Ireland

Measles elimination status Rubella elimination status Total population 4 818 690 < 1 year old 59 618 < 5 years old 328 993 Demographic information, 2018 Source: World Population Prospects: The 2019 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, 2018 Measles and rubella elimination country profile Ireland Measles and rubella immunization schedule, 2018 Source: WHO/UNICEF Joint Reporting Form on immunization, 2018 MMR = measles-mumps-rubella vaccine; MCV1 = first dose measles-containing vaccine; MCV2 = second dose measles-containing vaccine; RCV = rubella-containing vaccine Measles and rubella cases and immunization coverage, 2009–2018 Source: WHO/UNICEF Joint Reporting Form on immunization, 2018 and WHO/UNICEF Estimates of National Immunization Coverage (WUENIC), 2018 MCV1 = first dose of measles-containing vaccine MCV2= second dose of measles-containing vaccine Definition used for an outbreak Source: Measles and rubella elimination Annual Status Update report, 2018 An outbreak may be defined as two or more linked cases of the same illness or the situation where the observed number of cases exceeds the expected number 2017 eliminated 2018 eliminated Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC 2017 eliminated 2018 eliminated Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC Confirmed measles cases by month of onset, 2014-2018 Source: CISID, 2018 Vaccine Schedule MCV1 MMR 12 months MCV2 MMR 4-5 years Year of introduction MCV2 1992 RCV 1971 Measles vaccination in school Yes 0 10 20 30 40 50 60 70 80 90 100 0 50 100 150 200 250 300 350 400 450 500 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 % c o ve ra ge N u m b er o f ca se s Year Measles Rubella Coverage MCV1 Coverage MCV2 0 5 10 15 20 25 30 J F M AM J J A S O N D J F M AM J J A S O N D J F M AM J J A S O N D J F M AM J J A S O N D J F M AM J J A S O N D 2014 2015 2016 2017 2018 N u m b er o f ca se s Month and year Measles and rubella elimination country profile Ireland Information on CRS, 2018 No cases reported Source: Measles and rubella elimination Annual Status Update report, 2018 CRS = congenital rubella syndrome Measles cases by first subnational level, 2018 Source: Measles and rubella elimination Annual Status Update report, 2018 Measles genotypes by first subnational level, 2018 Source: MeaNS, 2018 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, 2018 Measles Rubella Imported 5 0 Import-related 60 0 Endemic 11 0 Unknown/ Not reported 0 0 Source: Measles and rubella elimination Annual Status Update report, 2018 Measles cases by age group and vaccination status, 2018 Source: Measles and rubella elimination Annual Status Update report, 2018 Note: Excludes imported cases 1dot=1case •B3 •D8 •H1 •D9 0 10 20 30 40 50 60 70 80 90 100 <1 1-4 5-9 10-14 15-19 20-29 30 + % o f c as es Age group (years) 0 doses 1 dose 2 or more doses Unknown 2 Suspected measles cases Confirmed measles cases Discarded as non- measles Measles incidence Genotypes detected Laboratory Epi- linked Clinically Total 2014 92 20 5 8 33 59 6.5 B3,D8 2015 71 2 0 0 2 69 0.2 D8 2016 197 43 0 0 43 154 8.7 B3,D8 2017 285 23 0 2 25 260 5.3 B3 2018 468 73 2 1 76 392 14.9 B3,D8 Measles incidence, epidemiologic and virologic characteristics, 2014-2018 Measles surveillance and laboratory performance indicators, 2014-2018 Source: Measles and rubella elimination Annual Status Update report, 2014-2018 Incidence calculated per 1 million population ND = Data not available; NA= Not applicable Source: Measles and rubella elimination Annual Status Update report, 2014-2018 ND = Data not available; NA= Not applicable A proficient laboratory is WHO accredited and/or has an established quality assurance programme with oversight by a WHO accredited laboratory Rubella incidence, epidemiologic and virologic characteristics, 2014-2018 Rubella surveillance and laboratory performance indicators, 2014-2018 Source: Measles and rubella elimination Annual Status Update report, 2014-2018 Incidence calculated per 1 million population ND = Data not available; NA= Not applicable * This case was weakly positive for IgM Source: Measles and rubella elimination Annual Status Update report, 2014-2018 ND = Data not available; NA= Not applicable A proficient laboratory is WHO accredited and/or has an established quality assurance programme with oversight by a WHO accredited laboratory Surveillance performance indicators and targets a. Rate of discarded cases: at least 2 discarded measles or rubella cases per 100 000 population b. % cases with adequate laboratory investigation: ≥ 80% c. % origin of infection known: ≥ 80% d. Rate of viral detection: ≥ 80% Measles and rubella elimination country profile Ireland Discarded non- measles rate % 1st sub- national unit with ≥ 2 discarded cases % cases with adequate laboratory investigation % origin of infection known # specimen tested for measles % positive for measles Rate of viral detection % WHO and proficient labs 2014 1.3 25% 95% 52% 23 9.1% 67% ND 2015 2 63% 99% 100% 333 9.3% 100% 100% 2016 3.4 50% 100% 100% 768 12.0% 100% 100% 2017 5 87.5% 100% 100% 299 7.7% 100% 100% 2018 8.2 100% 99% 100% 1289 5.9% 86% 100% Suspected rubella cases Confirmed rubella cases Discarded as non- rubella Rubella incidence Genotypes detected Laboratory Epi- linked Clinically Total 2014 12 1* 0 2 3 9 0.4 ND 2015 23 0 0 3 3 20 0.4 ND 2016 15 0 0 1 1 14 0.2 ND 2017 16 0 0 0 0 16 0 NA 2018 23 0 0 0 0 23 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 2014 0.2 ND 83.3% 67% 1780 0% 0% ND 2015 0.4 ND 91% 67% 241 0% 0% 100% 2016 0.3 ND 93% 0% 415 0% 0% 100% 2017 0.3 0% 100% 0% 866 0% 0% 80.1% 2018 0.5 12.5% 100% 0% 579 0% 0% 98.4% RVC comments, based on 2018 reporting The RVC concluded that endemic transmission of both measles and rubella remained interrupted in Ireland in 2018 and confirmed that measles- and rubella-elimination have been sustained. The RVC reiterated its concerns over the low vaccination coverage reported for Dublin and considers this a potential threat to maintaining elimination status. In view of the risk of widespread measles transmission following an importation, the RVC urges the implementation of WHO recom- mended strategies to close immunity gaps in the population and requests that the NVC and its secretariat provide compre- hensive coverage data and epidemiological analysis in future ASUs. Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC © World Health Organization 2020. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license.Document number: WHO/EURO:2020-1421-41171-55983 3