Measles and rubella elimination country profile: France

Measles elimination status Rubella elimination status Total population 64 979 548 < 1 year old 754 122 < 5 years old 3 824 185 Demographic information, 2017 Source: World Population Prospects: The 2017 Revision, New York, United Nations Measles and rubella surveillance National case-based surveillance for measles and CRS Lab confirmation for diagnosis of measles Source: WHO/UNICEF Joint Reporting Form on Immunization, 2017 Measles and rubella elimination country profile France 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 ND = Data not available 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 At least two measles or rubella cases including cases with epidemiological links Confirmed measles cases by month of onset, 2013-2017 Source: CISID 2017 Vaccine Schedule MCV1 MMR 12 months MCV2 MMR 18 months Year of introduction MCV2 1996 RCV 1970 Measles vaccination in school ND 2016 endemic 2017 endemic 2016 endemic 2017 endemic 0 20 40 60 80 100 120 140 160 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 er o f ca se s Month and year 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 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 France ©WHO 2019 Information on CRS, 2017 2 imported cases, laboratory confirmed 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 29 4 Import-related 0 0 Unknown/ Not reported 49 0 Endemic 441 3 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 2016 Refugees ≥ 1 and ≤ 35 MMR 63% 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 •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 1dot=1case Suspected measles cases Confirmed measles cases Discarded as non- measles Measles incidence Genotypes detected Laboratory Epi- linked Clinically Total 2013 326 132 8 119 259 67 4 B3,D4,D8,D9 2014 313 137 52 78 267 46 4.1 B3, D8 2015 401 157 136 71 364 36 5.7 B3,D4,D8 2016 112 50 3 26 79 33 1.2 B3, D8 2017 595 349 86 84 519 76 8 B3,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 France 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 100% 100% 506 0.6% 100% ND 2015 ND ND 42.6% 89.8% 330 19.1% ND ND 2016 ND ND 83% 91% 225 14.2% ND 100% 2017 ND ND 74% 92% 489 71.4% ND 100% Suspected rubella cases Confirmed rubella cases Discarded as non- rubella Rubella incidence Genotypes detected Laboratory Epi- linked Clinically Total 2013 427 8 0 0 8 383 ND ND 2014 506 3 0 0 3 491 ND ND 2015 410 ND ND ND 2 376 ND 1E 2016 608 3 0 0 3 538 ND 1E 2017 ND 7 0 0 7 ND ND 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 ND ND ND ND ND ND ND ND 2014 ND ND ND ND 14 21.4% ND ND 2015 ND ND ND ND 410 0.5% ND 100% 2016 ND ND ND ND 594 0.6% ND 100% 2017 ND ND ND ND 235 3.0% ND 100% RVC comments, based on 2017 reporting Regional Verification Commission for Measles and Rubella Elimination (RVC) commends introduction of mandatory school vaccination for 11 antigens from 2018 and the decision to initiate mandatory notification of rubella from 2019. RVC requests details on the implementation of case-based measles and rubella surveillance, to make it possible for the RVC to monitor standard surveillance indicators, especially sensitivity. ©WHO 2019 Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thrvc