Volume 12 • Issue 7 • July 2018 ISSN 1814 3601 Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, January 2017–June 2018, WHO Western Pacific Region Source: Case based and aggregate data reports to the Western Pacific Regional Office by 20 July 2018 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 2009. All rights reserved Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 July 2018 No cases <1 per million population Legend: *Map of Australia is from the Australian Bureau of Statistics Figure 1. Incidence rate of total (confirmed and compatible) measles cases with rash onset 1–30 June 2018, WHO Western Pacific Region 1.0-10.0 per million population >10.0 per million population No data submitted No geographical distribution information available Pacific island countries and areas 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 3 3 2 2 30 30 10 10 4 4 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 0 0 0 0 China 363 372 407 418 550 559 537 549 633 649 317 363 China, Hong Kong SAR 0 0 0 0 3 3 4 4 2 2 1 1 China, Macao SAR 0 0 0 0 0 0 0 0 1 1 0 0 Japan 1 1 7 7 20 20 86 92 43 44 10 10 Lao People's Democratic Republic 5 5 0 0 0 0 1 1 1 1 0 0 Malaysia 113 119 131 138 152 155 206 220 204 222 102 116 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 1 1 5 5 4 4 15 15 1 1 0 0 Papua New Guinea 0 0 3 3 0 0 0 0 0 0 0 0 Philippines 366 891 445 1179 506 1425 230 940 23 353 Not available Not available Republic of Korea 2 2 0 0 2 2 0 1 6 8 1 2 Singapore 4 4 3 3 6 6 7 7 5 5 0 0 Viet Nam 16 33 22 35 55 83 38 94 37 44 3 7 Pacific island countries and areas 0 0 0 0 0 0 0 0 0 0 0 0 Western Pacific Region 874 1431 1025 1790 1328 2287 1134 1933 960 1334 436 501 "-" No data 1 Reports only confirmed cases 2018 FebJan MayCountry/area JunAprMar Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2013–2018 as of 20 July 2018 Source: Measles and rubella monthly country reports to WHO by 20 July 2018 Table 2. Status of verification of measles elimination, WHO Western Pacific Region 2 Source: Measles and rubella monthly country reports to WHO by 20 July 2018 0 5 000 10 000 15 000 20 000 25 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n 2013 2014 2015 2016 2017 2018 N u m be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 49.5% 81 38 32 0 11 86.4% 51 27 16 0 8 84.3% Brunei Darussalam 2015 100.0% 0 - - - - - 0 - - - - - Cambodia 2015 0.0% 10 0 0 0 10 0.0% 0 - - - - - China - 0.0% 5 181 0 0 0 5 181 0.0% 2 807 0 0 0 2 807 0.0% China, Hong Kong SAR 2016 11.1% 4 3 0 0 1 75.0% 10 4 0 0 6 40.0% China, Macao SAR 2014 - 2 0 2 0 0 100.0% 1 1 0 0 0 100.0% Japan 2015 81.6% 183 34 136 0 13 92.9% 167 18 137 0 12 92.8% Lao People's Democratic Republic - 0.0% 3 0 0 0 3 0.0% 7 0 0 0 7 0.0% Malaysia - 95.6% 1 624 5 0 1 056 563 65.3% 909 3 0 579 327 64.0% Mongolia - 100.0% 9 0 0 9 0 100.0% 0 - - - - - New Zealand 2017 0.0% 14 0 0 0 14 0.0% 26 0 0 0 26 0.0% Papua New Guinea - - 7 0 0 0 7 0.0% 6 0 0 0 6 0.0% Philippines - 28.4% 251 0 0 43 208 17.1% 1 578 41 9 930 598 62.1% Republic of Korea 2014 100.0% 5 3 0 0 2 60.0% 11 3 2 0 6 45.5% Singapore - 75.7% 68 20 22 0 26 61.8% 25 7 0 0 18 28.0% Viet Nam - 0.0% 100 0 0 0 100 0.0% 162 0 0 0 162 0.0% Pacific island countries and areas - 0.0% 1 0 0 0 1 0.0% 0 - - - - - Total 18.2% 7 543 103 192 1 108 6 140 18.6% 5 760 104 164 1 509 3 983 30.9% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% 2018 No. of confirmed cases Source of infection % of cases with known source of infection 2017 No. of confirmed cases Source of infection % of cases with known source of infection 2016 % of cases with known source of infection Country/area Year verified Compatible cases Lab Epi- linked Total confirmed and compatible Annualized measles incidence per 1 million pop. Australia 340 14.5 74 3.1 99 4.1 81 3.3 24.8 51 0 0 0 51 0 51 4.1 0 24-Jun-18 Brunei Darussalam 0 0.0 4 9.6 1 2.4 0 0.0 0.4 13 0 13 0 0 0 0 0.0 0 7-Aug-16 Cambodia 0 0.0 18 372 1183.9 56 3.6 10 0.6 16.2 518 44 474 0 0 0 0 0.0 0 8-Jun-17 China 52 485 37.8 42 864 30.7 24 839 17.7 5 993 4.3 1415.0 18 372 615 12 935 103 2 783 24 2 910 4.1 1 30-Apr-18 China, Hong Kong SAR 50 6.9 18 2.5 9 1.2 4 0.5 7.4 20 0 10 0 10 0 10 2.7 0 21-May-18 China, Macao SAR 1 1.7 0 0.0 0 0.0 2 3.2 0.6 20 1 18 0 1 0 1 3.2 0 6-May-18 Japan 454 3.5 35 0.3 157 1.2 187 1.5 127.2 1 137 61 902 7 167 0 174 2.7 0 30-Jun-18 Lao People's Democratic Republic 70 10.6 56 8.4 8 1.2 3 0.4 7.0 446 91 348 0 2 5 7 2.0 0 11-May-18 Malaysia 222 7.3 1 318 42.9 1 587 50.9 1 648 52.1 32.0 5 025 425 3 629 62 898 11 971 60.6 0 26-Jun-18 Mongolia 0 0.0 20 374 6844.1 28 813 9517.4 9 2.9 3.1 178 67 111 0 0 0 0 0.0 0 5-May-17 New Zealand 274 60.0 13 2.8 104 22.3 15 3.2 4.7 37 4 7 0 25 1 26 10.9 0 7-May-18 Papua New Guinea 2 589 333.8 53 6.7 0 0.0 7 0.8 8.4 44 0 38 0 6 0 6 1.4 0 3-Jul-18 Philippines 54 669 546.1 2 003 19.7 641 6.2 1 224 11.7 106.5 8 367 3 106 447 3 236 1 236 342 4 814 90.4 21 21-May-18 Republic of Korea 442 8.8 7 0.1 18 0.4 7 0.1 51.2 443 9 419 4 11 0 15 0.6 0 2-Jun-18 Singapore 171 31.4 45 8.1 157 27.9 81 14.2 5.8 72 0 47 0 25 0 25 8.6 0 27-May-18 Viet Nam 16 741 180.9 884 9.4 368 3.9 588 6.2 96.5 925 215 412 136 162 0 298 6.2 1 5-Jul-18 Pacific island countries and areas4 279 87.9 20 6.2 6 1.8 1 0.3 3.3 50 0 50 0 0 0 0 0.0 0 1-May-17 Fiji 1 1.1 1 1.1 5 5.6 1 1.1 0.9 50 0 50 0 0 0 0 0.0 0 1-May-17 Federated States of Micronesia 257 2470.8 - - - - - - 0.1 - - - - - - - - - 26-Aug-14 Guam 1 6.2 - - - - - - 0.2 - - - - - - - - - 14-Mar-14 Solomon Islands 15 26.1 - - 1 1.7 0 0.0 0.6 - - - - - - - - - 21-Jan-16 Vanuatu 5 19.3 19 71.8 0 0.0 - - 0.3 - - - - - - - - - 23-Sep-15 Western Pacific Region 128 786 68.9 67 768 36.0 56 868 30.1 9 860 5.2 1910.3 35 718 4 638 19 860 3 548 5 377 383 9 308 9.7 23 1 Includes 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 2017 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 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases Pending classification Discarded cases3 Confirmed and compatible measles cases Deaths due to measles Total confirmed and compatible1 Measles incidence per 1 million pop. 2016 2017 Total confirmed and compatible1 Measles incidence per 1 million pop. Total confirmed and compatible1 Measles incidence per 1 million pop. 20152014 Total confirmed and compatible1 Measles incidence per 1 million pop. Country/area Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2014—2018 as of 20 July 2018 3 Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2017—2018 as of 20 July 2018 2 4 Discarded non-measles rate per 100 000 pop Annualized discarded non-measles rate per 100 000 pop ≥ 2 ≥ 2 Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.2 Not applicable 100.0% 100.0% 6.0 Not applicable 100.0% 100.0% Cambodia 5.4 80.0% 81.9% 78.8% 5.8 68.0% 79.5% 99.8% China 2.1 64.5% 97.8% 91.5% 1.8 35.5% 97.6% 90.8% China, Hong Kong SAR 0.1 Not applicable 100.0% 100.0% 0.0 Not applicable 100.0% 90.0% China, Macao SAR 2.6 Not applicable 83.3% 100.0% 5.7 Not applicable 65.0% 100.0% Japan 0.4 0.0% Insufficient data Insufficient data 1.4 2.1% Insufficient data Insufficient data Lao People's Democratic Republic 7.1 64.7% 82.1% 85.1% 10.0 88.2% 80.5% 83.4% Malaysia 19.8 93.8% 84.4% 91.3% 22.7 87.5% 89.5% 88.2% Mongolia 4.7 13.6% 88.3% 93.5% 7.1 45.5% 98.3% 94.9% New Zealand 0.4 Insufficient data Insufficient data Insufficient data 0.3 Insufficient data Insufficient data Insufficient data Papua New Guinea 0.5 10.0% 70.6% 84.3% 0.9 5.0% 43.2% 50.0% Philippines 1.9 29.4% 46.0% 69.3% 0.8 11.1% 65.5% 56.0% Republic of Korea 0.5 0.0% 71.2% 84.9% 1.6 12.5% 71.1% 67.9% Singapore 1.4 Not applicable 65.8% 67.1% 1.6 Not applicable 104.2% 81.9% Viet Nam 1.5 49.2% 55.5% 72.3% 0.9 14.3% 75.2% 64.6% Pacific island countries and areas4 2.8 4.3% 87.5% 82.3% 3.0 5.0% 46.0% 84.0% Western Pacific Region 2.2 36.4% 89.9% 89.2% 11.0 28.1% 87.3% 81.4% Green Reached or surpassed target Yellow Nearly reached target: 1.00–1.99 for non- measles suspected case rate; 10.1–25% for percent c linically confirmed cases; 60–79% for other indicators Red Substantially below target 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% Country/area 2017 2018 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% 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 Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2014–2018 as of 20 July 2018 5 Compatible cases Lab Epi- linked Total confirmed and compatible Annualized rubella incidence per 1 million pop. Australia - - - - - - - - 24.77 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.43 13 0 13 0 0 0 0 0.0 - Cambodia 31 2.0 18 1.2 4 0.3 7 0.4 16.25 518 44 474 0 0 0 0 0.0 - China 11 887 8.6 8 245 5.9 4 476 3.2 1 601 1.1 1 415.05 18 372 615 12 935 143 1 722 47 1 912 2.7 - China, Hong Kong SAR 1 0.1 12 1.7 3 0.4 1 0.1 7.43 4 0 0 1 3 0 4 1.1 - China, Macao SAR 0 0.0 2 3.3 1 1.6 0 0.0 0.63 19 1 18 0 0 0 0 0.0 - Japan - - 2 0.0 3 0.0 5 0.0 127.19 181 0 177 0 4 0 4 0.1 - Lao People's Democratic Republic 18 2.7 24 3.6 40 5.9 12 1.7 6.96 446 92 346 0 7 1 8 2.3 - Malaysia 226 7.5 34 1.1 68 2.2 113 3.6 32.04 5 069 425 4 581 0 63 0 63 3.9 - Mongolia 0 0.0 28 9.4 27 8.9 13 4.2 3.12 112 0 112 0 0 0 0 0.0 - New Zealand - - - - - - - - 4.75 0 - - - - - - - - Papua New Guinea - - 4 0.5 2 0.2 1 0.1 8.42 44 0 43 0 1 0 1 0.2 - Philippines 343 3.4 154 1.5 165 1.6 448 4.3 106.51 8 305 3 106 5 140 0 59 0 59 1.1 - Republic of Korea 2 0.0 2 0.0 3 0.1 2 0.0 51.16 443 3 439 0 1 0 1 0.0 - Singapore 0 0.0 1 0.2 0 0.0 3 0.5 5.79 12 0 12 0 0 0 0 0.0 - Viet Nam 50 0.5 972 10.4 350 3.7 126 1.3 96.49 818 307 461 31 19 0 50 1.0 - Pacific island countries and areas2 4 1.3 1 0.3 1 0.3 4 1.2 3.32 50 8 42 0 0 0 0 0.0 - Fiji 4 4.5 1 1.1 1 1.1 4 4.4 0.91 50 8 42 0 0 0 0 0.0 - Solomon Islands - - - - - - 0 0.0 0.62 0 - - - - - - - - Vanuatu 0 0.0 0 0.0 0 0.0 - - 0.28 0 - - - - - - - - Western Pacific Region 675 0.4 1 253 0.7 667 0.4 2 336 1.2 1910.32 34 406 4 601 24 793 175 1 879 48 2 102 2.2 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2017 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 Gray No data 2018 Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Confirmed and compatible rubella cases Congenital rubella syndrome 2014 2016 2017 Total confirmed and compatible Total confirmed and compatible Rubella incidence per 1 million pop. 2015 Country/area Rubella incidence per 1 million pop. Total confirmed and compatible Rubella incidence per 1 million pop. Total confirmed and compatible Rubella incidence per 1 million pop. Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2017 6 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 84 84 69 13 7 53.8 1 8% 0 - 84.6 1 0 73 71 68 1 0 - 0 - Brunei Darussalam DLS 20 20 20 20 0 0.0 2 10% 0 - 100.0 0 - 0 - 0 20 0 0.0 0 0% Cambodia NIPH 929 929 929 774 10 1.3 0 0% 155 0 80.6 0 - 0 - 10 928 5 0.5 0 0% China CCDC - - - - - - - - - - 91.2 - - - - - - - - - - China, Hong Kong SAR PHLC 289 289 242 248 4 1.6 5 2% 0 - 94.0 7 3 43 9 5 239 0 0.0 2 1% China, Macao SAR PHL 65 65 65 65 3 4.6 4 6% 0 - 100.0 0 - 6 2 3 65 0 0.0 1 2% Japan NIID 1 120 1 120 601 157 44 28.0 22 14% 0 - - 0 - 516 173 183 8 0 - 0 0% Lao People's Democratic Republic NCLE 409 409 409 409 2 0.5 9 2% 0 - 81.6 0 - 0 - 2 409 12 2.9 14 3% Malaysia NPHL 11 946 11 946 9 069 8 672 1 874 21.6 223 3% 0 - 95.5 1 807 129 0 - 1 922 6 479 186 2.9 176 3% Mongolia NCCD 640 640 640 634 3 0.5 13 2% 0 - 100.0 0 - 6 0 3 611 7 1.1 29 5% New Zealand CHL 325 325 299 123 4 3.3 9 7% 0 - 98.4 0 - 181 10 10 121 0 0.0 1 1% Papua New Guinea CPHL 51 51 51 49 7 14.3 0 0% 0 - 80.4 0 - 0 - 6 45 1 2.2 2 4% Philippines RITM 2 964 2 964 2 948 2 873 188 6.5 27 1% 70 10 97.2 172 6 221 30 220 2 862 313 10.9 129 5% Republic of Korea KCDC 529 529 448 350 39 11.1 22 6% 0 - 77.3 0 - 149 2 39 197 33 16.8 27 14% Singapore NPHL 549 549 565 102 11 10.8 0 0% 0 - 100.0 45 20 458 52 62 96 12 12.5 0 0% Viet Nam national lab (Northern) NIHE 620 620 620 611 15 2.5 6 1% 0 - 97.9 8 1 9 0 16 611 18 2.9 36 6% Viet Nam national lab (Southern) PI 366 366 342 333 10 3.0 5 2% 0 - 88.9 33 0 33 0 10 333 52 15.6 20 6% Viet Nam subnational lab (Central) PI 214 214 214 213 0 - 2 1% 0 - 37.6 0 - 1 0 0 213 3 - 2 1% Viet Nam subnational lab (Highland) IHE 65 65 65 65 0 - 0 0% 0 - 33.8 0 - 0 - 0 65 0 0.0 0 0% Fiji FCCDC 93 93 93 85 1 1.2 0 0% 4 0 - 0 - 0 - 1 88 4 4.5 2 2% Total 21 278 21 278 17 689 15 796 2 222 14. 1 350 2% 229 10 93.4 2 073 159 1 696 349 2 560 13 391 646 4.8 441 3% "-" No data Serum % of samples with results ≤4 days Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles Serology Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Measles IgM equiv Rubella IgM equiv DBS samples Total number of lab confirmed cases Blood Rubella Serum and blood (includes DBS) Samples tested for rubella IgM Rubella IgM (+) Virus detection Measles Virus isolation/ detection (swab, urine and others) Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2018 as of 20 July 2018 7 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 54 54 41 9 9 100.0 0 0% 0 - 66.7 0 - 45 45 41 0 - - - - Brunei Darussalam DLS 13 13 13 13 0 0.0 0 0% 0 - 100.0 0 - 0 - 0 13 0 0% 0 0% Cambodia NIPH 409 409 409 412 0 0.0 0 0% 62 0 47.8 0 - 0 - 0 410 0 0% 0 0% China CCDC - - - - - - - - - - 91.2 - - - - - - - - - - China, Hong Kong SAR PHLC 302 302 240 223 10 4.5 3 1% 0 - 89.0 5 1 77 9 13 200 5 3% 4 2% China, Macao SAR PHL 91 91 91 91 2 2.2 3 3% 0 - 100.0 0 - 3 1 2 90 7 8% 0 0% Japan NIID 1 824 1 614 927 190 20 10.5 25 13% 0 - - 0 - 702 159 169 4 1 - 0 - Lao People's Democratic Republic NCLE 373 373 373 352 2 0.6 5 1% 0 - 95.5 0 - 0 - 2 349 7 2% 23 7% Malaysia NPHL 7 960 7 960 5 606 5 339 1 057 19.8 151 3% 0 - 94.0 1 253 89 0 - 1 083 3 362 146 4% 94 3% Mongolia NCCD 157 157 157 157 0 0.0 0 0% 0 - 100.0 0 - 0 - 0 156 1 1% 0 0% New Zealand CHL 277 277 235 60 9 15.0 1 2% 0 - 95.0 1 0 199 24 27 27 0 0% 3 11% Papua New Guinea CPHL 39 39 39 39 3 7.7 0 0% 0 - 84.6 0 - 0 - 3 39 1 3% 0 0% Philippines RITM 6 968 6 968 6 883 6 539 1 118 17.1 34 1% 106 6 13.6 974 174 978 719 1 713 4 207 69 2% 31 1% Republic of Korea KCDC 436 436 332 309 31 10.0 32 10% 0 - 61.1 6 1 161 26 51 202 24 12% 31 15% Singapore NPHL 321 321 316 26 4 15.4 0 0% 0 - 100.0 21 6 215 25 29 24 2 8% 0 0% Viet Nam national lab (Northern) NIHE 458 458 414 300 116 38.7 12 4% 0 - 98.3 157 0 165 120 204 300 14 5% 7 2% Viet Nam national lab (Southern) PI 137 137 130 121 5 4.1 0 0% 0 - 94.2 16 0 16 0 5 121 10 8% 5 4% Viet Nam subnational lab (Central) PI 135 135 135 133 0 0.0 1 1% 0 - 56.1 0 - 2 0 1 133 2 2% 0 0% Viet Nam subnational lab (Highland) IHE 21 21 21 21 0 0.0 0 0% 0 - 9.5 0 - 0 - 0 21 0 0% 0 0% Fiji FCCDC 53 47 47 47 0 0.0 3 6% 6 0 No data 0 - 0 - 0 47 0 0% 2 4% Total 20 028 19 812 16 409 14 381 2 386 16. 6 270 2% 174 6 74.4 2 433 271 2 563 1 128 3 343 9 705 289 3% 200 2% "-" No data Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % 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 Rubella Serology Figure 3. Measles genotype distribution of cases with rash onset in 2017 and 2018, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in July 2017 to June 2018, WHO Western Pacific Region 8 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 2009. All rights reserved. 2018 Sources: Includes all cases reported to the Western Pacific Regional Office by 20 July 2018 and the Measles Nucleotide Surveillance online database (MeaNS). B3 D4 D8 D9 D11 G3 H1 2017 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 2 1 2 2 1 10 4 2 1 1 2 1 10 9 2 6 1 4 1 Brunei Darussalam Cambodia China 17 20 16 2 8 1 5 11 14 23 3 39 1 12 1 5 China, Hong Kong SAR 1 1 1 2 1 2 1 China, Macao SAR 2 1 Japan 2 8 8 1 5 2 4 9 11 1 8 1 4 Lao People's Democratic Republic Malaysia 4 5 1 1 Mongolia New Zealand 1 4 2 2 7 1 1 Papua New Guinea Philippines 2 1 1 2 17 4 19 12 Republic of Korea 1 2 5 Singapore 1 1 1 3 1 2 1 5 1 1 4 2 2 2 1 3 1 2 1 Viet Nam 3 9 4 29 Pacific island countries and areas Sep 2017 DecJul Oct NovAugCountry/area Feb Mar AprJan May Jun 2018 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 1 3 1 4 16 5 China, Hong Kong SAR China, Macao SAR Japan 1 1 2 1 1 Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines 4 Republic of Korea Singapore 1 1 1 1 Viet Nam Pacific island countries and areas Jun 2018 Apr MayFebJan MarJul Aug 2017 DecSep Oct NovCountry/area Figure 4. Rubella genotype distribution of cases with rash onset in 2017 and 2018, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in July 2017 to June 2018, WHO Western Pacific Region 9 Sources: Includes all cases reported to the Western Pacific Regional Office by 20 July 2018 and the Rubella Nucleotide Surveillance online database (RubeNS). 2B 1E 2017 2018 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 2009. All rights reserved. 10 Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2017—2018 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2017—2018 Expanded Programme on Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 5288001 Fax No. (63 2) 5211036, 5260279 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% 08 Feb 08 Mar 10 Apr 16 May 12 Jun 09 Jul 100% 83% Brunei Darussalam 100% 100% 07 Feb 06 Mar 07 Apr 07 May 05 Jun 07 Jul 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% China 100% 75% 13 Feb 12 Mar 15 Apr 16 May 05 Jul 12 Jul 100% 83% China, Hong Kong SAR 100% 100% 06 Feb 06 Mar 09 Apr 07 May 06 Jun 09 Jul 100% 100% China, Macao SAR 100% 100% 08 Feb 08 Mar 04 Apr 07 May 06 Jun 09 Jul 100% 100% Japan 100% 92% 09 Feb 10 Mar 10 Apr 10 May 10 Jun 10 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% 08 Feb 09 Mar 06 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% 08 Feb 07 Mar 10 Apr 08 May 06 Jun 05 Jul 100% 100% Papua New Guinea 100% 92% - 14 Mar 17 Apr 10 May 08 Jun 17 Jul 83% 33% Philippines 58% 25% 02 Mar - 27 Apr 22 May 21 Jun - 67% 0% Republic of Korea 100% 92% 08 Feb 10 Mar 10 Apr 10 May 10 Jun 13 Jul 100% 83% Singapore 100% 92% 08 Feb 10 Mar 07 Apr 10 May 07 Jun 07 Jul 100% 100% Viet Nam 100% 92% 09 Feb 09 Mar 10 Apr 09 May 08 Jun 09 Jul 100% 100% Pacific island countries and areas 100% 67% 16 Feb 10 Mar 07 Apr 14 May 08 Jun 13 Jul 100% 83% Completeness 98% 94% 94% 100% 100% 100% 94% 97% Timeliness 92% 82% 88% 88% 88% 88% 82% 86% 1 National measles surveillance monthly reports from June 2018. Legend: black = timely report; red = untimely report 2 Completeness is defined as the number of reports received by the end of the Completeness 2 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 Country 2017 Timeliness 3 2018 1 Completeness 2 Timeliness 3 MeaNS Submission to WPRO Rubens Submission to WPRO Australia 100% 100% 07 Feb 01 Mar 04 Apr 04 May 07 Jun 06 Jul 100% 100% 34 38 0 0 Brunei Darussalam 100% 100% 05 Feb 01 Mar 31 Mar 07 May 30 May 30 Jun 100% 100% 0 0 0 0 Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% 0 0 0 0 China 100% 100% 06 Feb 06 Mar 02 Apr 02 May 05 Jun 02 Jul 100% 100% 19 98 18 17 China, Hong Kong SAR 100% 100% 06 Feb 06 Mar 10 Apr 07 May 07 Jun 09 Jul 100% 100% 7 8 0 2 China, Macao SAR 100% 100% 08 Feb 09 Mar 06 Apr 08 May 10 Jun 06 Jul 100% 100% 1 1 0 0 Japan 100% 92% 09 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% 4 47 4 0 Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% 0 0 0 0 Malaysia 100% 100% 09 Feb 09 Mar 11 Apr 14 May 02 Jul 10 Jul 100% 67% 11 0 0 0 Mongolia 100% 83% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% 0 0 0 0 New Zealand 100% 100% 08 Feb 07 Mar 10 Apr 08 May 05 Jun 05-Jul 100% 100% 18 18 0 0 Papua New Guinea 100% 67% 08 Feb 10 Mar 04 Apr 10 May 08 Jun 04 Jul 100% 100% 0 0 0 0 Philippines 100% 92% 10 Feb 10 Mar 10 Apr 09 May 13 Jun 10 Jul 100% 83% 35 35 0 0 Republic of Korea 100% 100% 09 Feb 09 Mar 10 Apr 10 May 08 Jun 10 Jul 100% 100% 3 10 0 0 Singapore 100% 100% 08 Feb 10 Mar 07 Apr 10 May 07 Jun 07 Jul 100% 100% 15 19 1 1 Viet Nam national lab (Northern) 100% 100% 09 Feb 05 Mar 09 Apr 09 May 06 Jun 10 Jul 100% 100% 33 16 0 0 Viet Nam national lab (Southern) 100% 100% 08 Feb 08 Mar 09 Apr 09 May 10 Jun 09 Jul 100% 100% 0 0 0 0 Viet Nam subnational lab (Central) 100% 100% 09 Feb 05 Mar 09 Apr 09 May 06 Jun 10 Jul 100% 100% 0 0 0 0 Viet Nam subnational lab (Highland) 100% 100% 09 Feb 05 Mar 09 Apr 09 May 06 Jun 10 Jul 100% 100% 0 0 0 0 Fiji 100% 75% 16 Feb 16 Mar 07 Apr 14 May 08 Jun 13 Jul 100% 67% 0 0 0 0 Completeness 100% 100% 100% 100% 100% 100% 100% 100% Timeliness 95% 95% 95% 100% 95% 90% 100% 96% 1 National measles laboratory monthly reports from June 2018. 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. 2017 Completeness 2 Timeliness 3 Country/area Measles Rubella 2018 1 Jan Feb Mar Apr May Jun 180 290 23 20 Completeness 2 Timeliness 3 Genotype results by source of data
Volume 12 • Issue 7 • July 2018 ISSN 1814 3601 Table 1. Numbers of confirmed and total (confirmed and compatible) measles cases by month of rash onset, January 2017–June 2018, WHO Western Pacific Region Source: Case based and aggregate data reports to the Western Pacific Regional Office by 20 July 2018 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 2009. All rights reserved Source: Measles and rubella monthly country reports to the Western Pacific Regional Office by 20 July 2018 No cases <1 per million population Legend: *Map of Australia is from the Australian Bureau of Statistics Figure 1. Incidence rate of total (confirmed and compatible) measles cases with rash onset 1–30 June 2018, WHO Western Pacific Region 1.0-10.0 per million population >10.0 per million population No data submitted No geographical distribution information available Pacific island countries and areas 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 3 3 2 2 30 30 10 10 4 4 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 0 0 0 0 China 363 372 407 418 550 559 537 549 633 649 317 363 China, Hong Kong SAR 0 0 0 0 3 3 4 4 2 2 1 1 China, Macao SAR 0 0 0 0 0 0 0 0 1 1 0 0 Japan 1 1 7 7 20 20 86 92 43 44 10 10 Lao People's Democratic Republic 5 5 0 0 0 0 1 1 1 1 0 0 Malaysia 113 119 131 138 152 155 206 220 204 222 102 116 Mongolia 0 0 0 0 0 0 0 0 0 0 0 0 New Zealand 1 1 5 5 4 4 15 15 1 1 0 0 Papua New Guinea 0 0 3 3 0 0 0 0 0 0 0 0 Philippines 366 891 445 1179 506 1425 230 940 23 353 Not available Not available Republic of Korea 2 2 0 0 2 2 0 1 6 8 1 2 Singapore 4 4 3 3 6 6 7 7 5 5 0 0 Viet Nam 16 33 22 35 55 83 38 94 37 44 3 7 Pacific island countries and areas 0 0 0 0 0 0 0 0 0 0 0 0 Western Pacific Region 874 1431 1025 1790 1328 2287 1134 1933 960 1334 436 501 "-" No data 1 Reports only confirmed cases 2018 FebJan MayCountry/area JunAprMar Figure 2. Total (confirmed and compatible) measles cases by month of rash onset, WHO Western Pacific Region, 2013–2018 as of 20 July 2018 Source: Measles and rubella monthly country reports to WHO by 20 July 2018 Table 2. Status of verification of measles elimination, WHO Western Pacific Region 2 Source: Measles and rubella monthly country reports to WHO by 20 July 2018 0 5 000 10 000 15 000 20 000 25 000 Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n Ju l Au g Se p O ct N ov D ec Ja n Fe b M ar Ap r M ay Ju n 2013 2014 2015 2016 2017 2018 N u m be r of m ea sl es c as es China Malaysia Mongolia Papua New Guinea Philippines Viet Nam Others Imported Import- related Endemic Unknown / not reported Imported Import- related Endemic Unknown / not reported Australia 2014 49.5% 81 38 32 0 11 86.4% 51 27 16 0 8 84.3% Brunei Darussalam 2015 100.0% 0 - - - - - 0 - - - - - Cambodia 2015 0.0% 10 0 0 0 10 0.0% 0 - - - - - China - 0.0% 5 181 0 0 0 5 181 0.0% 2 807 0 0 0 2 807 0.0% China, Hong Kong SAR 2016 11.1% 4 3 0 0 1 75.0% 10 4 0 0 6 40.0% China, Macao SAR 2014 - 2 0 2 0 0 100.0% 1 1 0 0 0 100.0% Japan 2015 81.6% 183 34 136 0 13 92.9% 167 18 137 0 12 92.8% Lao People's Democratic Republic - 0.0% 3 0 0 0 3 0.0% 7 0 0 0 7 0.0% Malaysia - 95.6% 1 624 5 0 1 056 563 65.3% 909 3 0 579 327 64.0% Mongolia - 100.0% 9 0 0 9 0 100.0% 0 - - - - - New Zealand 2017 0.0% 14 0 0 0 14 0.0% 26 0 0 0 26 0.0% Papua New Guinea - - 7 0 0 0 7 0.0% 6 0 0 0 6 0.0% Philippines - 28.4% 251 0 0 43 208 17.1% 1 578 41 9 930 598 62.1% Republic of Korea 2014 100.0% 5 3 0 0 2 60.0% 11 3 2 0 6 45.5% Singapore - 75.7% 68 20 22 0 26 61.8% 25 7 0 0 18 28.0% Viet Nam - 0.0% 100 0 0 0 100 0.0% 162 0 0 0 162 0.0% Pacific island countries and areas - 0.0% 1 0 0 0 1 0.0% 0 - - - - - Total 18.2% 7 543 103 192 1 108 6 140 18.6% 5 760 104 164 1 509 3 983 30.9% Blue No measles cases Green ≥80% Yellow 60–79% Red <60% 2018 No. of confirmed cases Source of infection % of cases with known source of infection 2017 No. of confirmed cases Source of infection % of cases with known source of infection 2016 % of cases with known source of infection Country/area Year verified Compatible cases Lab Epi- linked Total confirmed and compatible Annualized measles incidence per 1 million pop. Australia 340 14.5 74 3.1 99 4.1 81 3.3 24.8 51 0 0 0 51 0 51 4.1 0 24-Jun-18 Brunei Darussalam 0 0.0 4 9.6 1 2.4 0 0.0 0.4 13 0 13 0 0 0 0 0.0 0 7-Aug-16 Cambodia 0 0.0 18 372 1183.9 56 3.6 10 0.6 16.2 518 44 474 0 0 0 0 0.0 0 8-Jun-17 China 52 485 37.8 42 864 30.7 24 839 17.7 5 993 4.3 1415.0 18 372 615 12 935 103 2 783 24 2 910 4.1 1 30-Apr-18 China, Hong Kong SAR 50 6.9 18 2.5 9 1.2 4 0.5 7.4 20 0 10 0 10 0 10 2.7 0 21-May-18 China, Macao SAR 1 1.7 0 0.0 0 0.0 2 3.2 0.6 20 1 18 0 1 0 1 3.2 0 6-May-18 Japan 454 3.5 35 0.3 157 1.2 187 1.5 127.2 1 137 61 902 7 167 0 174 2.7 0 30-Jun-18 Lao People's Democratic Republic 70 10.6 56 8.4 8 1.2 3 0.4 7.0 446 91 348 0 2 5 7 2.0 0 11-May-18 Malaysia 222 7.3 1 318 42.9 1 587 50.9 1 648 52.1 32.0 5 025 425 3 629 62 898 11 971 60.6 0 26-Jun-18 Mongolia 0 0.0 20 374 6844.1 28 813 9517.4 9 2.9 3.1 178 67 111 0 0 0 0 0.0 0 5-May-17 New Zealand 274 60.0 13 2.8 104 22.3 15 3.2 4.7 37 4 7 0 25 1 26 10.9 0 7-May-18 Papua New Guinea 2 589 333.8 53 6.7 0 0.0 7 0.8 8.4 44 0 38 0 6 0 6 1.4 0 3-Jul-18 Philippines 54 669 546.1 2 003 19.7 641 6.2 1 224 11.7 106.5 8 367 3 106 447 3 236 1 236 342 4 814 90.4 21 21-May-18 Republic of Korea 442 8.8 7 0.1 18 0.4 7 0.1 51.2 443 9 419 4 11 0 15 0.6 0 2-Jun-18 Singapore 171 31.4 45 8.1 157 27.9 81 14.2 5.8 72 0 47 0 25 0 25 8.6 0 27-May-18 Viet Nam 16 741 180.9 884 9.4 368 3.9 588 6.2 96.5 925 215 412 136 162 0 298 6.2 1 5-Jul-18 Pacific island countries and areas4 279 87.9 20 6.2 6 1.8 1 0.3 3.3 50 0 50 0 0 0 0 0.0 0 1-May-17 Fiji 1 1.1 1 1.1 5 5.6 1 1.1 0.9 50 0 50 0 0 0 0 0.0 0 1-May-17 Federated States of Micronesia 257 2470.8 - - - - - - 0.1 - - - - - - - - - 26-Aug-14 Guam 1 6.2 - - - - - - 0.2 - - - - - - - - - 14-Mar-14 Solomon Islands 15 26.1 - - 1 1.7 0 0.0 0.6 - - - - - - - - - 21-Jan-16 Vanuatu 5 19.3 19 71.8 0 0.0 - - 0.3 - - - - - - - - - 23-Sep-15 Western Pacific Region 128 786 68.9 67 768 36.0 56 868 30.1 9 860 5.2 1910.3 35 718 4 638 19 860 3 548 5 377 383 9 308 9.7 23 1 Includes 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 2017 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 Rash onset of last confirmed measles case Population (in millions) 2 Suspected measles cases Pending classification Discarded cases3 Confirmed and compatible measles cases Deaths due to measles Total confirmed and compatible1 Measles incidence per 1 million pop. 2016 2017 Total confirmed and compatible1 Measles incidence per 1 million pop. Total confirmed and compatible1 Measles incidence per 1 million pop. 20152014 Total confirmed and compatible1 Measles incidence per 1 million pop. Country/area Table 3. Measles case classification and incidence by country and area, WHO Western Pacific Region, 2014—2018 as of 20 July 2018 3 Table 4. Measles surveillance performance indicators by country and area, WHO Western Pacific Region, 2017—2018 as of 20 July 2018 2 4 Discarded non-measles rate per 100 000 pop Annualized discarded non-measles rate per 100 000 pop ≥ 2 ≥ 2 Australia 3 Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Insufficient data Brunei Darussalam 4.2 Not applicable 100.0% 100.0% 6.0 Not applicable 100.0% 100.0% Cambodia 5.4 80.0% 81.9% 78.8% 5.8 68.0% 79.5% 99.8% China 2.1 64.5% 97.8% 91.5% 1.8 35.5% 97.6% 90.8% China, Hong Kong SAR 0.1 Not applicable 100.0% 100.0% 0.0 Not applicable 100.0% 90.0% China, Macao SAR 2.6 Not applicable 83.3% 100.0% 5.7 Not applicable 65.0% 100.0% Japan 0.4 0.0% Insufficient data Insufficient data 1.4 2.1% Insufficient data Insufficient data Lao People's Democratic Republic 7.1 64.7% 82.1% 85.1% 10.0 88.2% 80.5% 83.4% Malaysia 19.8 93.8% 84.4% 91.3% 22.7 87.5% 89.5% 88.2% Mongolia 4.7 13.6% 88.3% 93.5% 7.1 45.5% 98.3% 94.9% New Zealand 0.4 Insufficient data Insufficient data Insufficient data 0.3 Insufficient data Insufficient data Insufficient data Papua New Guinea 0.5 10.0% 70.6% 84.3% 0.9 5.0% 43.2% 50.0% Philippines 1.9 29.4% 46.0% 69.3% 0.8 11.1% 65.5% 56.0% Republic of Korea 0.5 0.0% 71.2% 84.9% 1.6 12.5% 71.1% 67.9% Singapore 1.4 Not applicable 65.8% 67.1% 1.6 Not applicable 104.2% 81.9% Viet Nam 1.5 49.2% 55.5% 72.3% 0.9 14.3% 75.2% 64.6% Pacific island countries and areas4 2.8 4.3% 87.5% 82.3% 3.0 5.0% 46.0% 84.0% Western Pacific Region 2.2 36.4% 89.9% 89.2% 11.0 28.1% 87.3% 81.4% Green Reached or surpassed target Yellow Nearly reached target: 1.00–1.99 for non- measles suspected case rate; 10.1–25% for percent c linically confirmed cases; 60–79% for other indicators Red Substantially below target 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% Country/area 2017 2018 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% 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 Table 5. Rubella case classification and incidence by country and area, WHO Western Pacific Region, 2014–2018 as of 20 July 2018 5 Compatible cases Lab Epi- linked Total confirmed and compatible Annualized rubella incidence per 1 million pop. Australia - - - - - - - - 24.77 - - - - - - - - - Brunei Darussalam 0 0.0 0 0.0 0 0.0 0 0.0 0.43 13 0 13 0 0 0 0 0.0 - Cambodia 31 2.0 18 1.2 4 0.3 7 0.4 16.25 518 44 474 0 0 0 0 0.0 - China 11 887 8.6 8 245 5.9 4 476 3.2 1 601 1.1 1 415.05 18 372 615 12 935 143 1 722 47 1 912 2.7 - China, Hong Kong SAR 1 0.1 12 1.7 3 0.4 1 0.1 7.43 4 0 0 1 3 0 4 1.1 - China, Macao SAR 0 0.0 2 3.3 1 1.6 0 0.0 0.63 19 1 18 0 0 0 0 0.0 - Japan - - 2 0.0 3 0.0 5 0.0 127.19 181 0 177 0 4 0 4 0.1 - Lao People's Democratic Republic 18 2.7 24 3.6 40 5.9 12 1.7 6.96 446 92 346 0 7 1 8 2.3 - Malaysia 226 7.5 34 1.1 68 2.2 113 3.6 32.04 5 069 425 4 581 0 63 0 63 3.9 - Mongolia 0 0.0 28 9.4 27 8.9 13 4.2 3.12 112 0 112 0 0 0 0 0.0 - New Zealand - - - - - - - - 4.75 0 - - - - - - - - Papua New Guinea - - 4 0.5 2 0.2 1 0.1 8.42 44 0 43 0 1 0 1 0.2 - Philippines 343 3.4 154 1.5 165 1.6 448 4.3 106.51 8 305 3 106 5 140 0 59 0 59 1.1 - Republic of Korea 2 0.0 2 0.0 3 0.1 2 0.0 51.16 443 3 439 0 1 0 1 0.0 - Singapore 0 0.0 1 0.2 0 0.0 3 0.5 5.79 12 0 12 0 0 0 0 0.0 - Viet Nam 50 0.5 972 10.4 350 3.7 126 1.3 96.49 818 307 461 31 19 0 50 1.0 - Pacific island countries and areas2 4 1.3 1 0.3 1 0.3 4 1.2 3.32 50 8 42 0 0 0 0 0.0 - Fiji 4 4.5 1 1.1 1 1.1 4 4.4 0.91 50 8 42 0 0 0 0 0.0 - Solomon Islands - - - - - - 0 0.0 0.62 0 - - - - - - - - Vanuatu 0 0.0 0 0.0 0 0.0 - - 0.28 0 - - - - - - - - Western Pacific Region 675 0.4 1 253 0.7 667 0.4 2 336 1.2 1910.32 34 406 4 601 24 793 175 1 879 48 2 102 2.2 - 1 United Nations, Department of Economic and Social Affairs, Population Division World Population Prospects 2017 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 Gray No data 2018 Population (in millions) 1 Investigated for rubella Pending classification Discarded cases Confirmed and compatible rubella cases Congenital rubella syndrome 2014 2016 2017 Total confirmed and compatible Total confirmed and compatible Rubella incidence per 1 million pop. 2015 Country/area Rubella incidence per 1 million pop. Total confirmed and compatible Rubella incidence per 1 million pop. Total confirmed and compatible Rubella incidence per 1 million pop. Table 6A. Measles and rubella laboratory testing, WHO Western Pacific Region, 2017 6 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 84 84 69 13 7 53.8 1 8% 0 - 84.6 1 0 73 71 68 1 0 - 0 - Brunei Darussalam DLS 20 20 20 20 0 0.0 2 10% 0 - 100.0 0 - 0 - 0 20 0 0.0 0 0% Cambodia NIPH 929 929 929 774 10 1.3 0 0% 155 0 80.6 0 - 0 - 10 928 5 0.5 0 0% China CCDC - - - - - - - - - - 91.2 - - - - - - - - - - China, Hong Kong SAR PHLC 289 289 242 248 4 1.6 5 2% 0 - 94.0 7 3 43 9 5 239 0 0.0 2 1% China, Macao SAR PHL 65 65 65 65 3 4.6 4 6% 0 - 100.0 0 - 6 2 3 65 0 0.0 1 2% Japan NIID 1 120 1 120 601 157 44 28.0 22 14% 0 - - 0 - 516 173 183 8 0 - 0 0% Lao People's Democratic Republic NCLE 409 409 409 409 2 0.5 9 2% 0 - 81.6 0 - 0 - 2 409 12 2.9 14 3% Malaysia NPHL 11 946 11 946 9 069 8 672 1 874 21.6 223 3% 0 - 95.5 1 807 129 0 - 1 922 6 479 186 2.9 176 3% Mongolia NCCD 640 640 640 634 3 0.5 13 2% 0 - 100.0 0 - 6 0 3 611 7 1.1 29 5% New Zealand CHL 325 325 299 123 4 3.3 9 7% 0 - 98.4 0 - 181 10 10 121 0 0.0 1 1% Papua New Guinea CPHL 51 51 51 49 7 14.3 0 0% 0 - 80.4 0 - 0 - 6 45 1 2.2 2 4% Philippines RITM 2 964 2 964 2 948 2 873 188 6.5 27 1% 70 10 97.2 172 6 221 30 220 2 862 313 10.9 129 5% Republic of Korea KCDC 529 529 448 350 39 11.1 22 6% 0 - 77.3 0 - 149 2 39 197 33 16.8 27 14% Singapore NPHL 549 549 565 102 11 10.8 0 0% 0 - 100.0 45 20 458 52 62 96 12 12.5 0 0% Viet Nam national lab (Northern) NIHE 620 620 620 611 15 2.5 6 1% 0 - 97.9 8 1 9 0 16 611 18 2.9 36 6% Viet Nam national lab (Southern) PI 366 366 342 333 10 3.0 5 2% 0 - 88.9 33 0 33 0 10 333 52 15.6 20 6% Viet Nam subnational lab (Central) PI 214 214 214 213 0 - 2 1% 0 - 37.6 0 - 1 0 0 213 3 - 2 1% Viet Nam subnational lab (Highland) IHE 65 65 65 65 0 - 0 0% 0 - 33.8 0 - 0 - 0 65 0 0.0 0 0% Fiji FCCDC 93 93 93 85 1 1.2 0 0% 4 0 - 0 - 0 - 1 88 4 4.5 2 2% Total 21 278 21 278 17 689 15 796 2 222 14. 1 350 2% 229 10 93.4 2 073 159 1 696 349 2 560 13 391 646 4.8 441 3% "-" No data Serum % of samples with results ≤4 days Measles Reverse Transcription- Polymerase Chain Reaction Country/area Laboratory Measles and rubella Measles Serology Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Measles IgM equiv Rubella IgM equiv DBS samples Total number of lab confirmed cases Blood Rubella Serum and blood (includes DBS) Samples tested for rubella IgM Rubella IgM (+) Virus detection Measles Virus isolation/ detection (swab, urine and others) Table 6B. Measles and rubella laboratory testing, WHO Western Pacific Region, 2018 as of 20 July 2018 7 No. No. % No. % No. received No. (+) No. of samples tested No. of isolates No. of samples tested No. (+) No. No. % No. % Australia VIDRL 54 54 41 9 9 100.0 0 0% 0 - 66.7 0 - 45 45 41 0 - - - - Brunei Darussalam DLS 13 13 13 13 0 0.0 0 0% 0 - 100.0 0 - 0 - 0 13 0 0% 0 0% Cambodia NIPH 409 409 409 412 0 0.0 0 0% 62 0 47.8 0 - 0 - 0 410 0 0% 0 0% China CCDC - - - - - - - - - - 91.2 - - - - - - - - - - China, Hong Kong SAR PHLC 302 302 240 223 10 4.5 3 1% 0 - 89.0 5 1 77 9 13 200 5 3% 4 2% China, Macao SAR PHL 91 91 91 91 2 2.2 3 3% 0 - 100.0 0 - 3 1 2 90 7 8% 0 0% Japan NIID 1 824 1 614 927 190 20 10.5 25 13% 0 - - 0 - 702 159 169 4 1 - 0 - Lao People's Democratic Republic NCLE 373 373 373 352 2 0.6 5 1% 0 - 95.5 0 - 0 - 2 349 7 2% 23 7% Malaysia NPHL 7 960 7 960 5 606 5 339 1 057 19.8 151 3% 0 - 94.0 1 253 89 0 - 1 083 3 362 146 4% 94 3% Mongolia NCCD 157 157 157 157 0 0.0 0 0% 0 - 100.0 0 - 0 - 0 156 1 1% 0 0% New Zealand CHL 277 277 235 60 9 15.0 1 2% 0 - 95.0 1 0 199 24 27 27 0 0% 3 11% Papua New Guinea CPHL 39 39 39 39 3 7.7 0 0% 0 - 84.6 0 - 0 - 3 39 1 3% 0 0% Philippines RITM 6 968 6 968 6 883 6 539 1 118 17.1 34 1% 106 6 13.6 974 174 978 719 1 713 4 207 69 2% 31 1% Republic of Korea KCDC 436 436 332 309 31 10.0 32 10% 0 - 61.1 6 1 161 26 51 202 24 12% 31 15% Singapore NPHL 321 321 316 26 4 15.4 0 0% 0 - 100.0 21 6 215 25 29 24 2 8% 0 0% Viet Nam national lab (Northern) NIHE 458 458 414 300 116 38.7 12 4% 0 - 98.3 157 0 165 120 204 300 14 5% 7 2% Viet Nam national lab (Southern) PI 137 137 130 121 5 4.1 0 0% 0 - 94.2 16 0 16 0 5 121 10 8% 5 4% Viet Nam subnational lab (Central) PI 135 135 135 133 0 0.0 1 1% 0 - 56.1 0 - 2 0 1 133 2 2% 0 0% Viet Nam subnational lab (Highland) IHE 21 21 21 21 0 0.0 0 0% 0 - 9.5 0 - 0 - 0 21 0 0% 0 0% Fiji FCCDC 53 47 47 47 0 0.0 3 6% 6 0 No data 0 - 0 - 0 47 0 0% 2 4% Total 20 028 19 812 16 409 14 381 2 386 16. 6 270 2% 174 6 74.4 2 433 271 2 563 1 128 3 343 9 705 289 3% 200 2% "-" No data Samples tested for rubella IgM Rubella IgM (+) Rubella IgM equiv DBS samples Total number of samples received Total number of samples tested Total number of cases tested Samples tested for measles IgM Measles IgM (+) Measles IgM equiv Virus detection Total number of lab confirmed cases Serum and blood (includes DBS) Serum Blood % 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 Rubella Serology Figure 3. Measles genotype distribution of cases with rash onset in 2017 and 2018, WHO Western Pacific Region Table 7. Measles genotype distribution of cases with rash onset in July 2017 to June 2018, WHO Western Pacific Region 8 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 2009. All rights reserved. 2018 Sources: Includes all cases reported to the Western Pacific Regional Office by 20 July 2018 and the Measles Nucleotide Surveillance online database (MeaNS). B3 D4 D8 D9 D11 G3 H1 2017 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 2 1 2 2 1 10 4 2 1 1 2 1 10 9 2 6 1 4 1 Brunei Darussalam Cambodia China 17 20 16 2 8 1 5 11 14 23 3 39 1 12 1 5 China, Hong Kong SAR 1 1 1 2 1 2 1 China, Macao SAR 2 1 Japan 2 8 8 1 5 2 4 9 11 1 8 1 4 Lao People's Democratic Republic Malaysia 4 5 1 1 Mongolia New Zealand 1 4 2 2 7 1 1 Papua New Guinea Philippines 2 1 1 2 17 4 19 12 Republic of Korea 1 2 5 Singapore 1 1 1 3 1 2 1 5 1 1 4 2 2 2 1 3 1 2 1 Viet Nam 3 9 4 29 Pacific island countries and areas Sep 2017 DecJul Oct NovAugCountry/area Feb Mar AprJan May Jun 2018 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 1 3 1 4 16 5 China, Hong Kong SAR China, Macao SAR Japan 1 1 2 1 1 Lao People's Democratic Republic Malaysia Mongolia New Zealand Papua New Guinea Philippines 4 Republic of Korea Singapore 1 1 1 1 Viet Nam Pacific island countries and areas Jun 2018 Apr MayFebJan MarJul Aug 2017 DecSep Oct NovCountry/area Figure 4. Rubella genotype distribution of cases with rash onset in 2017 and 2018, WHO Western Pacific Region Table 8. Rubella genotype distribution of cases with rash onset in July 2017 to June 2018, WHO Western Pacific Region 9 Sources: Includes all cases reported to the Western Pacific Regional Office by 20 July 2018 and the Rubella Nucleotide Surveillance online database (RubeNS). 2B 1E 2017 2018 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 2009. All rights reserved. 10 Table 9A. Completeness and timeliness of epidemiologic reporting, WHO Western Pacific Region, 2017—2018 Table 9B. Completeness and timeliness of laboratory reporting, WHO Western Pacific Region, 2017—2018 Expanded Programme on Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. No. (63 2) 5288001 Fax No. (63 2) 5211036, 5260279 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% 08 Feb 08 Mar 10 Apr 16 May 12 Jun 09 Jul 100% 83% Brunei Darussalam 100% 100% 07 Feb 06 Mar 07 Apr 07 May 05 Jun 07 Jul 100% 100% Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% China 100% 75% 13 Feb 12 Mar 15 Apr 16 May 05 Jul 12 Jul 100% 83% China, Hong Kong SAR 100% 100% 06 Feb 06 Mar 09 Apr 07 May 06 Jun 09 Jul 100% 100% China, Macao SAR 100% 100% 08 Feb 08 Mar 04 Apr 07 May 06 Jun 09 Jul 100% 100% Japan 100% 92% 09 Feb 10 Mar 10 Apr 10 May 10 Jun 10 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% 08 Feb 09 Mar 06 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% 08 Feb 07 Mar 10 Apr 08 May 06 Jun 05 Jul 100% 100% Papua New Guinea 100% 92% - 14 Mar 17 Apr 10 May 08 Jun 17 Jul 83% 33% Philippines 58% 25% 02 Mar - 27 Apr 22 May 21 Jun - 67% 0% Republic of Korea 100% 92% 08 Feb 10 Mar 10 Apr 10 May 10 Jun 13 Jul 100% 83% Singapore 100% 92% 08 Feb 10 Mar 07 Apr 10 May 07 Jun 07 Jul 100% 100% Viet Nam 100% 92% 09 Feb 09 Mar 10 Apr 09 May 08 Jun 09 Jul 100% 100% Pacific island countries and areas 100% 67% 16 Feb 10 Mar 07 Apr 14 May 08 Jun 13 Jul 100% 83% Completeness 98% 94% 94% 100% 100% 100% 94% 97% Timeliness 92% 82% 88% 88% 88% 88% 82% 86% 1 National measles surveillance monthly reports from June 2018. Legend: black = timely report; red = untimely report 2 Completeness is defined as the number of reports received by the end of the Completeness 2 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 Country 2017 Timeliness 3 2018 1 Completeness 2 Timeliness 3 MeaNS Submission to WPRO Rubens Submission to WPRO Australia 100% 100% 07 Feb 01 Mar 04 Apr 04 May 07 Jun 06 Jul 100% 100% 34 38 0 0 Brunei Darussalam 100% 100% 05 Feb 01 Mar 31 Mar 07 May 30 May 30 Jun 100% 100% 0 0 0 0 Cambodia 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% 0 0 0 0 China 100% 100% 06 Feb 06 Mar 02 Apr 02 May 05 Jun 02 Jul 100% 100% 19 98 18 17 China, Hong Kong SAR 100% 100% 06 Feb 06 Mar 10 Apr 07 May 07 Jun 09 Jul 100% 100% 7 8 0 2 China, Macao SAR 100% 100% 08 Feb 09 Mar 06 Apr 08 May 10 Jun 06 Jul 100% 100% 1 1 0 0 Japan 100% 92% 09 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% 4 47 4 0 Lao People's Democratic Republic 100% 100% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% 0 0 0 0 Malaysia 100% 100% 09 Feb 09 Mar 11 Apr 14 May 02 Jul 10 Jul 100% 67% 11 0 0 0 Mongolia 100% 83% 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 100% 100% 0 0 0 0 New Zealand 100% 100% 08 Feb 07 Mar 10 Apr 08 May 05 Jun 05-Jul 100% 100% 18 18 0 0 Papua New Guinea 100% 67% 08 Feb 10 Mar 04 Apr 10 May 08 Jun 04 Jul 100% 100% 0 0 0 0 Philippines 100% 92% 10 Feb 10 Mar 10 Apr 09 May 13 Jun 10 Jul 100% 83% 35 35 0 0 Republic of Korea 100% 100% 09 Feb 09 Mar 10 Apr 10 May 08 Jun 10 Jul 100% 100% 3 10 0 0 Singapore 100% 100% 08 Feb 10 Mar 07 Apr 10 May 07 Jun 07 Jul 100% 100% 15 19 1 1 Viet Nam national lab (Northern) 100% 100% 09 Feb 05 Mar 09 Apr 09 May 06 Jun 10 Jul 100% 100% 33 16 0 0 Viet Nam national lab (Southern) 100% 100% 08 Feb 08 Mar 09 Apr 09 May 10 Jun 09 Jul 100% 100% 0 0 0 0 Viet Nam subnational lab (Central) 100% 100% 09 Feb 05 Mar 09 Apr 09 May 06 Jun 10 Jul 100% 100% 0 0 0 0 Viet Nam subnational lab (Highland) 100% 100% 09 Feb 05 Mar 09 Apr 09 May 06 Jun 10 Jul 100% 100% 0 0 0 0 Fiji 100% 75% 16 Feb 16 Mar 07 Apr 14 May 08 Jun 13 Jul 100% 67% 0 0 0 0 Completeness 100% 100% 100% 100% 100% 100% 100% 100% Timeliness 95% 95% 95% 100% 95% 90% 100% 96% 1 National measles laboratory monthly reports from June 2018. 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. 2017 Completeness 2 Timeliness 3 Country/area Measles Rubella 2018 1 Jan Feb Mar Apr May Jun 180 290 23 20 Completeness 2 Timeliness 3 Genotype results by source of data