SEA Region Measles and Rubella Quarterly update Oct -Dec 2021

SEA Region Measles and Rubella Quarterly update Oct -Dec 2021 Please note that all data contained within is provisional. The number of cases of measles and rubella officially reported by a member state is only available by July of each year (through the joint WHO UNICEF annual data collection exercise). If any numbers from this provisional data are quoted, they should be properly sourced with a date (i.e. provisional data based on weekly measles rubella case-based data reported to SEARO IVD as of 23 January 2022). Vol.4 Issue 8. Jan 2022 Key highlights – Q4 2021 (October to December 2021) • The Region has adopted the goal of “measles and rubella elimination by 2023” (SEA/RC73/R3). • Significant impact of COVID-19 on measles and rubella activities in the Region. • A virtual review of the measles and rubella elimination activities in he Region commission through independent expert between 1 October to 30 November and preliminary findings and recommendations shared with the participants. 2 Recent cases of measles and rubella in countries already verified for measles elimination, South-East Asia Region Country Year in which verified Confirmed cases 2021 Source of infection of measles cases % measles cases with known source Measles Rubella Measles Rubella Imported Import- related Unknown/ not reported Endemic Bhutan 2017 - 0 0 0 0 0 0 NA DPR Korea 2018 - 0 0 0 0 0 0 NA Maldives 2017 2020 0 0 0 0 0 0 NA Sri Lanka 2019 2020 0 0 0 0 0 0 NA Timor-Leste 2018 - 1 2 0 0 0 0 NA 3*Data Source: SEAR MR Surveillance database as of 23 January 2022 Measles and rubella incidence, 2017-2021 Data Source: Measles and rubella cases reported through JRF submitted by Member States and population data from AERF 2017-2019, Data for 2020 and 2021 from SEAR MR surveillance database as of 23 January 2022 Measles Incidence per million population Country 2017 2018 2019 2020 2021 Bangladesh 24.5 64.3 34.7 14.2 1.17 Bhutan 83.5 24.5 2.7 - - DPR Korea 0.0 0.0 0.0 - - India 10.0 14.3 7.8 4.0 4.08 Indonesia 34.5 20.0 7.3 1.1 0.35 Maldives 3.0 3.0 0.0 26.9 - Myanmar 24.8 26.5 98.6 8.1 0.15 Nepal 3.5 9.0 14.6 13.0 4.70 Sri Lanka 0.0 0.0 2.2 0.1 - Thailand 29.6 90.9 75.3 12.2 0.42 Timor-Leste 0.0 0.0 16.6 - - SEAR 15.2 21.7 14.7 4.9 3.07 Rubella Incidence per million population Country 2017 2018 2019 2020 2021 Bangladesh 1.8 1.9 1.0 0.4 0.75 Bhutan 11.4 15.0 9.4 - - DPR Korea 0.0 0.0 0.0 - - India 2.1 1.7 2.5 1.0 1.15 Indonesia 4.8 6.0 2.7 0.6 0.70 Maldives 3.0 0.0 0.0 1.8 - Myanmar 0.1 0.2 0.5 0.1 0.05 Nepal 0.7 1.2 1.5 1.2 1.42 Sri Lanka 0.0 0.0 0.0 - - Thailand 0.5 1.0 2.1 0.8 0.11 Timor-Leste 2.3 6.2 15.8 4.8 1.52 SEAR 2.3 2.2 2.3 0.8 0.98 4 Zero-dose and partially vaccinated children – 2020 cohort Source: Calculation done based on the population under 1 year from JRAF 2020 submitted by member states and WHO/UNICEF Joint Estimate 2020, July 2021 5 Country Under 1 year population MCV zero dose children MCV Partially vaccinated RCV zero dose children Number % Number % Number % Bangladesh 3 293 482 98 804 3% 131 739 4% 98 804 3% Bhutan 10 600 742 7% 106 1% 742 7% DPR Korea 306 153 3 062 1% - 0% 3 062 1% India 26 451 880 2 909 707 11% 2 116 150 8% 2 909 707 11% Indonesia 4 650 109 1 116 026 24% 1 255 529 27% 1 116 026 24% Maldives 8 853 89 1% 266 3% 89 1% Myanmar 927 884 83 510 9% 9 279 1% 83 510 9% Nepal 620 739 80 696 13% 80 696 13% 80 696 13% Sri Lanka 352 554 14 102 4% - 0% 14 102 4% Thailand 577 133 51 942 9% - 0% 51 942 9% Timor-Leste 31 905 6 700 21% 319 1% 6 700 21% SEAR 37 231 292 4 365 379 12% 3 594 085 10% 4 365 379 12% Measles Confirmed measles cases and coverage of MCV1 and MCV2 in SEAR 2000-2021 0 10 20 30 40 50 60 70 80 90 100 0 20 000 40 000 60 000 80 000 100 000 120 000 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 C o ve ra ge ( % ) N u m b e r o f m e as le s ca se s India Indonesia Myanmar Thailand Others MCV1 coverage MCV2 coverage 7Source: WHO/UNICEF coverage estimates, July 2021 and WHO/UNICEF JRF and EPI/MOHFW; Measles cases from JRF 2000-2020 and 2021 from SEAR MR surveillance database as of 23 January 2022 Measles cases by month and country (2018-2021*) 0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 20 1 8 -0 1 20 1 8 -0 2 20 1 8 -0 3 20 1 8 -0 4 20 1 8 -0 5 20 1 8 -0 6 20 1 8 -0 7 20 1 8 -0 8 20 1 8 -0 9 20 1 8 -1 0 20 1 8 -1 1 20 1 8 -1 2 20 1 9 -0 1 20 1 9 -0 2 20 1 9 -0 3 20 1 9 -0 4 20 1 9 -0 5 20 1 9 -0 6 20 1 9 -0 7 20 1 9 -0 8 20 1 9 -0 9 20 1 9 -1 0 20 1 9 -1 1 20 1 9 -1 2 20 2 0 - 0 1 20 2 0 - 0 2 20 2 0 - 0 3 20 2 0 - 0 4 20 2 0 - 0 5 20 2 0 - 0 6 20 2 0 - 0 7 20 2 0 - 0 8 20 2 0 - 0 9 20 2 0 -1 0 20 2 0 -1 1 20 2 0 -1 2 20 2 1 - 0 1 20 2 1 - 0 2 20 2 1 - 0 3 20 2 1 -0 4 20 2 1 -0 5 20 2 1 -0 6 20 2 1 -0 7 20 2 1 -0 8 20 2 1 -0 9 20 2 1 -1 0 20 2 1 -1 1 20 2 1 -1 2 M ea sl es c as es ( La b +E p i+ C lin ic al ly co m p at ib le ) Month of onset Bangladesh Bhutan DPR Korea India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor Leste 8*Data Source: SEAR MR Surveillance database as of 23 January 2022 Measles cases by country, 2020-2021* 9*Data Source: SEAR MR Surveillance database as of 23 January 2022 Country Suspected cases Confirmed Measles cases (Lab+Epi+Cln) Lab confirmed Epi-Linked Clinically compatible Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Bangladesh 4 029 203 121 26 56 7 7 54 27 5 4 3 11 14 28 18 25 23-Jan-22 Bhutan 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23-Jan-22 DPR Korea 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 08-Nov-21 India 32 775 5 794 1 817 475 3 502 269 349 515 317 167 315 613 671 758 584 590 646 22-Jan-22 Indonesia 2 172 94 94 3 6 4 9 5 7 1 5 10 21 8 15 17-Jan-22 Maldives 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26-Jan-22 Myanmar 30 8 5 3 1 2 0 1 1 2 0 0 1 0 0 0 21-Jan-22 Nepal 1 418 142 81 60 1 19 9 12 4 3 2 5 45 29 11 2 1 23-Jan-22 Sri Lanka 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17-Jan-22 Thailand 244 28 8 20 4 3 4 4 1 3 1 0 2 2 2 2 24-Jan-22 Timor Leste 43 1 1 0 0 0 0 0 0 0 0 0 0 0 1 29-Dec-21 SEAR 41 363 6 270 2 127 561 3 582 303 376 589 362 182 333 623 732 814 646 620 690 Country Suspected cases Confirmed Measles cases (Lab+Epi+Cln) Lab confirmed Epi-Linked Clinically compatible Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Bangladesh 5 825 2 410 1 347 638 425 627 784 751 122 3 12 8 8 27 32 27 9 23-Jan-22 Bhutan 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23-Jan-22 DPR Korea 525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 08-Nov-21 India 17 947 5 564 2 565 605 2 394 968 1 444 1 168 297 199 179 118 124 199 280 280 308 22-Jan-22 Indonesia 3 211 305 305 122 89 58 8 2 2 1 3 4 3 9 4 17-Jan-22 Maldives 254 15 14 1 8 7 0 0 0 0 0 0 0 0 0 0 26-Jan-22 Myanmar 682 442 206 211 25 136 129 62 5 54 36 8 3 5 2 1 1 21-Jan-22 Nepal 1 381 388 230 155 3 37 57 169 52 21 4 4 9 13 13 4 5 23-Jan-22 Sri Lanka 90 2 2 0 2 0 0 0 0 0 0 0 0 0 0 17-Jan-22 Thailand 1 933 789 343 196 250 202 278 131 39 27 19 16 28 17 16 9 7 24-Jan-22 Timor Leste 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29-Dec-21 SEAR 32 078 9 915 5 012 1 805 3 098 2 100 2 790 2 339 523 306 252 155 175 265 346 330 334 Reported measles cases in 2021 Confirmed measles cases by month in 2021 Date Received Date Received Reported measles cases in 2020 Confirmed measles cases by month in 2020 Rubella Confirmed rubella cases and RCV coverage in SEAR 2005-2021 0 10 20 30 40 50 60 70 80 90 100 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 18 000 20 000 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 C o ve ra ge ( % ) N u m b e r o f ru b el la c as es Bangladesh India Indonesia Nepal Thailand Others SEAR RCV1 coverage Source: WHO/UNICEF coverage estimates, July 2021 and WHO/UNICEF JRF and EPI/MOHFW; Rubella cases from JRF 2000-2020 and 2021 from SEAR MR surveillance database as of 23 January 2022 11 Rubella cases by month and country (2018-2021*) 0 200 400 600 800 1000 1200 1400 2 0 18 -0 1 2 0 18 -0 2 2 0 18 -0 3 2 0 18 -0 4 2 0 18 -0 5 2 0 18 -0 6 2 0 18 -0 7 2 0 18 -0 8 2 0 18 -0 9 2 0 18 -1 0 2 0 18 -1 1 2 0 18 -1 2 2 0 19 -0 1 2 0 19 -0 2 2 0 19 -0 3 2 0 19 -0 4 2 0 19 -0 5 2 0 19 -0 6 2 0 19 -0 7 2 0 19 -0 8 2 0 19 -0 9 2 0 19 -1 0 2 0 19 -1 1 2 0 19 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 20 -1 0 2 0 20 -1 1 2 0 20 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 21 -0 4 2 0 21 -0 5 2 0 21 -0 6 2 0 21 -0 7 2 0 21 -0 8 2 0 21 -0 9 2 0 21 -1 0 2 0 21 -1 1 2 0 21 -1 2 R u b el la c as es ( La b +E p i) Month of onset Bangladesh Bhutan DPR Korea India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor Leste 12*Data Source: SEAR MR Surveillance database as of 23 January 2022 Rubella cases by country, 2020-2021* 13*Data Source: SEAR MR Surveillance database as of 23 January 2022 Country Rubella cases Lab confirmed Epi-Linked Clinically compatible Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Bangladesh 129 127 2 0 8 7 7 5 6 7 2 14 26 19 12 16 23-Jan-22 Bhutan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23-Jan-22 DPR Korea 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 08-Nov-21 India 1 633 1 596 37 0 98 102 109 41 30 74 138 224 232 202 226 157 22-Jan-22 Indonesia 190 190 0 0 4 2 7 8 10 8 6 9 20 45 42 29 17-Jan-22 Maldives 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26-Jan-22 Myanmar 3 3 0 0 1 0 0 0 0 1 0 0 0 0 1 0 21-Jan-22 Nepal 43 43 0 0 5 4 4 4 2 3 6 3 3 4 3 2 23-Jan-22 Sri Lanka 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17-Jan-22 Thailand 7 7 0 0 0 0 2 1 1 2 0 0 0 1 0 0 24-Jan-22 Timor Leste 2 2 0 0 0 2 0 0 0 0 0 0 0 0 0 0 29-Dec-21 SEAR 2 007 1 968 39 0 116 117 129 59 49 95 152 250 281 271 284 204 Country Rubella cases Lab confirmed Epi-Linked Clinically compatible Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Bangladesh 66 66 0 6 19 1 0 0 2 2 4 6 10 11 5 23-Jan-22 Bhutan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23-Jan-22 DPR Korea 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 08-Nov-21 India 1 388 1 295 93 0 180 286 210 70 35 52 49 46 63 115 123 159 22-Jan-22 Indonesia 159 159 0 35 53 29 9 3 5 5 6 3 1 8 2 17-Jan-22 Maldives 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 26-Jan-22 Myanmar 3 3 0 0 0 0 0 1 1 0 0 1 0 0 0 21-Jan-22 Nepal 37 37 0 2 7 4 0 2 2 3 2 6 2 3 4 23-Jan-22 Sri Lanka 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17-Jan-22 Thailand 52 52 0 8 25 2 2 3 0 5 0 2 3 2 0 24-Jan-22 Timor Leste 6 6 0 0 0 0 0 0 0 1 1 2 1 1 0 29-Dec-21 SEAR 1 712 1 619 93 0 231 391 246 81 44 62 65 59 83 132 148 170 Date Received Date Received Reported rubella cases in 2021 Reported rubella cases in 2020 Confirmed rubella cases by month in 2021 Confirmed rubella cases by month in 2020 Surveillance for measles and rubella 14 15 Definition of suspected measles and rubella cases Countries Fever and rash Bangladesh, Bhutan, DPR Korea, India, Indonesia , Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste Fever, rash and 3 C’s –Cough, Coryza or conjunctivitis Surveillance and laboratory performance indicators (2020 vs 2021) 16*Data Source: SEAR MR Surveillance database as of 23 January 2022 2020 2021 2020 2021 2020 2021 2020 2021 2020 2021 2020 2021 2020 2021 Bangladesh 5 827 4 029 95 97 77 91 4 505 3 436 99 100 100 100 65 100 Bhutan 122 148 95 99 95 96 109 136 69 74 99 98 74 83 DPR Korea 525 397 100 100 100 100 525 397 100 0 100 0 100 0 India 17 953 32 775 77 85 79 85 12 840 23 374 98 99 98 97 50 69 Indonesia 3 217 2 172 68 67 99 100 3 171 2 159 98 0 100 0 59 0 Maldives 254 24 78 52 94 87 238 19 97 0 100 0 92 0 Myanmar 684 30 96 53 66 87 449 26 95 0 100 0 96 0 Nepal 1 381 1 418 100 99 89 99 1 231 1 366 100 100 100 100 62 80 Sri Lanka 90 83 97 96 94 93 74 24 80 0 100 0 65 0 Thailand 1 933 244 34 43 82 95 1 532 215 65 60 98 99 98 99 Timor-Leste 108 43 100 100 97 93 104 40 97 98 93 88 72 83 SEAR 32 094 41 363 79 86 82 87 24 778 31 192 96 98 99 98 60 75 Countries Number of serum specimens received in laboratory % serum specimens received at laboratory w/in 5 days of collection % specimens tested for serology of specimens received in the laboratory % serology results reported w/in 4 days of specimen received at laboratory Number of suspected measles cases % suspected cases with adequate investigation initiated w/in 48 hours of notification % suspected cases with serum specimens collected Case classification (2020 vs 2021) La bo ra to ry - co nf irm ed Ep id em io lo gi ca lly - co nf irm ed Cl in ic al ly - co m pa tib le La bo ra to ry - co nf irm ed Ep id em io lo gi ca lly - co nf irm ed Cl in ic al ly - co m pa tib le La bo ra to ry - co nf irm ed Ep id em io lo gi ca lly - co nf irm ed La bo ra to ry - co nf irm ed Ep id em io lo gi ca lly - co nf irm ed Q1-Q4 2020 Q1-Q4 2021 Q1-Q4 2020 Q1-Q4 2021 Bangladesh 1 347 638 425 121 26 56 66 127 2 3 349 3 697 Bhutan 0 0 0 0 0 0 0 0 0 0 122 148 DPR Korea 0 0 0 0 0 0 0 0 0 0 525 396 1 India 2 565 605 2 394 1 817 475 3 502 1 295 93 1 596 37 10 995 24 949 399 Indonesia 305 94 159 190 0 2 736 1 868 11 20 Maldives 14 1 0 0 0 1 0 0 236 24 2 Myanmar 206 211 25 5 3 3 3 0 237 18 1 Nepal 230 155 3 81 60 1 37 43 0 956 1 213 20 Sri Lanka 2 0 0 0 0 0 0 0 88 83 Thailand 343 196 250 8 20 52 7 0 1 092 199 10 Timor-Leste 0 0 0 1 6 2 0 91 32 11 8 SEAR 5 012 1 805 3 098 2 127 561 3 582 1 619 93 1 968 39 20 427 32 627 24 459 Countries Q1-Q4 2020 Q1-Q4 2021 Q1-Q4 2020 Q1-Q4 2021 Measles Rubella D isc ar de d n on - m ea sle s n on -r ub el la ca se s Pe nd in g cl as sif ic at io n 17Data Source: SEAR MR Surveillance database as of 23 January 2022 * Import/import related case Case classification (Q1-Q4 2020 vs Q1-Q4 2021) 18Data Source: SEAR MR Surveillance database as of 23 January 2022 Surveillance performance indicators 19 2019 (Q1-Q4) 2020 (Q1-Q4) 2021 (Q1-Q4) 2019 (Q1-Q4) 2020 (Q1-Q4) 2021 (Q1-Q4) Bangladesh 3.35 1.93 2.00 91 52 55 Bhutan 39.72 15.98 19.44 85 50 60 DPR Korea 2.10 2.09 1.60 ND ND ND India 1.05 0.77 1.69 16 11 36 Indonesia 1.92 0.99 0.69 21 10 6 Maldives 18.40 41.54 4.21 ND ND ND Myanmar 2.43 0.43 0.03 37 4 0 Nepal 5.53 3.15 3.97 92 81 81 Sri Lanka 1.55 0.39 0.10 27 0 0 Thailand 5.99 1.61 0.30 ND ND ND Timor-Leste 31.63 7.08 2.43 38 46 8 SEAR 1.68 0.98 1.52 0 Countries Reporting rate of discarded non-measles non- rubella cases per 100,000 population % districts reporting at least 2 discarded non-measles non-rubella cases per 100,000 population Data Source: SEAR MR Surveillance database as of 23 January 2022 Non-measles non-rubella discarded case rate per 100,000 population by 1st sub-national level, 2019-2021 20*Data Source: SEAR MR Surveillance database as of 23 January 2022 Vaccination status of measles cases (Q1-Q4-2020 vs Q1-Q4-2021) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f m ea sl es c as e s Vaccination status of confirmed measles cases by age group In SEAR 2021 (n=6,270) 0 dose 1 dose >=2 doses Unknown 22*Data Source: SEAR MR Surveillance database as of 23 January 2022 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f m ea sl es c as e s Vaccination status of confirmed measles cases by age group In SEAR 2020 (n=9,904) 0 dose 1 dose >=2 doses Unknown Vaccination status of rubella cases (Q1-Q4-2020 vs Q1-Q4-2021) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+yrs Unknown N u m b er o f R u b el la c as e s Vaccination status of confirmed rubella cases by age group In SEAR 2021 (n=2,007) 0 dose 1+ dose Unknown 23 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+yrs Unknown N u m b er o f R u b el la c as e s Vaccination status of confirmed rubella cases by age group In SEAR 2020 (n=1,711) 0 dose 1+ dose Unknown *Data Source: SEAR MR Surveillance database as of 23 January 2022 Vaccination status by age and by sex of rubella cases 25*Data Source: SEAR MR Surveillance database as of 23 January 2022 Q1-Q4-2020 Q1-Q4-2021 Vaccination status of non-measles non-rubella discarded cases (Q1-Q4-2020 vs Q1-Q4-2021) 0% 20% 40% 60% 80% 100% <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs UnknownN u m b er o f d is ca rd ed c as e s Measles vaccination status of discarded non measles non-rubella cases by age group in SEAR 2020 (n=20,455) 0 dose 1 dose >1 dose Unknown 0% 20% 40% 60% 80% 100% <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+yrs UnknownN u m b er o f d is ca rd ed c as e s Measles vaccination status of discarded non measles non-rubella cases by age group in SEAR, 2021 (n=32,627) 0 dose 1 dose >1 dose Unknown 0% 20% 40% 60% 80% 100% <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f d is ca rd ed c as e s Rubella vaccination status of discarded non measles non-rubella cases by age group in SEAR 2020 (n=20,455) 0 dose 1+ dose Unknown 0% 20% 40% 60% 80% 100% <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f d is ca rd ed c as e s Rubella vaccination status of discarded non measles non-rubella cases by age group in SEAR 2021 (n=32,627) 0 dose 1+ dose Unknown 26*Data Source: SEAR MR Surveillance database as of 23 January 2022 Outbreaks of measles and rubella 27 Major outbreaks reported in Q4, 2021 28 *Data Source: SEAR MR Surveillance database as of 23 January 2022 Measles outbreak Rubella outbreak 1 dot = 1 outbreak Measles outbreak Country Province District Total cases date of onset of the first case Date of onset of the last case Bihar Begusarai 13 13-Dec-21 28-Dec-21 Bihar Champaran East 9 02-Dec-21 10-Dec-21 Bihar Gaya 4 20-Dec-21 02-Jan-22 Bihar Madhubani 36 03-Nov-21 02-Jan-22 Bihar Madhubani 27 05-Nov-21 28-Nov-21 Bihar Madhubani 6 17-Dec-21 21-Dec-21 Bihar Madhubani 5 03-Dec-21 04-Dec-21 Bihar Patna 78 18-Nov-21 20-Dec-21 Haryana Palwal 12 16-Sep-21 04-Oct-21 Jharkhand Godda 3 24-Dec-21 25-Dec-21 Jharkhand Pakur 9 28-Nov-21 24-Dec-21 Jharkhand Sahibganj 30 05-Dec-21 13-Jan-22 Jharkhand Sahibganj 20 03-Dec-21 16-Dec-21 Jharkhand Sahibganj 8 14-Dec-21 06-Jan-22 Jharkhand Sahibganj 8 26-Dec-21 07-Jan-22 Jharkhand Sahibganj 4 20-Oct-21 04-Nov-21 Nagaland Mon 6 03-Oct-21 03-Nov-21 Odisha Kalahandi 8 26-Nov-21 03-Dec-21 India Country Province District Total cases date of onset of the first case Date of onset of the last case Bangladesh Chittagong Chittagong CC. 4 15-Sep-21 23-Sep-21 India Uttar Pradesh Kasganj 4 25-Sep-21 02-Oct-21 Rubella outbreak Laboratory Network 29 Measles and rubella laboratory network in SEA Region Country National laboratory Sub-national laboratory National reference laboratory Regional reference laboratory Total Bangladesh 1 1 Bhutan 1 1 DPR Korea 1 1 India 11 5 2 18 Indonesia 4 3 7 Maldives 1 1 Myanmar 1 1 2 Nepal 1 1 2 Sri Lanka 1 1 Thailand 13 1 14 Timor Leste 1 1 Total 23 23 2 1 49 30 Country Serology only (IgM/IgG) Serology + Molecular (RT- PCR) Serology + Molecular (RT- PCR) + Sequencing Bangladesh 1 Bhutan 1 DPR Korea 1 India 5 12 1 Indonesia 3 2 2 Maldives 1 Myanmar 1 1 Nepal 2 Sri Lanka 1 Thailand 9 4 1 Timor-Leste 1 Total 20 25 4 India Nepal D8, B3 Bhutan Bangladesh Sri Lanka Myanmar Thailand Indonesia Timor Leste Maldives DPRK D4, B3, D8 D8, B3 D9, D4, D8 D9, B3, D8, H1 D8,D9,B3, H1B3, D8 D8 Source: MeaNS database , National Institute of Health, Thailand, MeaNS, NIVMU Country 2016 2017 2018 2019 2020 Bangladesh D8 B3, D8 B3, D8 B3, D8 B3 Bhutan D8 D8 D8 DPRK India B3,D4,D8 D4,D8 D8 B3, D4, D8 B3, D4, D8 Indonesia D8,D9 D8 D8 Maldives D8 D8 Myanmar H1, D8 H1 D8, H1 B3, D8,H1 Nepal D8, D9 D8 D4, D8 Sri Lanka B3 B3, D8, H1 Thailand H1,B3,D8 H1,B3, D8 B3, D8,H1 B3, D8,H1 D8 Timor-Leste Measles genotypes circulating between 2013 and 2020* *Data as of 12 April 2021 31 India Nepal Bhutan Bangladesh Sri Lanka Myanmar Thailand Indonesia Timor Leste Maldives DPRK 1E, 2B 2B 1E, 2B, 1a 1J, 2B 1E,2B Rubella genotype distribution between 2013- 2020* Country 2016 2017 2018 2019 2020 Bangladesh Bhutan DPRK India 1J, 2B 2B 2B 2B Indonesia Maldives 1a Myanmar Nepal Sri Lanka Thailand 2B 1E 1a, 1E 1E Timor-Leste Ref: RubeNS database 32 1a *Data as of 12 April 2021 The BIG SIX countries Measles Measles cases: Bangladesh 0 200 400 600 800 1000 1200 1400 1600 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 - 0 7 2 0 2 1 - 0 8 2 0 2 1 - 0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Measles cases distribution by month (2019-2021) Lab confirmed Epi-linked Clinically compatible Discarded 0 20 40 60 80 100 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1 dose 2+doses Unknown *Dots are randomly placed within districts 01 Jan 2021 to 31 Dec 2021 34 01 Jan 2020 to 31 Dec 2020 Spot map of Measles cases *Data Source: SEAR MR Surveillance database as of 23 January 2022 Measles cases: India 0 1000 2000 3000 4000 5000 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Measles cases distribution by month (2019-2021) Lab confirmed Epi-linked Clinically compatible Discarded Spot map of Measles cases 35 0 500 1000 1500 2000 2500 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1 dose 2+doses Unknown *Dots are randomly placed within states *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 Measles cases: Indonesia 36 0 5 10 15 20 25 30 35 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1 dose 2+doses Unknown 0 200 400 600 800 1000 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Measles cases distribution by month (2019-2021) Lab confirmed Epi-linked Clinically compatible Discarded *Dots are randomly placed within provinces Spot map of Measles cases *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 Measles cases: Myanmar 0 50 100 150 200 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Measles cases distribution by month (2019-2021) Lab confirmed Epi-linked Clinically compatible Discarded Spot map of Measles cases 37 0 0.5 1 1.5 2 2.5 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1 dose 2+doses Unknown *Dots are randomly placed within provinces *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 Measles cases: Nepal 0 50 100 150 200 250 300 350 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Measles cases distribution by month (2019-2021) Lab confirmed Epi-linked Clinically compatible Discarded 38 0 10 20 30 40 50 60 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1 dose 2+doses Unknown *Dots are randomly placed within districts Spot map of Measles cases *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 Measles cases: Thailand 0 500 1000 1500 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Measles cases distribution by month (2019-2021) Lab confirmed Epi-linked Clinically compatible Discarded Spot map of Measles cases 39 0 2 4 6 8 10 12 14 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+ yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1 dose 2+doses Unknown *Dots are randomly placed within provinces *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 The BIG SIX countries Rubella Rubella cases: Bangladesh 0 5 10 15 20 25 30 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Rubella cases distribution by month (2019-2021) Lab confirmed Epi-linked 41 0 10 20 30 40 50 60 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1+dose Unknown Spot map of Rubella cases *Dots are randomly placed within districts *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 Rubella cases: India 42 0 200 400 600 800 1000 1200 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Rubella cases distribution by month (2019-2021) Lab confirmed Epi-linked Spot map of Rubella cases 0 100 200 300 400 500 600 700 800 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1+dose Unknown *Dots are randomly placed within states *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 Rubella cases: Indonesia 43 0 20 40 60 80 100 120 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Rubella cases distribution by month (2019-2021) Lab confirmed Epi-linked Spot map of Rubella cases 0 10 20 30 40 50 60 70 80 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1+dose Unknown *Dots are randomly placed within provinces *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 Rubella cases: Myanmar 44 0 1 2 3 4 5 6 7 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Rubella cases distribution by month (2019-2021) Lab confirmed Epi-linked Spot map of Rubella cases *Dots are randomly placed within provinces 0 0.2 0.4 0.6 0.8 1 1.2 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1+dose Unknown *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 Rubella cases: Nepal 45 0 2 4 6 8 10 12 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Rubella cases distribution by month (2019-2021) Lab confirmed Epi-linked Spot map of Rubella cases 0 5 10 15 20 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1+dose Unknown *Dots are randomly placed within districts *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 Rubella cases: Thailand 46 0 5 10 15 20 25 30 2 0 1 9 - 0 1 2 0 1 9 - 0 2 2 0 1 9 - 0 3 2 0 1 9 - 0 4 2 0 1 9 - 0 5 2 0 1 9 - 0 6 2 0 1 9 - 0 7 2 0 1 9 - 0 8 2 0 1 9 - 0 9 2 0 1 9 -1 0 2 0 1 9 -1 1 2 0 1 9 -1 2 2 0 2 0 - 0 1 2 0 2 0 - 0 2 2 0 2 0 - 0 3 2 0 2 0 - 0 4 2 0 2 0 - 0 5 2 0 2 0 - 0 6 2 0 2 0 - 0 7 2 0 2 0 - 0 8 2 0 2 0 - 0 9 2 0 2 0 -1 0 2 0 2 0 -1 1 2 0 2 0 -1 2 2 0 2 1 - 0 1 2 0 2 1 - 0 2 2 0 2 1 - 0 3 2 0 2 1 - 0 4 2 0 2 1 - 0 5 2 0 2 1 - 0 6 2 0 2 1 -0 7 2 0 2 1 -0 8 2 0 2 1 -0 9 2 0 2 1 -1 0 2 0 2 1 -1 1 2 0 2 1 -1 2 N u m b er o f ca se s Month of onset Rubella cases distribution by month (2019-2021) Lab confirmed Epi-linked Spot map of Rubella cases 0 1 2 3 4 5 <1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-24 yrs 25-39 yrs 40+yrs Unknown N u m b er o f ca se s Age at onset Age distribution by vaccination status (2021-01 to 2021-12) 0 dose 1+dose Unknown *Dots are randomly placed within provinces *Data Source: SEAR MR Surveillance database as of 23 January 2022 01 Jan 2021 to 31 Dec 2021 01 Jan 2020 to 31 Dec 2020 The SEAR Measles and Rubella quarterly bulletin is based on surveillance case-based data/aggregated data reported by Member States to the regional offices weekly and measles lab network data monthly. Numbers of cases might differ from the official numbers reported annually as part of the WHO/UNICEF Joint reporting process (JRF). The difference can be due to the time lag as the annual data might not be complete at the time of reporting. Types of data provided to Regional office • Epidemiologic Data: Case-based and to SEAR IVD by member states • At SEAR IVD, we collect a limited set of variables, including, age, date of onset, country reporting, 1st 2nd and 3rd administrative unit of residence, vaccination status (by recall), date related to specimen collection/testing, and final classification as per SEAR recommended data dictionary. Often suspected cases with recent date of onset are not classified as pending/blank; however, at SEAR we classify as pending cases. • Limitations • Underreporting/lack of reporting and delay reporting • Genetic sequence data are not update properly in the case-based data and taken from different sources • SEAR laboratory network data • SEAR Measles Rubella Laboratory Network laboratories report the number of samples received as well as the number of samples tested for IgM serology, as well as the number positive, negative and equivocal, serum results available within 4 days of specimen receipt in the lab. • These aggregated data are collected to account for the inadequate linking between laboratory and epidemiological data in some countries. • Numbers of cases reported may differ from the number of samples tested positive for various reasons • Samples tested result in a laboratory may not reported to the surveillance system • Inconsistent reporting from laboratories. • This is based on the number of SAMPLES tested, not the number of CASES tested. One case can have multiple samples being tested (e.g. different specimen types, repeat specimen collection based on timing of collection). • Limitations • Data are only from network laboratories • Non-network laboratories are not included • Genotyping Data • Genotyping data are obtained from the MeaNS (www.who-measles.org) and RubeNS (www.who-rubella.org). • Limitations • Inadequate sample collection for genotyping challenges interpretation of the data • Underreporting • WHO recommends that Member States submit genotyping data to these databases, but it is not currently a requirement so there is underreporting • Genotype data can’t be linked to epidemiologic data at the regional level Data source for data contained within this slide deck 47 Disclaimer for all maps: The boundaries and names shown and the designations used on all 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, of concerning the delimitation of its frontiers or boundaries. For contact or feedback: Immunization and Vaccine Development (IVD), Department of Communicable Diseases (CDS) World Health Organization, Regional Office for South-East Asia, New Delhi – 110002, India Tel: 91-11-2337-0804 / 91-11-4304-0000 E-mail: SearEpidata@who.int 48