Global Measles and Rubella Update

April 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 monthly data reported to WHO
(Geneva) as of April 2021"). For official data from 1980-2019, please visit our website.
 Data sources for data contained within this slide deck

The Global Measles and Rubella Report is based on surveillance data reported by Member States to the regional offices weekly or monthly. The regional compilation is reported to HQ monthly. Data are to be reported from the
regions on the 1st Friday of the month, and HQ attempts to release the monthly report by the 3rd Monday of the month.
• 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.
• In addition the difference can be due to multiple surveillance systems at country level. In these cases, the monthly data are extracted from the case based surveillance system while the annual data can be from the
aggregated system.
Types of data provided to WHO
Epidemiologic Data: Case-based and/or Aggregate Reporting to WHO
• Epidemiologic data comes from Member States in one of two forms
• Case-based data, which is our recommendation, is provided by most member states.
• At WHO HQ, we collect a limited set of variables, including, age, date of onset, country reporting, 1st/2nd administrative unit of residence, vaccination status (by recall), date related to specimen
collection/testing, and final classification.
• Regions might or might not collect more data than this.
• Often suspected cases with recent date of onset are not classified; however, at HQ we classify pending cases as clinically compatible and update the data if/when new data are provided to HQ.
• For AFR, we classify all cases that are rubella IgM positive as rubella laboratory-confirmed cases.
• Aggregated data on number of suspected, lab-confirmed, epi-linked, and clinically compatible cases of measles/rubella, by month/year of onset, and by subnational area (though some member states do not provide
this level of disaggregation).
• Source for zero-reporting from some member-states though this is not a consistent process.
• A few member states send us both case-based and aggregated data as they have two different surveillance systems in the country.
• If both aggregate and case-based data are sent to HQ, numbers from aggregate surveillance are considered case counts for the country, while case-based data are used for the national slides to show
age distribution, proportion vaccinated, and age-specific incidence.
• Limitations
• Reporting delays: It can take 2-3 months from the time a case is reported to public health in a member state to the time the data are provided to WHO HQ.
• Some of this is due to normal reporting delays that are expected as it takes time to get information from a health center to Geneva based on reporting frequencies set by various levels
• We are working to decrease the delays in reporting.
• Underreporting/lack of reporting
• Case definitions for suspect, epidemiologically linked and clinically compatible cases may vary between countries.
• Completeness of the data reported to WHO is unknown
• For this monthly update, pending cases are considered measles clinically compatible.
• These cases may later be discarded or confirmed based on laboratory testing in which case historical case counts may vary from one report to another.
• This could lead to differences between the Global monthly report and Regional or National surveillance bulletins published by WHO Offices and National authorities.
ELISA Laboratory Data from the Global Measles and Rubella Laboratory Network (GMRLN)
• The Global 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.
• 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 positive in a laboratory may not reported to the surveillance system
• IgG screening results are inappropriately included in the surveillance database
• 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
• Some laboratories don’t report
• IgG results are sometimes inappropriately reported
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 global level
Measles
 Number of Reported Measles Cases by
WHO Regions
2021
Member Suspected Measles Date
Region Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
States* cases cases Received
AFR 31/47 5482 3425 2329 279 817 1890 1272 263 0 0 0 0 0 0 0 0 0 2021-04

AMR 16/35 1368 271 0 0 271 169 93 9 0 0 0 0 0 0 0 0 0 2021-04

EMR 7/21 927 351 33 0 318 152 197 2 0 0 0 0 0 0 0 0 0 2021-04

EUR 23/53 434 15 4 0 11 10 5 0 0 0 0 0 0 0 0 0 0 2021-04

SEAR 10/11 4100 981 689 84 208 283 339 359 0 0 0 0 0 0 0 0 0 2021-04

WPR 21/27 1820 199 129 0 70 101 98 0 0 0 0 0 0 0 0 0 0 2021-04

Total 108/194 14131 5242 3184 363 1695 2605 2004 633 0 0 0 0 0 0 0 0 0

2020
Member Suspected Measles Date
Region Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
States* cases cases Received
AFR 42/47 68044 46747 12740 22273 11734 13445 13630 9116 3330 1425 1024 649 624 684 793 1087 940 2021-04

AMR 26/35 24154 8700 0 12 8688 1685 2260 3241 946 99 71 67 80 97 105 48 1 2021-04

EMR 20/21 21264 9827 6768 326 2733 1265 1498 1342 665 484 475 674 615 793 919 852 245 2021-04

EUR 51/53 16433 12189 4573 1684 5932 3323 4022 3366 1172 205 27 13 17 9 15 11 9 2021-04

SEAR 11/11 32033 10067 3375 1816 4876 2118 2831 2360 529 313 258 163 185 270 356 346 338 2021-04

WPR 24/27 43630 6383 3301 255 2827 2125 1738 959 290 168 168 178 177 160 162 167 91 2021-04

Total 174/194 205558 93913 30757 26366 36790 23961 25979 20384 6932 2694 2023 1744 1698 2013 2350 2511 1624

Notes: Based on data received 2021-04 - This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region
 Number of Reported Measles Cases by
WHO Regions
2021
Member Suspected Measles Date
Region Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
States* cases cases Received
AFR 31/47 5482 3425 2329 279 817 1890 1272 263 0 0 0 0 0 0 0 0 0 2021-04

AMR 16/35 1368 271 0 0 271 169 93 9 0 0 0 0 0 0 0 0 0 2021-04

EMR 7/21 927 351 33 0 318 152 197 2 0 0 0 0 0 0 0 0 0 2021-04

EUR 23/53 434 15 4 0 11 10 5 0 0 0 0 0 0 0 0 0 0 2021-04

SEAR 10/11 4100 981 689 84 208 283 339 359 0 0 0 0 0 0 0 0 0 2021-04

WPR 21/27 1820 199 129 0 70 101 98 0 0 0 0 0 0 0 0 0 0 2021-04

Total 108/194 14131 5242 3184 363 1695 2605 2004 633 0 0 0 0 0 0 0 0 0

2020
Member Suspected Measles Date
Region Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
States* cases cases Received
AFR 36/47 19741 14489 3257 6750 4482 7538 5663 1288 0 0 0 0 0 0 0 0 0 2020-04

AMR 22/35 9099 1659 0 0 1659 877 660 122 0 0 0 0 0 0 0 0 0 2020-04

EMR 17/21 2901 652 212 66 374 356 296 0 0 0 0 0 0 0 0 0 0 2020-04

EUR 52/53 6240 4670 786 1225 2659 2713 1904 53 0 0 0 0 0 0 0 0 0 2020-04

SEAR 11/11 9047 3671 1706 428 1537 1954 1474 243 0 0 0 0 0 0 0 0 0 2020-04

WPR 14/27 5368 2955 1979 185 791 1735 1218 2 0 0 0 0 0 0 0 0 0 2020-04

Total 152/194 52396 28096 7940 8654 11502 15173 11215 1708 0 0 0 0 0 0 0 0 0

Notes: Based on data received 2021-04 and 2020-04 - This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region
 Measles cases (Lab+Epi+Clinical)

2021-04-06
110000
100000
120000
130000

10000
20000
30000
40000
50000
60000
70000
80000
90000

0
2017-01
2017-02
2017-03
2017-04
2017-05
2017-06
2017-07
2017-08
2017-09
2017-10
2017-11
2017-12
2018-01
2018-02
2018-03
2018-04
2018-05

AFR
2018-06
2018-07
WHO Region (2017-2021)

2018-08
2018-09

AMR
2018-10
2018-11
2018-12
2019-01

EMR
2019-02
2019-03
2019-04
2019-05

EUR
2019-06
Month of onset 2019-07
2019-08
2019-09
2019-10
SEAR
Measles case distribution by month and

2019-11
2019-12
2020-01
2020-02
WPR

2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10
2020-11
2020-12
2021-01
Notes: Based on data received 2021-04 - Data Source: IVB Database - This is surveillance data, hence for the last month(s), the data may be incomplete.

2021-02
2021-03
2021-04
Measles Incidence Rate per Million
(12M period)
Top 10**
Country Cases Rate
Nigeria 5785 28.06
Brazil 4821 22.68
India**** 3729 2.7
DRCongo 3542 39.55
Yemen 2540 85.16
Somalia 1883 118.48
Pakistan 1779 8.05
Uzbekistan 1714 51.21
Burundi 1454 122.28
Tanzania 1387 23.22

Other countries with high incidence

rates***
Country Cases Rate Measles cases from countries with known discrepancies between case-based and aggregate surveillance, as
CAR 1112 230.24 reported by country
Cases in Cases in
Liberia 457 90.36 Country Year Data Source for aggregate #s
Case-based Aggregate
Chad 1283 78.11
DR Congo 2020 15,098 75,863 AFR Partner’s Weekly Update, 31 March
Eq. Guinea 82 58.45 2021 472 12,289 2021
Burkina Faso 1197 57.26 Somalia 2020 211 2,596
Kazakhstan 1075 57.25 Not yet Somali  EPI/POL Weekly Update  Week 13
South Sudan 622 55.57 2021 reported to 973
HQ

Notes: Based on data received 2021-04 and covering the period between 2020-03 and 2021-02 - Incidence: Number of cases / population* * 1,000,000 - * World population prospects, 2019 revision - ** Countries with the highest number of cases for the period - *** Countries with the highest incidence rates (excluding those already
listed in the table above) - ****WHO classifies all suspected measles cases reported from India as measles clinically compatible if a specimen was not collected as per the algorithm for classification of suspected measles in the WHO VPD Surveillance Standards. Thus numbers might be different between what WHO reports and what
India reports.
Number of Reported Measles Cases
(6M period)

Top 10*
Country Cases
India** 1620

Nigeria 1501

Yemen 1235

Tanzania 1170

DRCongo 777

Somalia 715

Burundi 686

Pakistan 593

Brazil 513

Afghanistan 476

Notes: Based on data received 2021-04 - Surveillance data from 2020-09 to 2021-02 - * Countries with highest number of cases for the period - **WHO classifies all suspected measles cases reported from India as measles clinically compatible if
a specimen was not collected as per the algorithm for classification of suspected measles in the WHO VPD Surveillance Standards. Thus numbers might be different between what WHO reports and what India reports.
Disclaimer
This document contains data provided to WHO by member states. Note that some member states only
provide aggregate data to WHO, and for these, we are unable to generate a country profile. Some
member states report all cases at one time point for the entire year, and thus epidemiologic curves
generated are not accurate and a reporting artifact. For some countries, cases are reported by age
category, not by exact age in months and/or years. Thus, age distribution/incidence is approximate.
Cases classified as pending by countries are classified at WHO as clinically compatible at this time, and
thus numbers might different between data shown here and provided by the member state or WHO
country/regional offices.

*UN population data is used as the denominator for calculating incidence.

 Measles case distribution (AFR), 2017-2021
Uganda DR Congo
80000 Others Chad
Nigeria CAR
Niger Cameroon
Madagascar Angola
70000 Ethiopia
Number of measles cases

60000

50000

40000

30000

20000

10000

0
2017-02
2017-03
2017-04
2017-05
2017-06

2018-01
2018-02
2018-03
2018-04
2018-05

2018-07

2018-12
2019-01
2019-02
2019-03
2019-04
2019-05
2019-06

2020-01
2020-02
2020-03
2020-04
2020-05

2020-07

2020-12
2021-01
2021-02
2021-03
2017-01

2017-07
2017-08
2017-09
2017-10

2017-12

2018-06

2018-08
2018-09
2018-10

2019-07
2019-08
2019-09
2019-10

2019-12

2020-06

2020-08
2020-09
2020-10
2017-11

2018-11

2019-11

2020-11
Month of onset

Notes: Based on data received 2021-04 - Data Source: IVB Database

DRC has experienced a nationwide epidemic that has affected all Provinces, however, only a small proportion of the measles cases in the IDSR aggregate reporting
2021-04-06 system are reflected in the case based data. As of 27 May 2013, South Sudan has reassigned to the Africa region (AFR) from the Eastern Mediterranean region
(EMR). For data presentation and statistical purposes, South Sudan data is presented in AFR for all the years.
 Distribution of final case classification by
month for the period of 2019-03 to 2021-
03 (AFR)

100

90

Confirmed + Discarded Measles Cases

80000
80
Percentage of cases (%)

70
60000
60

50
40000
40
Confirmed
Year
Cases
30 2006 9800
2007 11303
20000 2008 19300
20 2009 20640
2010 128238
2011 48688
10 2012 24791
2013 77073
2014 42957
0 0 2015 46103
2016 36753
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2019-11

2020-11

2017 24845
2018 42167
Discarded 2019 289766
Clinical 2020 46747
2021 3425
Epi Month of onset
Lab
Measles cases: Democratic Republic of Congo
Due to surveillance gaps, case-based data is a poor representation of the current situation in DRC. As of Week 11, there
have been 12,289 suspected cases, with 162 deaths as per AFR’s MR weekly update March 31. 259/539 suspected cases
with samples are measles IgM+, 76/539 are rubella IgM+.

Sub-national (6-59 M)

8000
Number of cases

6000

COVID cases
6000
4000
4000
2000
2000
0 0

2020-10
2019-03

2019-04

2019-05

2019-06

2019-07

2019-08

2019-09

2019-10

2019-12

2020-01

2020-02

2020-03

2020-04

2020-05

2020-06

2020-07

2020-08

2020-09

2020-12

2021-01

2021-02

2021-03

2021-04
2019-11

2020-11
Discarded
Clinical
Epi
Lab Month of onset
COVID cases National SIA Sub-national SIA
Confirmed
Year
Cases

Incidence rate per 1,000,000

Democratic Republic of Congo age distribution, vaccination status, and incidence, 2020-03 to 2021-02 2006 1047
2007 611
2008 219
2000 250 2009 104
Number of cases

211.1 2010 204

200 2011 1685
1500 2012 2559
142.4 150 2013 2531
1000 100
2014 1701
2015 5028
500 44.1 50 2016 5091
20.6 6.9
2017 3620
4.2 0.9 2018 5492
0 0 2019 18467
2020 14577
<1 year 1-4 years 5-9 years 10-14 years 15-24 years 25-39 years 40+ years
2021 472
Age at onset
0 doses 1 dose 2+ doses Unknown

Notes: Based on data received 2021-04 - Data Source: IVB Database.

2021-04-06 Main epi curve was built using case-based surveillance data. Age distribution curve was built using case-based surveillance data.
 Measles cases: Ethiopia
National (9-59 M)
Cov: 98.8%
Number of cases

1200

COVID cases
1000 40000
800
600
20000
400
200
0 0

2020-10
2019-03

2019-04

2019-05

2019-06

2019-07

2019-08

2019-09

2019-10

2019-12

2020-01

2020-02

2020-03

2020-04

2020-05

2020-06

2020-07

2020-08

2020-09

2020-12

2021-01

2021-02

2021-03

2021-04
2019-11

2020-11
Discarded
Clinical
Epi
Lab Month of onset
COVID cases National SIA Sub-national SIA
Confirmed
Year
Cases

Incidence rate per 1,000,000

Ethiopia age distribution, vaccination status, and incidence, 2020-03 to 2021-02 2006 1287
2007 1483
2008 3168
2009 2655
Number of cases

200 15.8 2010 6206

14.2 15 2011 3566
150 10.4 2012 4603
10 2013 6126
100 2014 14280
2015 17778
4.3 5 2016 4568
50 2.1 1.7 2017 1912
0.1 2018 1351
0 0 2019 3610
2020 1947
<1 year 1-4 years 5-9 years 10-14 years 15-24 years 25-39 years 40+ years
2021 85
Age at onset
0 doses 1 dose 2+ doses Unknown

Notes: Based on data received 2021-04 - Data Source: IVB Database.

2021-04-06 Main epi curve was built using case-based surveillance data. Age distribution curve was built using case-based surveillance data.
 Measles cases: Nigeria
Sub-national (9-59 M)
Cov: 104%
Number of cases

10000

COVID cases
40000

5000
20000

0 0

2020-10
2019-03

2019-04

2019-05

2019-06

2019-07

2019-08

2019-09

2019-10

2019-12

2020-01

2020-02

2020-03

2020-04

2020-05

2020-06

2020-07

2020-08

2020-09

2020-12

2021-01

2021-02

2021-03

2021-04
2019-11

2020-11
Discarded
Clinical
Epi
Lab Month of onset
COVID cases National SIA Sub-national SIA
Confirmed
Year
Cases

Incidence rate per 1,000,000

Nigeria age distribution, vaccination status, and incidence, 2020-03 to 2021-02 2006 1210
2007 3161
2008 10492
120 2009 1512
Number of cases

3000 106.4 2010 9167

100 2011 19190
80 2012 3948
2000 2013 55448
50.2 60 2014 6857
43.8 2015 12391
1000 40
20.4 2016 17581
7.5 20 2017 11188
2.7 1.4 2018 6836
0 0 2019 28302
2020 10227
<1 year 1-4 years 5-9 years 10-14 years 15-24 years 25-39 years 40+ years
2021 1107
Age at onset
0 doses 1 dose 2+ doses Unknown

Notes: Based on data received 2021-04 - Data Source: IVB Database.

2021-04-06 Main epi curve was built using case-based surveillance data. Age distribution curve was built using case-based surveillance data.
 Number of measles cases

2021-04-06
2021

1000
1500
2000
2500
3000
3500
4000
4500
5000
5500
6000
6500

500
0
2017-01
USA

Peru
2017-02

Others
Mexico
2017-03 Uruguay
Venezuela

2017-04
2017-05
2017-06
2017-07
Chile

Brazil

2017-08
Canada

2017-09
Colombia

Argentina

2017-10
2017-11
2017-12
2018-01
2018-02
2018-03
2018-04
2018-05
2018-06
2018-07
2018-08

Notes: Based on data received 2021-04 - Data Source: IVB Database

2018-09
2018-10
2018-11
2018-12
2019-01
2019-02
2019-03
2019-04
2019-05
2019-06

Month of onset
2019-07
2019-08
2019-09
2019-10
Measles case distribution (AMR), 2017-

2019-11
2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10
2020-11
2020-12
2021-01
2021-02
2021-03
2021-04
 Distribution of final case classification by
month for the period of 2019-03 to 2021-
03 (AMR)

100
30000
90

Confirmed + Discarded Measles Cases

80
25000
Percentage of cases (%)

70

60 20000

50
15000
40
Confirmed
Year
Cases
30 10000 2014 1796
2015 425
2016 103
20 2017 876
5000 2018 16791
2019 23252
10 2020 8700
2021 271
0 0
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2019-11

2020-11

Discarded
Clinical
Epi Month of onset
Lab
 Number of measles cases

2021-04-06
2021
11000

10000
10500

1000
1500
2000
2500
3000
3500
4000
4500
5000
5500
6000
6500
7000
7500
8000
8500
9000
9500

500
0
2017-01
2017-02
Sudan
Yemen
Tunisia

Somalia
2017-03

Pakistan
2017-04
2017-05 Saudi Arabia
2017-06
2017-07
Iraq

2017-08
Libya
Others

2017-09
Lebanon

2017-10
Afghanistan

2017-11
2017-12
2018-01
2018-02
2018-03
2018-04
2018-05
2018-06
2018-07

Notes: Based on data received 2021-04 - Data Source: IVB Database

2018-08
2018-09
2018-10
2018-11
2018-12
2019-01
2019-02
2019-03
2019-04
2019-05

Month of onset
2019-06
2019-07
2019-08
Measles case distribution (EMR), 2017-

2019-09
2019-10
2019-11
2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10
2020-11
2020-12
2021-01
2021-02
2021-03
 Distribution of final case classification by
month for the period of 2019-03 to 2021-
03 (EMR)

100

90

Confirmed + Discarded Measles Cases

8000
80
Percentage of cases (%)

70
6000
60

50
4000
40
Confirmed
Year
Cases
30 2006 15207
2007 10950
2000 2008 11693
20 2009 15558
2010 6727
2011 12909
10 2012 25414
2013 17055
2014 9573
0 0 2015 14137
2016 6446
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2019-11

2020-11

2017 36132
2018 67720
Discarded 2019 30703
Clinical 2020 9827
2021 355
Epi Month of onset
Lab
 Measles cases: Afghanistan
300
Number of cases

COVID cases
15000
200
10000
100
5000

0 0

2020-10
2019-03

2019-04

2019-05

2019-06

2019-07

2019-08

2019-09

2019-10

2019-12

2020-01

2020-02

2020-03

2020-04

2020-05

2020-06

2020-07

2020-08

2020-09

2020-12

2021-01

2021-02

2021-03

2021-04
Discarded

2019-11

2020-11
Clinical
Epi
Lab COVID cases Month of onset
Confirmed
Year
Cases

Incidence rate per 1,000,000

Afghanistan age distribution, vaccination status, and incidence, 2020-03 to 2021-02 2006 4458
2007 982
2008 1258
400 2009 2874
Number of cases

288.3 300 2010 1991

300 250 2011 1384
2012 2791
200 2013 430
200 150 2014 552
2015 1191
100 2016 641
100
18.4 31 15 50 2017 1512
0.9 0.1 0 2018 2012
0 0 2019 212
2020 545
<1 year 1-4 years 5-9 years 10-14 years 15-24 years 25-39 years 40+ years
2021 321
Age at onset
0 doses 1 dose 2+ doses Unknown

Notes: Based on data received 2021-04 - Data Source: IVB Database.

2021-04-06 Main epi curve was built using case-based surveillance data. Age distribution curve was built using case-based surveillance data.
 Measles cases: Pakistan
2000
Number of cases

COVID cases
100000
1000

0 0

2020-10
2019-03

2019-04

2019-05

2019-06

2019-07

2019-08

2019-09

2019-10

2019-12

2020-01

2020-02

2020-03

2020-04

2020-05

2020-06

2020-07

2020-08

2020-09

2020-12

2021-01

2021-02

2021-03

2021-04
2019-11

2020-11
Discarded
Clinical
Epi
Lab Month of onset
COVID cases
Confirmed
Year
Cases

Incidence rate per 1,000,000

Pakistan age distribution, vaccination status, and incidence, 2020-03 to 2021-02 2006 35
2007 33
2008 53
1200 2009 455
Number of cases

80.1
1000 80 2010 1111
2011 2688
800 60 2012 8048
44.8 2013 8030
600 2014 1370
40
2015 338
400 2016 2844
9.8 20
200 2
2017 6791
0.2 0 0 0 2018 33007
0 2019 2066
2020 2863
<1 year 1-4 years 5-9 years 10-14 years 15-24 years 25-39 years 40+ years
2021 2
Age at onset
0 doses 1 dose 2+ doses Unknown

Notes: Based on data received 2021-04 - Data Source: IVB Database.

2021-04-06 Main epi curve was built using case-based surveillance data. Age distribution curve was built using case-based surveillance data.
 Number of measles cases

2021-04-06
2021

10000
12000
14000
16000
18000
20000

2000
4000
6000
8000

0
2017-01
2017-02

Serbia
Turkey
Ukraine
2017-03

Romania
Uzbekistan

2017-04
2017-05
2017-06
Russian Federation

2017-07
2017-08
2017-09
Italy

2017-10
Others

France

2017-11
Georgia

2017-12
Kazakhstan

2018-01
2018-02
2018-03
2018-04
2018-05
2018-06
2018-07

Notes: Based on data received 2021-04 - Data Source: IVB Database

2018-08
2018-09
2018-10
2018-11
2018-12
2019-01
2019-02
2019-03
2019-04
2019-05

Month of onset
2019-06
2019-07
Measles case distribution (EUR), 2017-

2019-08
2019-09
2019-10
2019-11
2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10
2020-11
2020-12
2021-01
2021-02
 Distribution of final case classification by
month for the period of 2019-03 to 2021-
03 (EUR)

100

90

Confirmed + Discarded Measles Cases

30000
80
Percentage of cases (%)

70

60
20000
50

40
Confirmed
Year
Cases
30 2006 7862
10000 2007 4882
2008 8760
20 2009 7224
2010 30604
2011 33258
10 2012 27729
2013 32853
2014 16208
0 0 2015 28392
2016 5269
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2019-11

2020-11

2017 25872
2018 88687
Discarded 2019 104442
Clinical 2020 12189
2021 15
Epi Month of onset
Lab
 Number of measles cases

2021-04-06
1000
1500
2000
2500
3000

500

0
2017-01
2017-02
2017-03
2017-04
2017-05
2017-06
2017-07
2017-08
2017-09
2017-10
2017-11
India)), 2017-2021

2017-12
2018-01
2018-02
2018-03
2018-04
2018-05
2018-06
2018-07

Notes: Based on data received 2021-04 - Data Source: IVB Database

2018-08
2018-09
2018-10
2018-11
2018-12
2019-01
2019-02
2019-03
2019-04
2019-05

Month of onset
2019-06
2019-07
Measles case distribution (SEAR (excl.

2019-08
2019-09
2019-10
2019-11
2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
Nepal

2020-09
Thailand

Myanmar
Sri Lanka

2020-10
Timor-Leste

2020-11
2020-12
2021-01
2021-02
2021-03
Bhutan
Maldives
Indonesia

Bangladesh
 Distribution of final case classification by
month for the period of 2019-03 to 2021-
03 (SEAR (excl. India))

100

90

Confirmed + Discarded Measles Cases

5000
80
Percentage of cases (%)

70 4000

60

50 3000

40
Confirmed
2000 Year
Cases
30 2009 23660
2010 22364
2011 36991
20 2012 23985
1000 2013 16804
2014 11958
10 2015 7980
2016 4033
2017 11390
0 0 2018 11719
2019 18431
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2019-11

2020-11

2020 4453
2021 155
Discarded
Clinical
Epi Month of onset
Lab
 Measles cases: Indonesia
1500
Number of cases

COVID cases
300000
1000
200000
500
100000

0 0

2020-10
2019-03

2019-04

2019-05

2019-06

2019-07

2019-08

2019-09

2019-10

2019-12

2020-01

2020-02

2020-03

2020-04

2020-05

2020-06

2020-07

2020-08

2020-09

2020-12

2021-01

2021-02

2021-03

2021-04
2019-11

2020-11
Discarded
Clinical
Epi
Lab Month of onset
COVID cases
Confirmed
Year
Cases

Incidence rate per 1,000,000

Indonesia age distribution, vaccination status, and incidence, 2020-03 to 2021-02 2009 17175
2010 18870
2011 23925
2012 14832
Number of cases

5 0.7 2013 9940

2014 7989
2015 5280
2016 1633
2017 3949
2018 2885
0.2 0.2 0.2 2019 1822
0.1 2020 393
0 0 0 2021 17
0
<1 year 1-4 years 5-9 years 10-14 years 15-24 years 25-39 years 40+ years
Age at onset

0 doses 1 dose 2+ doses Unknown

Notes: Based on data received 2021-04 - Data Source: IVB Database.

2021-04-06 Main epi curve was built using aggregate surveillance data. Age distribution curve was built using case-based surveillance data.
 Number of measles cases

2021-04-06
10000

5000

0
2017-01
2017-02
2017-2021

2017-03
2017-04
2017-05
2017-06
2017-07
2017-08
2017-09
2017-10
2017-11
2017-12
2018-01
2018-02
2018-03
2018-04
2018-05
2018-06
2018-07

Notes: Based on data received 2021-04 - Data Source: IVB Database

2018-08
2018-09
2018-10
2018-11
2018-12
2019-01
2019-02
2019-03
2019-04
2019-05

Month of onset
2019-06
2019-07
2019-08
2019-09
Measles case distribution (SEAR, India),

2019-10
2019-11
2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10
2020-11
2020-12
2021-01
India

2021-02
2021-03
 Distribution of final case classification by
month for the period of 2019-03 to 2021-
03 (SEAR, India)

100
8000
90

Confirmed + Discarded Measles Cases

80
Percentage of cases (%)

70 6000

60

50 4000
40
Confirmed
Year
Cases
30 2014 80920
2015 82461
2000 2016 69888
20 2017 58054
2018 19367
2019 10708
10 2020 5614
2021 826
0 0
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2019-11

2020-11

Discarded
Clinical
Epi Month of onset
Lab
 Measles cases: India
Number of cases

8000 2800000

COVID cases
6000 2400000
2000000
4000 1600000
1200000
2000 800000
400000
0 0

2020-10
2019-03

2019-04

2019-05

2019-06

2019-07

2019-08

2019-09

2019-10

2019-12

2020-01

2020-02

2020-03

2020-04

2020-05

2020-06

2020-07

2020-08

2020-09

2020-12

2021-01

2021-02

2021-03

2021-04
2019-11

2020-11
Discarded
Clinical
Epi
Lab Month of onset
COVID cases
Confirmed
Year
Cases

Incidence rate per 1,000,000

India age distribution, vaccination status, and incidence, 2020-03 to 2021-02 2014 80920
2015 82461
2016 69888
1500 2017 58054
Number of cases

48 2018 19367
2019 10708
40 2020 5614
1000 2021 826

14.4 20
500
5.4
2 0.8 0.3 0.1
0 0
<1 year 1-4 years 5-9 years 10-14 years 15-24 years 25-39 years 40+ years
Age at onset
0 doses 1 dose 2+ doses Unknown

Notes: Based on data received 2021-04 - Data Source: IVB Database.

2021-04-06 Main epi curve was built using a combination of case-based and aggregate surveillance data. Age distribution curve was built using case-based surveillance data.
 Number of measles cases

2021-04-06
2021

10000
12000
14000
16000

2000
4000
6000
8000

0
2017-01
2017-02
2017-03
2017-04
2017-05
2017-06
2017-07
2017-08
2017-09
2017-10
Others
VietNam

Malaysia

2017-11
Singapore
Philippines

2017-12
New Zealand

2018-01
2018-02
2018-03
Laos

2018-04
China
Japan

2018-05
Australia
Cambodia

2018-06
2018-07

Notes: Based on data received 2021-04 - Data Source: IVB Database

2018-08
2018-09
2018-10
2018-11
2018-12
2019-01
2019-02
2019-03
2019-04
2019-05

Month of onset
2019-06
2019-07
2019-08
Measles case distribution (WPR), 2017-

2019-09
2019-10
2019-11
2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10
2020-11
2020-12
2021-01
2021-02
 Distribution of final case classification by
month for the period of 2019-03 to 2021-
03 (WPR)

100

90

Confirmed + Discarded Measles Cases

50000
80
Percentage of cases (%)

70
40000
60

50 30000

40
Confirmed
20000 Year
Cases
30 2008 14670
2009 9071
2010 11963
20 2011 21054
10000 2012 10701
2013 34815
10 2014 127612
2015 68024
2016 57661
0 0 2017 11081
2018 30115
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2019-11

2020-11

2019 63797
2020 6383
Discarded 2021 199
Clinical
Epi Month of onset
Lab
Distribution of measles genotypes
(last 12 months)

Notes: Data Source: MeaNS database (Genotypes) and IVB Database (Incidence) as of 2021-04-06 and covering the period 2020-03-01 to 2021-02-28 - Pie charts proportional to the number of sequenced viruses
Rubella
Number of Reported Rubella Cases by
WHO Regions
2021
Member Rubella Date
Region Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
States* cases Received
AFR 25/47 109 0 0 109 79 23 7 0 0 0 0 0 0 0 0 0 2021-04

AMR 12/35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2021-04

EMR 5/21 11 0 0 11 9 2 0 0 0 0 0 0 0 0 0 0 2021-04

EUR 15/53 9 8 0 1 9 0 0 0 0 0 0 0 0 0 0 0 2021-04

SEAR 8/11 281 0 28 253 119 116 46 0 0 0 0 0 0 0 0 0 2021-04

WPR 12/27 83 10 0 73 55 28 0 0 0 0 0 0 0 0 0 0 2021-04

Total 77/194 493 18 28 447 271 169 53 0 0 0 0 0 0 0 0 0

2020
Member Rubella Date
Region Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
States* cases Received
AFR 42/47 2241 0 0 2241 330 583 647 208 89 49 47 64 66 68 36 54 2021-04

AMR 21/35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2021-04

EMR 19/21 572 57 11 504 73 129 149 29 11 16 19 17 59 25 38 7 2021-04

EUR 25/53 91 50 1 40 26 26 11 8 2 6 2 2 1 1 1 5 2021-04

SEAR 11/11 1573 0 89 1484 208 355 237 81 39 55 57 45 76 123 139 158 2021-04

WPR 14/27 2943 494 392 2057 1276 523 134 74 89 103 77 76 130 81 270 110 2021-04

Total 132/194 7420 601 493 6326 1913 1616 1178 400 230 229 202 204 332 298 484 334

Notes: Based on data received 2021-04 - This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region
Number of Reported Rubella Cases by
WHO Regions
2021
Member Rubella Date
Region Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
States* cases Received
AFR 25/47 109 0 0 109 79 23 7 0 0 0 0 0 0 0 0 0 2021-04

AMR 12/35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2021-04

EMR 5/21 11 0 0 11 9 2 0 0 0 0 0 0 0 0 0 0 2021-04

EUR 15/53 9 8 0 1 9 0 0 0 0 0 0 0 0 0 0 0 2021-04

SEAR 8/11 281 0 28 253 119 116 46 0 0 0 0 0 0 0 0 0 2021-04

WPR 12/27 83 10 0 73 55 28 0 0 0 0 0 0 0 0 0 0 2021-04

Total 77/194 493 18 28 447 271 169 53 0 0 0 0 0 0 0 0 0

2020
Member Rubella Date
Region Clin Epi Lab Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
States* cases Received
AFR 36/47 799 0 0 799 268 425 106 0 0 0 0 0 0 0 0 0 2020-04

AMR 15/35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2020-04

EMR 17/21 57 0 1 56 44 13 0 0 0 0 0 0 0 0 0 0 2020-04

EUR 22/53 93 77 0 16 55 38 0 0 0 0 0 0 0 0 0 0 2020-04

SEAR 11/11 376 0 11 365 160 184 32 0 0 0 0 0 0 0 0 0 2020-04

WPR 14/27 284 5 8 271 156 128 0 0 0 0 0 0 0 0 0 0 2020-04

Total 115/194 1609 82 20 1507 683 788 138 0 0 0 0 0 0 0 0 0

Notes: Based on data received 2021-04 and 2020-04 - This is surveillance data, hence for the last month, the data may be incomplete. * Member States Reporting / Total Member States in Region
 Rubella cases (Lab+Epi+Clinical)

2021-04-06
10000
10500

1000
1500
2000
2500
3000
3500
4000
4500
5000
5500
6000
6500
7000
7500
8000
8500
9000
9500

500
0
2015-01
2015-02
2015-03
2015-04
2015-05
2015-06
2015-07
2015-08
2015-09
2015-10
2015-11
2015-12
2016-01
2016-02
2016-03
2016-04
2016-05
2016-06
2016-07
2016-08
2016-09
2016-10
2016-11
2016-12
2017-01
2017-02
2017-03
WHO Region (2015-2021)

2017-04
2017-05
2017-06
2017-07
2017-08
2017-09
2017-10
2017-11
2017-12
2018-01
2018-02
2018-03
2018-04
2018-05
2018-06
2018-07

Month of onset
2018-08
2018-09
2018-10
2018-11
2018-12
2019-01
2019-02
Rubella Case Distribution by Month and

2019-03
2019-04
2019-05
2019-06
2019-07
2019-08
2019-09
2019-10
2019-11
2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07
2020-08
2020-09
2020-10
2020-11
Notes: Based on data received 2021-04 - Data Source: IVB Database - This is surveillance data, hence for the last month(s), the data may be incomplete.

2020-12
2021-01
2021-02
2021-03
AFR
EUR

AMR
EMR
WPR
SEAR
Rubella Reported Cases per Million
(12M period)
Top 10**
Country Cases Rate
India 1059 0.770
China 963 0.670
DRCongo 504 5.630
Nigeria 442 2.140
Sudan 153 3.490
Yemen 110 3.690
Malaysia 69 2.130
Philippines 68 0.620
Indonesia 63 0.230
Pakistan 62 0.280

Other countries with high incidence

rates***
Country Cases Rate
Timor-Leste 8 6.070
Eritrea 19 5.360
CAR 16 3.310
Liberia 14 2.770
Côte d'Ivoire 52 1.970

Notes: Based on data received 2021-04 and covering the period between 2020-03 and 2021-02 - Incidence: Number of cases / population* * 1,000,000 - * World population prospects, 2019 revision - ** Countries with the
highest number of cases for the period - *** Countries with the highest incidence rates (excluding those already listed in the table above)
 Rubella cases: AFR
AFR Rubella Case Distribution (March 2019-April 2021)
800
Number of cases
(IgM+ only)

600
400 Top 10 countries (last 12 M)
RCV in % of
200 label Cases
RI Total
DRCongo No 309 39
0
Nigeria No 150 19
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08

2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2021-04
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07

2020-11
2019-11
Others - 119 15
Côte d'Ivoire 2018 50 6
Month of onset
Mozambique 2018 32 4
Introduced <5 years ago Introduced >=5 years ago
Not introduced in EPI (after 2015) (2015 and before) Ghana 2013 29 4
South Africa No 23 3
AFR Age distribution of Rubella IgM+ cases by vaccine introduction status Cameroon 2015 20 3
200 in the National EPI Programme (March 2020-April 2021)
Madagascar No 20 3
Number of cases

Tanzania 2014 20 3
(IgM+ only)

150
Eritrea 2018 18 2
100

50

0
10

12
13
14
15
16
17

19
20
21

23
24
25
26
27
28
29
30

32
33

35
36

38
39
40

42

44
45
0
1
2
3
4
5
6
7
8
9

18

22

31

34

37

41

43

46
11

Age at onset (in years)

Rubella vaccine not introduced before 1 January 2017 Rubella vaccine introduced before 1 January 2017

Notes: Based on data received 2021-04 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 2018.
2021-04-06
 Rubella cases: EMR
(lab + epi-linked + clinical)

EMR Rubella Case Distribution (March 2019-April 2021)

600
Number of cases

500
400
300 Top 10 countries (last 12 M)
200 RCV in % of
label Cases
100 RI Total
Yemen 2015 95 41
0
Sudan No 57 25
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08

2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2021-04
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07

2020-11
2019-11
Pakistan No 29 12
Afghanistan No 14 6
Month of onset
Saudi Arabia 1982 14 6
Introduced <5 years ago Introduced >=5 years ago
Not introduced in EPI (after 2015) (2015 and before) Tunisia 2012 11 5
Syria 1999 4 2
(lab + epi-linked + clinical)

EMR Age distribution of Rubella cases by vaccine introduction status UAE 1985 3 1
in the National EPI Programme (March 2020-April 2021)
Libya 1993 2 1
Number of cases

40 Morocco 2003 2 1
30 Others - 1 0
20
10
0
10

12
13
14
15
16
17

19
20
21

23
24
25
26
27
28
29
30

32
33

35
36

38
39
40

42

44
45
0
1
2
3
4
5
6
7
8
9

18

22

31

34

37

41

43

46
11

Age at onset (in years)

Rubella vaccine not introduced before 1 January 2017 Rubella vaccine introduced before 1 January 2017

Notes: Based on data received 2021-04 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 2018.
2021-04-06
 Rubella cases: EUR
(lab + epi-linked + clinical)

EUR Rubella Case Distribution (March 2019-April 2021)

40
Number of cases

20 Top 10 countries (last 12 M)

RCV in % of
label Cases
RI Total
Ukraine 2003 17 46
0
Germany 1991 10 27
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08

2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2021-04
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07

2020-11
2019-11
Turkey 2006 6 16
Italy 1972 2 5
Month of onset
Introduced <5 years ago Introduced >=5 years ago Austria 1972 1 3
Not introduced in EPI (after 2015) (2015 and before) Ireland 1971 1 3
(lab + epi-linked + clinical)

EUR Age distribution of Rubella cases by vaccine introduction status

in the National EPI Programme (March 2020-April 2021)
Number of cases

10

0
10

12
13
14
15
16
17

19
20
21

23
24
25
26
27
28
29
30

32
33

35
36

38
39
40

42

44
45
0
1
2
3
4
5
6
7
8
9

18

22

31

34

37

41

43

46
11

Age at onset (in years)

Rubella vaccine not introduced before 1 January 2017 Rubella vaccine introduced before 1 January 2017

Notes: Based on data received 2021-04 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 2018. Spikes in
2021-04-06 age-distribution curve are an artifact of reporting by age bands ( 0=<1 yrs, 2=1-4 yrs, 7=5-9 yrs, 12=10-14 yrs, 17=15-19 yrs, 25=20-29 yrs, 45=30+yrs) instead of by
age from some member states.
 Rubella cases: SEAR (excl. India)
(lab + epi-linked + clinical)

SEAR (excl. India) Rubella Case Distribution (March 2019-April 2021)

200
Number of cases

150

100 Top 10 countries (last 12 M)

RCV in % of
50 label
RI
Cases
Total
Bangladesh 2012 59 36
0
Indonesia 2018 40 25
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08

2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2021-04
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07

2020-11
2019-11
Nepal 2013 34 21
Thailand 1997 19 12
Month of onset
Timor-Leste 2016 8 5
Introduced <5 years ago Introduced >=5 years ago
Not introduced in EPI (after 2015) (2015 and before) Myanmar 2015 3 2
(lab + epi-linked + clinical)

SEAR (excl. India) Age distribution of Rubella cases by vaccine introduction status
in the National EPI Programme (March 2020-April 2021)
Number of cases

40
30
20
10
0
10

12
13
14
15
16
17

19
20
21

23
24
25
26
27
28
29
30

32
33

35
36

38
39
40

42

44
45
0
1
2
3
4
5
6
7
8
9

18

22

31

34

37

41

43

46
11

Age at onset (in years)

Rubella vaccine not introduced before 1 January 2017 Rubella vaccine introduced before 1 January 2017

Notes: Based on data received 2021-04 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 2018.
2021-04-06
 Rubella cases: SEAR, India
(lab + epi-linked + clinical)

SEAR, India Rubella Case Distribution (March 2019-April 2021)

1200
Number of cases

1000
800
600 Top 10 countries (last 12 M)
400 RCV in % of
label Cases
RI Total
200
India 2018 891 100
0
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08

2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2021-04
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07

2020-11
2019-11

Month of onset
Introduced <5 years ago Introduced >=5 years ago
Not introduced in EPI
(after 2015) (2015 and before)
(lab + epi-linked + clinical)

SEAR, India Age distribution of Rubella cases by vaccine introduction status

300 in the National EPI Programme (March 2020-April 2021)
Number of cases

200

100

0
10

12
13
14
15
16
17

19
20
21

23
24
25
26
27
28
29
30

32
33

35
36

38
39
40

42

44
45
0
1
2
3
4
5
6
7
8
9

18

22

31

34

37

41

43

46
11

Age at onset (in years)

Rubella vaccine not introduced before 1 January 2017 Rubella vaccine introduced before 1 January 2017

Notes: Based on data received 2021-04 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 2018.
2021-04-06
 Rubella cases: WPR
(lab + epi-linked + clinical)

WPR Rubella Case Distribution (March 2019-April 2021)

10000
Number of cases

5000 Top 10 countries (last 12 M)

RCV in % of
label Cases
RI Total
China 2008 900 82
0
Malaysia 2004 65 6
2019-03
2019-04
2019-05
2019-06
2019-07
2019-08

2020-08
2020-09
2020-10

2020-12
2021-01
2021-02
2021-03
2021-04
2019-09
2019-10

2019-12
2020-01
2020-02
2020-03
2020-04
2020-05
2020-06
2020-07

2020-11
2019-11
VietNam 2015 34 3
Philippines 2010 29 3
Month of onset Japan 1995 27 2
Introduced <5 years ago Introduced >=5 years ago
Not introduced in EPI Cambodia 2013 23 2
(after 2015) (2015 and before)
Singapore 1982 8 1
(lab + epi-linked + clinical)

WPR (Excl. China) Age distribution of Rubella cases by vaccine introduction status Laos 2012 5 0
in the National EPI Programme (March 2020-April 2021) Fiji 2003 1 0
70
Number of cases

60 Papua New
2015 1 0
Guinea
50
40
30
20
10
0
10

12
13
14
15
16
17

19
20
21

23
24
25
26
27
28
29
30

32
33

35
36

38
39
40

42

44
45
0
1
2
3
4
5
6
7
8
9

18

22

31

34

37

41

43

46
11

Age at onset (in years)

Rubella vaccine not introduced before 1 January 2017 Rubella vaccine introduced before 1 January 2017

Notes: Based on data received 2021-04 Data Source: IVB Database. RCV in RI: Rubella-containing vaccine in Routine Immunization as of 31 Dec 2018.
2021-04-06
Distribution of rubella genotypes
(last 12 months)

Notes: Data Source: RubNS database (Genotypes) and IVB Database (Incidence) as of 2021-04-06 and covering the period 2020-03-01 to 2021-02-28 - Pie charts proportional to the number of sequenced viruses
Laboratory
 Measles and Rubella IgM Data Summary
2021
Measles Rubella
Member Specimen Measles Measles Measles Rubella Rubella Rubella
Region equivocal equivocal
States* s received tested positive n(%) negative n(%) tested positive n(%) negative n(%)
n(%) n(%)
AFR 30/47 1797 1692 536 (32) 54 (3) 1102 (65) 1187 118 (10) 15 (1) 1054 (89)
AMR 12/35 332 318 16 (5) 2 (1) 286 (90) 317 21 (7) 2 (1) 282 (89)
EMR 7/21 608 483 10 (2) 1 (0) 472 (98) 578 84 (15) 3 (1) 491 (85)
EUR 31/53 1559 1018 20 (2) 11 (1) 987 (97) 2194 93 (4) 11 (1) 2090 (95)
SEAR 10/11 2409 2393 128 (5) 25 (1) 2238 (94) 2211 153 (7) 21 (1) 2037 (92)
WPR 25/27 703 685 32 (5) 409 (60) 241 (35) 674 62 (9) 380 (56) 231 (34)
Total 115/194 7408 6589 742 (11) 502 (8) 5326 (81) 7161 531 (7) 432 (6) 6185 (86)

2020
Measles Rubella
Member Specimen Measles Measles Measles Rubella Rubella Rubella
Region equivocal equivocal
States* s received tested positive n(%) negative n(%) tested positive n(%) negative n(%)
n(%) n(%)
AFR 43/47 34211 33432 11366 (34) 775 (2) 21290 (64) 23563 2735 (12) 405 (2) 20421 (87)
AMR 22/35 3834 3785 266 (7) 53 (1) 3324 (88) 3566 121 (3) 29 (1) 3284 (92)
EMR 20/21 17506 17312 3009 (17) 82 (0) 14221 (82) 16492 779 (5) 155 (1) 15558 (94)
EUR 38/53 24325 19406 5706 (29) 109 (1) 13552 (70) 20686 529 (3) 64 (0) 20075 (97)
SEAR 11/11 26381 25518 4586 (18) 299 (1) 20612 (81) 22018 1255 (6) 229 (1) 20493 (93)
WPR 25/27 14510 13572 2685 (20) 287 (2) 10575 (78) 10778 929 (9) 187 (2) 9646 (89)
Total 159/194 120767 113025 27618 (24) 1605 (1) 83574 (74) 97103 6348 (7) 1069 (1) 89477 (92)

Notes: Based on data received 2021-04 - * Member States Reporting / Total Member States in Region
 Measles and Rubella IgM Data Summary
Data as of April 2021
2021
Measles Rubella
Member Specimen Measles Measles Measles Rubella Rubella Rubella
Region equivocal equivocal
States* s received tested positive n(%) negative n(%) tested positive n(%) negative n(%)
n(%) n(%)
AFR 30/47 1797 1692 536 (32) 54 (3) 1102 (65) 1187 118 (10) 15 (1) 1054 (89)
AMR 12/35 332 318 16 (5) 2 (1) 286 (90) 317 21 (7) 2 (1) 282 (89)
EMR 7/21 608 483 10 (2) 1 (0) 472 (98) 578 84 (15) 3 (1) 491 (85)
EUR 31/53 1559 1018 20 (2) 11 (1) 987 (97) 2194 93 (4) 11 (1) 2090 (95)
SEAR 10/11 2409 2393 128 (5) 25 (1) 2238 (94) 2211 153 (7) 21 (1) 2037 (92)
WPR 25/27 703 685 32 (5) 409 (60) 241 (35) 674 62 (9) 380 (56) 231 (34)
Total 115/194 7408 6589 742 (11) 502 (8) 5326 (81) 7161 531 (7) 432 (6) 6185 (86)

Data as of April 2020

2020
Measles Rubella
Member Specimen Measles Measles Measles Rubella Rubella Rubella
Region equivocal equivocal
States* s received tested positive n(%) negative n(%) tested positive n(%) negative n(%)
n(%) n(%)
AFR 37/47 9491 9491 4032 (42) 238 (3) 5221 (55) 6055 867 (14) 148 (2) 5040 (83)
AMR 17/35 1234 1179 87 (7) 13 (1) 944 (80) 1140 30 (3) 8 (1) 987 (87)
EMR 17/21 2405 2334 452 (19) 36 (2) 1846 (79) 2320 84 (4) 74 (3) 2162 (93)
EUR 36/53 8066 7057 2757 (39) 32 (0) 4254 (60) 4984 110 (2) 9 (0) 4852 (97)
SEAR 11/11 9053 6348 1502 (24) 81 (1) 4765 (75) 4963 278 (6) 56 (1) 4619 (93)
WPR 27/27 6026 5342 1699 (32) 118 (2) 3516 (66) 3829 416 (11) 77 (2) 3324 (87)
Total 145/194 36275 31751 10529 (33) 518 (2) 20546 (65) 23291 1785 (8) 372 (2) 20984 (90)

Notes: Based on data received 2021-04 and 2020-04- * Member States Reporting / Total Member States in Region
Performance of Surveillance
Surveillance sensitivity reporting rate of
measles and rubella (12 months, discarded
cases* per 100,000 population)

Notes: Based on data received 2021-04 and covering the period between 2020-03 and 2021-02 - Target: >= 2 discarded cases* / 100,000 population** - * Suspected cases investigated and discarded as non-measles non-rubella using laboratory
testing and/or epidemiological linkage to another etiology ** World population prospects, 2019 revision
Supplementary Immunization Activities
 VPD campaigns postponed due to COVID-19, by antigen
1st April 2021

1-April-2021
50 |
Regional Bulletins and Newsletters
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• AFR Monthly feedback tables

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• EMR: Home page
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Monthly data
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EPI country fact sheets
• WPR: Monthly Bulletin
Country profiles

Link to global Measles Surveillance

HQ website