World Health Organization, South-East Asia Regional Office

Vol. 21, Week 52, 2017

Published 2 January 2018

Meetings/ Important events:
Regional Working Group Meeting on Immunization, New Delhi, India, 28-30 January 2018
 Lessons from the Big Six- Closing the Immunity Gap for Measles Elimination and Rubella/ CRS control, New Delhi, India, 31 January-02
February 2018


Table 1: Measles & Rubella Laboratory Supported Case-based Surveillance Performance Indicators by Country, 2017* (data as of 2 January 2018)
Case classification (number)

Pending classification

Epidemiologicallyconfirmed

Reporti ng
% di s tri cts
ra te of
reporti ng a t

di s ca rded
Mea s l es
Rubel l a
l ea s t
non2 di s ca rded i nci dence 1 i nci dence 2
mea s l es
nonper
per
non-rubel l a
mea s l es
mi l l i on
mi l l i on
ca s es a t the
n
non-rubel l a
pop
pop n
na ti ona l
ca s es per
l evel per

n
100,000 pop
100,000 pop n

Laboratory-confirmed

Discarded non-measles nonrubella cases

Rubel l a

Clinically-confirmed

% s erol ogy
res ul ts
reported
w/i n 4 da ys
of
s peci men
recei ved a t
l a bora tory


Mea s l es

Epidemiologicallyconfirmed

Number of
s erum
s peci mens
recei ved i n
l a bora tory

% s erum
s peci mens
recei ved a t
l a bora tory
w/i n 5
da ys of
col l ecti on

%

s peci mens
tes ted for
s erol ogy
of
s peci mens
recei ved
i n the
l a bora tory

Laboratory-confirmed

%
s us pected
%
ca s es wi th
Number of a dequa te s us pected
s us pected i nves ti ga ti ca s es wi th
mea s l es
s erum
on

ca s es
i ni ti a ted s peci mens
col l ected
w/i n 48
hours of
noti fi ca ti on

8,048

92

80

6,421

100

100

63


2,649

961

509

222

58

3,649

0

2.34

75

26.40


Bhutan

221

84

79

166

59

105

46

14

0


0

2

0

160

45

21.47

65

18.79

2.68

DPR Korea


105

100

100

105

100

100

99

0

0

0


0

0

105

0

0.42

0.00

0.00

Countries

Bangladesh

India 3


19,013

0

32

5,974

81

87

60

2,944

6,154

0

733

2,003

2,692

4,487

0.21

4,946

47

100

2,468

93

73

27

662

0

0

343

0

342

3,599

0.14

Maldives

63

97

100

63

100

100

70

1

0

0

1

0

59

2

17.26

60

2.93

2.93

Myanmar

1,661

40

88

1,459

99

100

94

1,000

179

71

3

0

377

31

0.73

14

24.31

0.06

Nepal

897

23

89

386

64

190

68

57

25

11

16

0

711

77

2.60

55

3.41

0.59

Sri Lanka

203

98

89

177

90

100

62

1

0

18

1

0

183

0

0.89

23

62.00

0.42

Thailand

2,834

29

88

2,390

58

95

59

1,426

14

453

24

0

825

92

1.27

127

100

99

119

100

72

52

0

0

0

3

0

120

4

9.90

38,118

32

60

19,728

87

94

59

8,754

7,333

1,062

1,348

2,061

9,223

8,337

0.49

Indonesia

4

Timor-Leste
SEAR
1

Includes labo rato ry-co nfirmed, epidemio lo gically-linked and clinically-co nfirmed measles cases

2

Includes labo rato ry-co nfirmed and epidemio lo gically-linked rubella cases

4

5

1.79

38

A lso includes the cases fro m enhanced measles case-based surveillance.

7.19

2.16

2.63

1.36

29.18

0.37

0.00

2.48

9.20

1.83

ND=No data

3 Cases fro m suspected measles o utbreak investigatio n o nly, case based surveillance is gradually exCA nding in the co untry

* Figures in the table 1 are restricted to availability of various dates required for calculation. Thus they may not adequately reflect cases with missing dates for various timelines.

Table 2: Measles & Rubella Laboratory Supported Case-based Surveillance Performance Indicators by Country, 2016* (data as of 2 January 2018)
Case classification (number)

Pending classification

Discarded non-measles nonrubella cases

Epidemiologicallyconfirmed

Reporti ng
% di s tri cts
ra te of
reporti ng a t
di s ca rded
Mea s l es
Rubel l a
l ea s t
non2 di s ca rded i nci dence 1 i nci dence 2
mea s l es
nonper
per
non-rubel l a
mea s l es
mi l l i on
mi l l i on
ca s es a t the
n
n
non-rubel l a
pop
pop
na ti ona l
ca s es per
l evel per
n
100,000 pop
100,000 pop n

Laboratory-confirmed

DPR Korea

Rubel l a

Clinically-confirmed

Bhutan

% s erol ogy
res ul ts
reported
w/i n 4 da ys
of
s peci men
recei ved a t
l a bora tory

Epidemiologicallyconfirmed

Bangladesh

Number of
s erum
s peci mens
recei ved i n
l a bora tory

%
% s erum s peci mens
s peci mens tes ted for
recei ved a t s erol ogy
of
l a bora tory
w/i n 5 s peci mens
recei ved
da ys of
i n the
col l ecti on
l a bora tory

Mea s l es

Laboratory-confirmed

Countries

%
s us pected
%
ca s es wi th
Number of a dequa te s us pected
s us pected i nves ti ga ti ca s es wi th
s erum
on
mea s l es
i ni ti a ted s peci mens
ca s es
col l ected
w/i n 48
hours of
noti fi ca ti on

4 298

94

87

3 732

100

100

92

619

354

96

165

0

3 064

0

1.96

80

6.85

1.06

149

63

87

127

59

102

47

10

0

0

0

0

60

79

8.05

55

13.42

0.00

0.00

0.00

3

12.93

7.18

11.25

4.65

73

100

100

73

100

100

100

0

0

0

0

0

66

7

0.27

41 350

0

22

9 022

84

83

31

3 649

12 713

0

1 618

7 466

6 989

9 018

0.55

8 065

44

100

5 856

98

84

32

2 837

0

0

1 172

0

2 402

1 652

0.95

Maldives

11

100

100

11

100

0

0

0

0

0

0

0

11

0

3.22

15

0.00

0.00

Myanmar

587

0

86

503

100

99

97

194

59

21

10

0

303

0

0.59

11

5.33

0.19

1 079

13

82

1

100

0

137

102

31

22

0

772

15

2.83

56

9.89

0.81

Sri Lanka

339

63

86

291

88

100

68

64

0

48

1

0

226

0

1.09

27

62.00

0.42

Thailand

1 431

25

87

1 096

61

99

58

695

15

239

7

0

415

60

0.64

14.63

0.11

122

75

91

111

100

95

63

2

0

11

9

0

100

0

8.25

10.73

7.43

57 504

15

42

20 823

90

92

46

8 207

13 243

446

3 004

7 466

14 408

10 831

0.77

11.74

5.61

India 3
Indonesia

Nepal

4

5

Timor-Leste
SEAR
1

Includes labo rato ry-co nfirmed, epidemio lo gically-linked and clinically-co nfirmed measles cases

4

A lso includes the cases fro m enhanced measles case-based surveillance.

2

Includes labo rato ry-co nfirmed and epidemio lo gically-linked rubella cases

5

So me Lab data variables no t available.

46

ND=No data

3 Cases fro m suspected measles o utbreak investigatio n o nly, case based surveillance is gradually exCA nding in the co untry

* Figures in the table 2 are restricted to availability of various dates required for calculation. Thus they may not adequately reflect cases with missing dates for various timelines.

Data Sources: Ministries of Health in SEAR Countries.
Published by Immunization & Vaccine Development, World Health Organization, Regional Office for South-East Asia, New Delhi – 110002, India
Tel: 91-11-2337-0804 / 91-11-4304-0000 Fax: 91-11-2337-0251 / 0106 E-mail: SearEpidata@who.int, URL:

Vol. 21,
Week 52, 2017

Vaccine Preventable Disease Surveillance Bulletin

Page 2

Table 3: Classification of AFP Cases and Key Surveillance Indicators, 2016-2017 (data as of 2 January 2018)
2016 (Onset)

2017 (Onset)

AFP

Surveillance Indicators
1

2

Case Classification 1

Total

>90 Days 3

0

0

2.85

2.85

99

100

1,356

0

0

0

1,281

75

14

2.72

2.57

98

99

11

0

0

5.11

5.11

73

100

8

0

0

0

7

1

0

3.24

2.83

88

100

DPR Korea

105

0

0

0

105

0

0

1.83

1.83

98

100

103

0

0

0

65

38

17

1.80

1.14

96

99

Non-Polio AFP Rate

AFP Rate

4

Vaccine Derived
Poliovirus Cases

Non-Polio AFP Rate

AFP Rate

>90 Days 3

Total

Vaccine Derived
Poliovirus Cases

AFP Cases

% with any specimen

Discarded (Non-polio
AFP)

1,437

0

Pending

% with 2 spec., at least
24 hrs apart, w/in 14
days

Compatible

0

0

Wild Poliovirus Cases

0

0

Pending

% with 2 spec., at least
24 hrs apart, w/in 14
days

0

11

Bangladesh

4

1,437

Bhutan

Country

Wild Poliovirus Cases

AFP Cases

Specim en

% with any specimen

Specim en

Discarded (Non-polio
AFP)

AFP Rates

Surveillance Indicators
Annualized
AFP Rates 2

Compatible

Case Classification

AFP

India

46,500

0

1

15

46,484

0

0

10.60 10.60

87

98

37,646

0

0

12

34,596 3,038 1,191

8.59

7.89

86

98

Indonesia

1,409

0

0

0

1,409

0

0

2.01

2.01

86

96

1,441

0

0

1

1,214

226

122

2.05

1.73

83

97

Maldives

2

0

0

0

2

0

0

2.11

2.11

0

100

6

0

0

0

4

2

0

6.34

4.23

67

100

Myanm ar

466

0

0

0

466

0

0

3.38

3.38

96

100

360

0

0

0

310

50

2

2.67

2.30

96

100

Nepal

455

0

0

0

455

0

0

5.24

5.24

96

100

342

0

0

0

326

16

2

3.94

3.76

99

100

Sri Lanka

65

0

0

0

65

0

0

1.20

1.20

85

98

69

0

0

0

65

4

0

1.27

1.20

84

99

Thailand

246

0

0

0

246

0

0

2.04

2.04

75

98

171

0

0

0

130

41

25

1.48

1.12

65

92

Tim or-Leste

10

0

0

0

10

0

0

2.16

2.16

50

80

3

0

0

0

1

2

1

0.65

0.22

33

100

50,706

0

1

15

50,690

0

0

8.38

8.38

87

98

41,505

0

0

13

6.87

6.29

86

98

SEAR

37,999 3,493 1,374

1

All countries are using the virologic classification scheme.

2

AFP rates per 100,000 children aged 15 years of age or missing age information are excluded).

3

90 days calculation based on date of paralysis onset subtracted from date of last report received from member countries by SEARO.
2016 India: One type 2 VDPV (iVDPV=1)
[a=ambiguous c=circulating i=immunodeficiency]

4

Table 4: Intratypic Differentiation (ITD) of Isolates from AFP Cases, 2016-2017 (data as of 2 January 2018)

0

0

1

3

0

0

1

0

0

20

0

0

0

0

0

0

0

0

0

0

DPR Korea

NPL, Pyongyong

India

0

0

0

0

0

Vaccine
mixture
NPEV by
PCR

0

8

0

0

0

0

7

5

7
Days days

0

BJMC, Ahmedabad

258

0

78

0

25

0

0

74

80

1

0

0

0

0

227

0

78

0

0

0

0

66

76

7

0

0

0

0

NIV, Bengaluru

225

0

56

0

24

0

0

67

70

6

2

0

0

0

151

0

57

0

0

0

0

35

45

14

0

0

0

0

ERC, Mumbai

172

0

53

0

13

0

0

52

43

11

0

0

0

0

154

0

52

0

0

0

0

45

36

21

0

0

0

0

SGPGI, Lucknow

311

0

56

0

53

0

0

86

66

16

34

0

0

0

289

0

60

0

0

0

0

100

63

25

41

0

0

0

KIPM, Chennai

98

0

26

0

17

1

0

26

28

0

0

0

0

0

48

0

9

0

0

0

0

27

12

0

0

0

0

0

NCDC, Delhi

231

0

47

0

38

0

0

91

52

3

0

0

0

0

204

0

58

0

0

0

0

87

51

8

0

0

0

0

IoS, Kolkatta

113

0

26

0

18

0

0

35

33

0

1

0

0

0

170

0

54

0

0

0

0

39

57

17

3

0

0

0

CRI, Kasauli

35

0

5

0

7

0

0

11

12

0

0

0

0

0

21

0

11

0

0

0

0

6

4

0

0

0

0

0

1,443

0

347

0

195

1

0

442

384

37

37

0

0

0

1,264

0

379

0

0

0

0

92

44

0

0

0

India Total

Indonesia

0

Negative

0
1

Results
pending

NEV

0
0

Vaccine

3
0

Wild

0
0

VDPV

8
1

Vaccine

IPH, Dhaka
NIH, Bangkok

Wild

Bangladesh
Bhutan

Vaccine

7
Days days

Intratypic Differentiation results
Polio 1
Polio 2
Polio 3
Wild

Results
pending

AFP cases
referred
for ITD

NEV

Negative

2017

Vaccine
mixture
NPEV by
PCR

Vaccine

Wild

VDPV

Vaccine

Wild

Vaccine

ITD Labs

Wild

Country of
Case

AFP cases
referred
for ITD

2016
Intratypic Differentiation results
Polio 1
Polio 2
Polio 3

405 344

Bio Farma, Bandung

18

0

9

0

3

0

0

1

5

0

0

0

0

0

2

0

0

0

0

0

0

2

0

0

0

0

0

0

NIHRD, Jakarta

12

0

4

0

0

0

0

5

3

0

0

0

0

0

2

0

0

0

0

0

0

0

2

0

0

0

0

0

PHL, Surabaya

13

0

2

0

4

0

0

4

3

0

0

0

0

0

1

0

0

0

0

0

0

1

0

0

0

0

0

0

43

0

15

0

7

0

0

10

11

0

0

0

0

0

5

0

0

0

0

0

0

3

2

0

0

0

0

0

Indonesia Total
Myanmar

NHL, Yangon

7

0

1

0

1

0

0

2

3

0

0

0

0

0

6

0

1

0

0

0

0

4

1

0

0

0

0

0

Nepal

NIH, Bangkok

6

0

2

0

2

0

0

1

1

0

0

0

0

0

5

0

0

0

0

0

0

3

2

0

0

0

0

0

Sri Lanka

MRI, Colombo

1

0

0

0

0

0

0

1

0

0

0

0

0

0

0

Thailand

NIH, Bangkok

4

0

0

0

0

0

0

2

2

0

0

0

0

0

5

0

2

0

0

0

0

3

0

1,513

0

368

0

206

1

0

459

404

37

37

1

0

0

1,305

0

390

0

0

0

0

TOTAL

425 354

0

0

0

0

0

92

44

0

0

0