Measles and Rubella monthly update for the WHO Europes Region January 2019

1. Measles and rubella monthly update
for the WHO European Region
Data as of 1 February 2019
Vaccine-preventable Diseases and Immunization programme
Division of Health Emergencies and Communicable Diseases

2. Measles
2

3. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2019. All rights reserved.
Measles cases in the WHO European Region, January–December 2018
3
Top 10 countries
Country Cases
Ukraine 53218
Serbia 5076
Israel 2919
France 2913
Italy 2517
Russian Federation 2256
Georgia 2203
Greece 2193
Albania 1466
Romania 1087

4. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Measles incidence per million population in the WHO European Region,
January–December 2018
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
4
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2019. All rights reserved.
Top 10 countries
Country Incidence
Ukraine 1209.25
Serbia 579.32
Georgia 563.84
Albania 499.60
Israel 345.33
Montenegro 322.62
Greece 196.82
Kyrgyzstan 164.36
Slovakia 104.96
Republic of Moldova 84.14

5. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
1087
1466
2193
2203
2256
2517
2913
2919
5076
53218
0 10000 20000 30000 40000 50000 60000
Romania
Albania
Greece
Georgia
Russian Federation
Italy
France
Israel
Serbia
Ukraine
Number of cases
Ten countries with the highest numbers of measles cases in the WHO European
Region, January–December 2018
Out of 82 596 measles cases reported for 2018, 75 848 (92%)
cases were reported by these 10 countries.
5

6. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
367
518
651
702
897
936
1067
4782
5393
9072
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Belgium
France
Tajikistan
Serbia
Russian Federation
Germany
Greece
Ukraine
Italy
Romania
Number of cases
Ten countries with the highest numbers of measles cases in the WHO European
Region, January–December 2017
6
Out of 25 863 measles cases reported for 2017, 24 385 (94%)
cases were reported by these 10 countries.

7. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Measles cases by month in the WHO European Region, 2016–2018
7
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
2000
4000
6000
8000
10000
12000
14000
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=5273)
2017
(n=25863)
2018
(n=82596)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

8. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Measles cases and incidence by age group and vaccination status in the WHO
European Region, January–December 2018*
8
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
*Age was unknown for 7 cases.
596
319
235
182 164
114
29
0
100
200
300
400
500
600
700
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
<1
(n=6441)
1–4
(n=14371)
5–9
(n=13292)
10–14
(n=9694)
15–19
(n=8409)
20–29
(n=13383)
30+
(n=16998)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

9. Ten countries with the highest numbers
of measles cases in the WHO European Region
for the period January–December 2018
(in alphabetical order)
9

10. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Albania: measles cases by month, 2016–2018
10
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
50
100
150
200
250
300
350
400
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=0)
2017
(n=12)
2018
(n=1466)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

11. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Albania: measles cases and incidence by age group and vaccination status,
January–December 2018
11
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
8014
1488
286 430
1170
605
194
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
0
50
100
150
200
250
300
350
400
<1
(n=270)
1–4
(n=208)
5–9
(n=46)
10–14
(n=72)
15–19
(n=256)
20–29
(n=273)
30+
(n=341)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

12. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
France: measles cases by month, 2016–2018
12
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
100
200
300
400
500
600
700
800
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=79)
2017
(n=518)
2018
(n=2913)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

13. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
France: measles cases and incidence by age group and vaccination status,
January–December 2018*
13
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
*Age was unknown for 1 case.
374
201
74
88 87
63
13
0
50
100
150
200
250
300
350
400
0
100
200
300
400
500
600
700
<1
(n=283)
1–4
(n=614)
5–9
(n=290)
10–14
(n=349)
15–19
(n=341)
20–29
(n=479)
30+
(n=556)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

14. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Georgia: measles cases by month, 2016–2018
14
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
100
200
300
400
500
600
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=14)
2017
(n=96)
2018
(n=2203)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

15. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Georgia: measles cases and incidence by age group and vaccination status,
January–December 2018
15
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
4635
1451
486
750 744
1121
258
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
0
100
200
300
400
500
600
700
<1
(n=220)
1–4
(n=309)
5–9
(n=130)
10–14
(n=173)
15–19
(n=158)
20–29
(n=591)
30+
(n=622)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

16. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Greece: measles cases by month, 2016–2018
16
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
100
200
300
400
500
600
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=0)
2017
(n=1067)
2018
(n=2193)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

17. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Greece: measles cases and incidence by age group and vaccination status,
January–December 2018
17
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
2780
1349
544 484
230 175
71
0
500
1000
1500
2000
2500
3000
0
100
200
300
400
500
600
<1
(n=234)
1–4
(n=496)
5–9
(n=298)
10–14
(n=277)
15–19
(n=127)
20–29
(n=201)
30+
(n=560)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

18. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Israel: measles cases by month, 2016–2018
18
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
100
200
300
400
500
600
700
800
900
1000
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=10)
2017
(n=16)
2018
(n=2919)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

19. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Israel: measles cases and incidence by age group and vaccination status,
January–December 2018
19
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
3131
1258
581
422
251 179 100
0
500
1000
1500
2000
2500
3000
3500
0
100
200
300
400
500
600
700
800
900
<1
(n=506)
1–4
(n=847)
5–9
(n=464)
10–14
(n=301)
15–19
(n=164)
20–29
(n=210)
30+
(n=427)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

20. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Italy: measles cases by month, 2016–2018
20
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
200
400
600
800
1000
1200
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=861)
2017
(n=5393)
2018
(n=2517)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

21. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Italy: measles cases and incidence by age group and vaccination status,
January–December 2018*
21
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
*Age was unknown for 2 cases.
334
166
33 35
54
137
21
0
50
100
150
200
250
300
350
400
0
100
200
300
400
500
600
700
800
900
1000
<1
(n=160)
1–4
(n=325)
5–9
(n=90)
10–14
(n=100)
15–19
(n=151)
20–29
(n=805)
30+
(n=884)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

22. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Romania: measles cases by month, 2016–2018
22
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
200
400
600
800
1000
1200
1400
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=2432)
2017
(n=9072)
2018
(n=1087)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

23. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Romania: measles cases and incidence by age group and vaccination status,
January–December 2018
23
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
1707
449
143 100 51 23 6
0
200
400
600
800
1000
1200
1400
1600
1800
0
50
100
150
200
250
300
350
400
<1
(n=314)
1–4
(n=335)
5–9
(n=144)
10–14
(n=105)
15–19
(n=53)
20–29
(n=54)
30+
(n=82)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

24. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Russian Federation: measles cases by month, 2016–2018
24
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
50
100
150
200
250
300
350
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=180)
2017
(n=897)
2018
(n=2256)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

25. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Russian Federation: measles cases and incidence by age group and vaccination
status, January–December 2018
25
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
122
75
27
22 19 17
7
0
20
40
60
80
100
120
140
0
100
200
300
400
500
600
700
<1
(n=214)
1–4
(n=569)
5–9
(n=241)
10–14
(n=163)
15–19
(n=127)
20–29
(n=298)
30+
(n=644)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

26. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Serbia: measles cases by month, 2016–2018
26
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
200
400
600
800
1000
1200
1400
1600
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=14)
2017
(n=702)
2018
(n=5076)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

27. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Serbia: measles cases and incidence by age group and vaccination status,
January–December 2018*
27
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
*Age was unknown for 3 cases.
4408
1885
401 275
445
630 474
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
0
500
1000
1500
2000
2500
3000
<1
(n=410)
1–4
(n=699)
5–9
(n=188)
10–14
(n=137)
15–19
(n=235)
20–29
(n=715)
30+
(n=2689)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

28. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Ukraine: measles cases by month, 2016–2018
28
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
2000
4000
6000
8000
10000
12000
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=90)
2017
(n=4782)
2018
(n=53218)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

29. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Ukraine: measles cases and incidence by age group and vaccination status,
January–December 2018
29
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
6091
4500 4421
3451 3272
1629
292
0
1000
2000
3000
4000
5000
6000
7000
0
2000
4000
6000
8000
10000
12000
<1
(n=2666)
1–4
(n=8393)
5–9
(n=10863)
10–14
(n=7551)
15–19
(n=6305)
20–29
(n=8743)
30+
(n=8697)
Incidencepermillionpopulation
Numberofcases
Age group (years)
0 dose 1 dose 2+ doses Unknown Incidence

30. Measles genotypes
30

31. Measles genotypes by week of sample collection in the WHO European Region, 2016–2018
31Data source: WHO measles nucleotide surveillance online database (MeaNS) data as of 1 February 2019
0
20
40
60
80
100
120
140
160
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
2016 2017 2018
Numberofsequencesreported
Week of sample collection
B3 D4 D8 D9
2016 2017 2018

32. Rubella
32

33. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
16
23
57
235
450
0 50 100 150 200 250 300 350 400 450 500
Turkey
Italy
Germany
Ukraine
Poland
Number of cases
Five countries with the highest numbers of rubella cases in the WHO European
Region, January–December 2018
33
Out of 850 rubella cases reported for 2018,781 (92%)
cases were reported by these 5 countries.

34. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
9
41
68
74
476
0 50 100 150 200 250 300 350 400 450 500
Romania
Austria
Italy
Germany
Poland
Number of cases
Five countries with the highest numbers of rubella cases in the WHO European
Region, January–December 2017
34
Out of 702 rubella cases reported for 2017,668 (95%)
cases were reported by these 5 countries.

35. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Rubella cases by month in the WHO European Region, 2016–2018
35
0
20
40
60
80
100
120
140
160
180
200
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=1322)
2017
(n=702)
2018
(n=850)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.

36. Five countries with the highest numbers
of rubella cases in the WHO European Region
for the period January–December 2018
(in alphabetical order)
36

37. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Germany: rubella cases by month, 2016–2018
37
0
2
4
6
8
10
12
14
16
18
20
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=96)
2017
(n=74)
2018
(n=57)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.

38. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Italy: rubella cases by month, 2016–2018
38
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
2
4
6
8
10
12
14
16
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=30)
2017
(n=68)
2018
(n=23)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

39. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Poland: rubella cases by month, 2016–2018
39
0
20
40
60
80
100
120
140
160
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=1105)
2017
(n=476)
2018
(n=450)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.

40. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Turkey: rubella cases by month, 2016–2018
40
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.
0
1
2
3
4
5
6
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
(n=0)
2017
(n=2)
2018
(n=16)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible

41. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Ukraine: rubella cases by month, 2018
41
*Rubella cases reporting began January 2018.
0
5
10
15
20
25
30
35
40
45
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016* 2017* 2018
(n=235)
Numberofcases
Month
Lab confirmed Epi linked Clinically compatible
Criteria for date of case inclusion may differ in accordance with Member States’ surveillance systems.

42. Verification of measles and rubella elimination
42

43. Measles and rubella elimination status in the WHO European Region, 2017
43Data source: 7th meeting of the European Regional Verification Commission for Measles and Rubella Elimination (RVC). Meeting report (2018).
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2019. All rights reserved.

44. Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe directly or via ECDC/TESSy data as of 1 February 2019
Measles discard rate per hundred thousand population in the WHO European
Region, January–December 2018
Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision.
44
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2019. All rights reserved.