BULLETIN. World Health Organization, Western Pacific Regional Office, Manila, Philippines Issue 12 April 2007 ISSN

Transcription

1 BULLETIN World Health Organization Regional Office for the Western Pacific Expanded Programme on Immunization World Health Organization, Western Pacific Regional Office, Manila, Philippines Issue 12 April 2007 ISSN Global reduction in deaths exceeds target the Western Pacific Region leads all other regions in per cent reduction in deaths In a joint news release, the Global Measles Initiative Partnership announced that global deaths had fallen 60% from in 1999 to in 200, exceeding the 0% reduction goal set by the World Health Assembly 1. Among the six WHO Regions, the African Region had the greatest reduction in estimated numbers of deaths, from in 1999 to in 200, whereas the Western Pacific Region had the greatest percentage reduction in deaths, from to 000 (81%) 1 (Figure 1). Figure1. Regional progress in reducing mortality, The Western Pacific Region s success in substantially reducing mortality during this period was achieved by maintaining high population immunity against through routine immunization with a first dose of containing vaccine (MCV1) and providing a second dose of vaccine (MCV2) either through routine immunization or supplementary immunization activities (SIAs). In 1999, the Western Pacific Region led the other four -endemic regions in MCV1 coverage with 8%. By 200, MCV1 coverage in the Region increased to 87% 1. In addition, more than 0 million children in Western Pacific Region countries (Cambodia, the Lao People s Democratic Republic, Papua New Guinea, the Philippines and Viet Nam) which did not have MCV2 as part of their national routine immunization programme were provided vaccine through SIAs. China also conducted SIAs in several large provinces. The countries of the Western Pacific Region are to be commended for their outstanding achievements in surpassing the global goal of 0% reduction in deaths by 200, and nearing achievement of the next global goal of a 90% reduction in deaths by These efforts, especially when integrated with other child health interventions (e.g. vitamin A supplementation, deworming medicine), also contribute to achieving Millennium Development Goal Number 4: a two thirds reduction in child deaths from 1990 to 201. The Western Pacific Region has a goal to eliminate by 2012, and achieving that goal will require the concerted effort of all countries in the Region to increase routine MCV1 and MCV2 coverage to 9%, conduct SIAs when needed to prevent epidemics, and establish sensitive case-based surveillance to identify virus circulation and monitor progress towards the elimination goal. To that end, many countries in the Region (Cambodia, China, the Lao People s Democratic Republic, Mongolia, Papua New Guinea, the Philippines and Viet Nam) are conducting SIAs in To sustain the gains from SIAs, countries must also focus their efforts on increasing routine coverage and establishing sensitive case-based surveillance. 1 Wolfson LJ, et al. Has the 200 mortality reduction goal been achieved? A natural history modeling study. Lancet 2007; 369: AMRO WHO Regional Office for the Americas 3 EURO WHO Regional Office for Europe 4 WPRO WHO Regional Office for the Western Pacific EMRO WHO Regional Office for the Eastern Mediterranean 6 SEARO - WHO Regional Office for the South East Asia 7 AFRO - WHO Regional Office for Africa

2 BULLETIN Cambodia Population: (2007) MCV1: at 9 months: coverage 79% (200) MCV2: currently not given Measles campaigns: a. National campaign from 2000 to 2004: 98% coverage. b. February to March 2007; target 1. million children 9-9 months old Surveillance: reporting rate decreased from 94 to 1.06/ from 2000 to Figure 1. Number of suspected cases by week, Cambodia, 2006 Unconfirmed cases Confirmed cases Total suspected cases: 08 Total confirmed cases: 188 (37%) Total pending cases: 33 Number of cases Jan Feb Mar Apr May Jun July Aug Sep Oct Nov Dec 2

3 BULLETIN F ig u re 2. N u m b e r o f s u s p e c te d m e a s le s c a s es b y a g e gro u p, C a m bo d ia, U n con firm e d C o nfirm ed Number of cases > 2 U n k n o w n Of 188 confirmed cases, 106 (6.3%) were <9 months, 62 (32.9%) were 9 9 months, 13 (6.9%) were 14 years, and 7 (3.7%) were adults. Figure 3. Confirmed cases by immunization status Cambodia, 2006 <9 months old 0% 18% 9 9 months old 14 years old 8% 100% 82% 92% N=106 N=62 N=13 For those 9 9 months, 11 out of 62 (18%) confirmed cases were vaccinated. For those 14 years old, 1 out of 13 confirmed cases was vaccinated. For the confirmed cases <9 months old, there were no cases immunized. The first vaccine dose is given at 9 months of age in the national immunization programme.

4 Country Table 1. Country surveillance data, Western Pacific Region, 2007* Australia Nov 2006 Brunei Darussalam 0.39 Cambodia Feb 2007 China 1, , , , , Hong Kong (China) Dec 2006 Japan Ω Lao People's Democratic Republic Macao (China) Jun 2006 Malaysia , Mongolia Feb 2007 New Zealand Mar 2007 Papua New Guinea 6.11 Philippines Ω Mar 2007 Republic of Korea Nov 2006 Singapore Mar 2007 Viet Nam , ,61 1, Dec 2006 Pacific island countries: American Samoa Cook Islands Fiji French Polynesia Guam Kiribati Marshall Islands Micronesia, Federated States of Nauru New Caledonia Niue Northern Mariana Islands Palau Samoa 0.18 Solomon Islands Tokelau Tonga Tuvalu Vanuatu Wallis and Futuna Western Pacific Region 1, , ,901 1, , , , * Data are based on country reports and other sources available to EPI/Western Pacific Regional Office. Φ Population figures from World Population Prospects: The 2004 Revision, New York, United Nations, 200. Case Fatality Rate Ω Sentinel surveillance system Population Φ (in millions) cases cases (/ ) 2006 No. pending confirmation Confirmed No. No. of No. confirmed No. confirmed pending deaths Measles cases (/1 confirmation 000) due to CFR cases (/100 Clinical Lab/Epi Total cases ) Clinical Lab/Epi Total 2007 Confirmed cases (/ ) No. of deaths due to Measles CFR Rash onset of last confirmed case

5 BULLETIN Australia Brunei Darussalam Table 2. Country surveillance data, Western Pacific Region, 2007 Cambodia China Hong Kong (China) Japan Country Lao People's Democratic Republic Macao (China) Malaysia Mongolia New Zealand Papua New Guinea No. of districts* Total number of suspected cases % districts with > 1 suspected case/ % suspected cases with adequate investigation % suspected cases with adequate specimen % specimens with lab results within 7 days % of transmission chains with viral isolate Philippines Republic of Korea Singapore Viet Nam * or 2nd administrative unit investigated within 48 hours with following data: age or DOB, vaccination status, date of last vaccination, district, date of rash onset, date of specimen collection excluding from denominator cases that are epidemiologically linked to a laboratory-confimed case Expanded Programme on Immunization WORLD HEALTH ORGANIZATION Regional Office for the Western Pacific, United Nations Avenue, P.O. Box 2932, 1000 Manila, Philippines Fax No. (632) , , Tel. No. (632) Comments may be sent to WHO/WPRO Measles Bulletin _bulletin@wpro.who.int. Please send quarterly data to Mr Dexter Bersonda at bersondad@wpro.who.int