WHO EpiData. A monthly summary of the epidemiological data on selected Vaccine preventable diseases in the WHO European Region

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1 A monthly summary of the epidemiological data on selected Vaccine preventable diseases in the WHO European Region Table 1: Reported cases for the period January December 2018 (data as of 01 February 2019) Population in Incidence Rate Jan - Dec 2018 cases Month and year of rash onset Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Month & year of last report Albania Dec-18 Andorra Dec-18 Armenia Dec-18 Austria Dec-18 Azerbaijan Dec-18 Belarus Dec-18 Belgium Dec-18 Bosnia and Herzegovina Dec-18 Bulgaria Dec-18 Croatia Dec-18 Cyprus Dec-18 Czech Republic Dec-18 Denmark Dec-18 Estonia Dec-18 Finland Dec-18 France Dec-18 Georgia Dec-18 Germany Dec-18 Greece Dec-18 Hungary Dec-18 Iceland Dec-18 Ireland Dec-18 Israel Dec-18 Italy Dec-18 Kazakhstan Dec-18 Kyrgyzstan Dec-18 Latvia Dec-18 Lithuania Dec-18 Luxembourg Dec-18 Malta Dec-18 Monaco Dec-18 Montenegro Dec-18 Netherlands Dec-18 Norway Dec-18 Poland Dec-18 Portugal Dec-18 Republic of Moldova Dec-18 Romania Dec-18 Russian Federation Dec-18 San Marino Dec-18 Serbia Dec-18 Slovakia Dec-18 Slovenia Dec-18 Spain Dec-18 Sweden Dec-18 Switzerland Dec-18 Tajikistan Dec-18 Republic of Macedonia Dec-18 Turkey Dec-18 Turkmenistan Dec-18 Ukraine Dec-18 United Kingdom Dec-18 Uzbekistan Dec-18 Region Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe or via ECDC/TESSy. Member States submitting aggregate data: Belgium, Bosnia and Herzegovina, Kazakhstan, Serbia, the former Yugoslav and Ukraine. 1 Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision. Tables 1- are based on monthly data as reported by Member States surveillance system. Criteria for case inclusion per month may differ between Member States.

2 Table 2: Reported rubella cases for the period January December 2018 (data as of 01 February 2019) Population in Incidence Rate Jan - Dec 2018 rubella cases Month and year of rash onset Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Month & year of Albania Dec-18 Andorra Dec-18 Armenia Dec-18 Austria Dec-18 Azerbaijan Dec-18 Belarus Dec-18 Belgium Bosnia and Herzegovina Dec-18 Bulgaria Dec-18 Croatia Dec-18 Cyprus Dec-18 Czech Republic Dec-18 Denmark Estonia Dec-18 Finland Dec-18 France Georgia Dec-18 Germany Dec-18 Greece Dec-18 Hungary Dec-18 Iceland Dec-18 Ireland Dec-18 Israel Dec-18 Italy Dec-18 Kazakhstan Dec-18 Kyrgyzstan Dec-18 Latvia Dec-18 Lithuania Dec-18 Luxembourg Dec-18 Malta Dec-18 Monaco Dec-18 Montenegro Dec-18 Netherlands Dec-18 Norway Dec-18 Poland Dec-18 Portugal Dec-18 Republic of Moldova Dec-18 Romania Dec-18 Russian Federation Dec-18 San Marino Dec-18 Serbia No Report Slovakia Dec-18 Slovenia Dec-18 Spain Dec-18 Sweden Dec-18 Switzerland Dec-18 Tajikistan Dec Dec-18 Turkey Dec-18 Turkmenistan Dec-18 Ukraine Dec-18 United Kingdom Dec-18 Uzbekistan Dec-18 Region Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe or via ECDC/TESSy. Member States submitting aggregate data: Bosnia and Herzegovina, Kazakhstan, Poland, the former Yugoslav and Ukraine. 1 Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision. 2 does not have a comprehensive rubella surveillance system.

3 Table 3: Measles classification, reporting and surveillance performance, January December 2018 (data as of 01 February 2019) Population in Incidence Rate 2017 (as of 01 February 2019) death Incidence Rate Lab confirmed Classification Epi-Link Albania % 50% Dec-18 97% % 79% Andorra % 100% Dec Armenia % 83% Dec % 8.1 8% 100% Austria % 100% Dec-18 79% % 15% Azerbaijan % 100% Dec-18 9% % 100% Belarus % 58% Dec %.5 0% 0% Belgium % 92% Dec Bosnia and Herzegovina % 58% Dec Bulgaria % 100% Dec % - 77% 100% Croatia % 92% Dec % % 0% Cyprus % 100% Dec % - 100% 0% Czech Republic % 83% Dec-18 87% - 86% 0% Denmark % 100% Dec % - 100% 0% Estonia % 100% Dec %. 100% 100% Finland % 100% Dec % - 33% 0% France % 100% Dec-18 81% - 83% 0% Georgia % 58% Dec-18 83% % 96% Germany % 100% Dec-18 92% - 81% 0% Greece % 100% Dec-18 7% % 0% Hungary % 100% Dec % % 92% Iceland % 100% Dec Ireland % 100% Dec-18 9% - 71% 8% Israel % 75% Dec-18 82% - 0% 91% Italy % 100% Dec-18 8% 0. 88% 0% Kazakhstan % 83% Dec Kyrgyzstan % 75% Dec-18 66% % 89% Latvia % 92% Dec % - 0% 100% Lithuania % 92% Dec % - 100% 77% Luxembourg % 100% Dec % - 100% 100% Malta % 100% Dec % - 100% 0% Monaco % 75% Dec Montenegro % 33% Dec-18 93% % 95% Netherlands % 100% Dec-18 91% - 38% 0% Norway % 100% Dec % - 83% 100% Poland % 100% Dec-18 68% - 9% 100% Portugal % 92% Dec-18 97%.0 88% 82% Republic of Moldova % 92% Dec % % 100% Romania % 100% Dec-18 98% - 100% 100% Russian Federation % 100% Dec-18 99% % 31% San Marino % 75% Dec Serbia % 100% Dec Slovakia % 100% Dec-18 3% % 100% Slovenia % 100% Dec-18 89% - % 100% Spain % 100% Dec-18 97% % 96% Sweden % 100% Dec-18 97% - 97% 0% Switzerland % 100% Dec-18 99% % 26% Tajikistan % 83% Dec % % % 67% Dec Turkey % 67% Dec % % 97% Turkmenistan % 17% Dec % % Ukraine % 83% Dec United Kingdom % 92% Dec % - 98% 0% Uzbekistan % 92% Dec % % 99% Region % 87.9% 90.0% % 53.% Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe or via ECDC/TESSy. Member States submitting aggregate data: Belgium, Bosnia and Herzegovina, Kazakhstan, Serbia, the former Yugoslav and Ukraine. 1 Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision. Clinically compatible 3 Discarded Measles Imported cases Measles Death 2018 Completeness Report Timeliness Month & year of Laboratory investigation rate Surveillance Indicators 6 Rate of discarded cases 5 Origin of infection Timeliness of investigation 2 All confirmed cases regardless of origin. Target (>=80%) not achieving are highlighted in red. 3 Unless specified as laboratory confirmed or epi-linked, cases are classified as clinically compatible. 5 Rate of discarded cases not achieving the target (>=2 discarded cases per ) are highlighted in red. Rate of discarded cases is not calculated for the countries submitting only confirmed cases. 6 Surveillance indicators can not be calculated for Member States submitting aggregate data. 7 classifies discard cases as discarded, not, not rubella.

4 Table : Rubella classification, reporting and surveillance performance, January December 2018 (data as of 01 February 2019) 2017 (as of 01 February 2019) 2018 Population in Incidence Rate rubella Incidence Rate rubella Lab confirmed Classification Epi-Link Clinically compatible 3 Discarded Rubella Imported cases Completeness Report Timeliness Month & year of Laboratory investigation rate Surveillance Indicators 6 Rate of discarded cases 5 Origin of infection Timeliness of investigation Albania % 50% Dec % 3.2-7% Andorra % 100% Dec Armenia % 83% Dec Austria % 100% Dec % - 100% 0% Azerbaijan % 100% Dec % % Belarus % 58% Dec-18 99%.5 100% 0% Belgium Bosnia and Herzegovina % 50% Dec Bulgaria % 100% Dec-18 0% - 0% 100% Croatia % 83% Dec Cyprus % 100% Dec Czech Republic % 58% Dec % - 100% 0% Denmark Estonia % 100% Dec % % Finland % 100% Dec France Georgia % 33% Dec-18 7% % Germany % 100% Dec-18 25% - 58% 0% Greece % 100% Dec Hungary % 75% Dec % % Iceland % 100% Dec Ireland % 100% Dec-18 25% - 50% 75% Israel % 67% Dec % - 0% 100% Italy % 100% Dec-18 85% % 0% Kazakhstan % 75% Dec Kyrgyzstan % 75% Dec-18 51% % 86% Latvia % 83% Dec % - 100% 33% Lithuania % 92% Dec % - 100% 0% Luxembourg % 100% Dec Malta % 100% Dec Monaco % 17% Dec Montenegro % 33% Dec Netherlands % 100% Dec Norway % 92% Dec Poland % 100% Dec Portugal % 92% Dec-18 81% % 56% Republic of Moldova % 83% Dec % % Romania % 75% Dec-18 75% - 100% 100% Russian Federation % 100% Dec % % 67% San Marino % 75% Dec Serbia No Report Slovakia % 100% Dec-18 0% - 100% 100% Slovenia % 100% Dec Spain % 100% Dec % 0.0 8% 95% Sweden % 100% Dec % % Switzerland % 100% Dec-18 91% 0. 50% 12% Tajikistan % 92% Dec % % % 67% Dec Turkey % 67% Dec-18 96% % 97.1% Turkmenistan % 17% Dec % % Ukraine % 75% Dec United Kingdom % 83% Dec % - 100% 0% Uzbekistan % 92% Dec % % Region % 78.0% 90.0% % 82.0% Data source: Monthly aggregated and case-based data reported by Member States to WHO/Europe or via ECDC/TESSy. Member States submitting aggregate data: Bosnia and Herzegovina, Kazakhstan, Poland, the former Yugoslav and Ukraine. 1 Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision. 2 All confirmed rubella cases regardless of origin. 3 Unless specified as laboratory confirmed or epi-linked, cases are classified as clinically compatible. Target (>=80%) not achieving are highlighted in red. 5 Rate of discarded cases not achieving the target (>=2 discarded cases per ) are highlighted in red. Rate of discarded cases is not calculated for the countries submitting only confirmed rubella cases. 6 Surveillance indicators can not be calculated for Member States submitting aggregate data. 7 classifies discard cases as discarded, not, not rubella. 8 does not have a comprehensive rubella surveillance system.

5 Table 5: Measles and rubella laboratory test results, January December 2018 (data as of 01 February 2019) Measles Rubella Report Genotypes Positive for specimens reported to tested 1 (%) 1 MeaNS 2 Sequencing reported within 60 days 2 specimens tested 1 Positive for rubella (%) 1 Genotypes reported to RubeNS 3 Sequencing reported within 60 days 3 Completeness Timeliness Month of Albania (52.0) B3 0% % 75% Dec-18 Andorra No Lab Armenia (7.0) D8 0% (0.0) % 50% Dec-18 Austria (.0) B3,D8 100% (0.0) 1E,2B 0% 100% 92% Dec-18 Azerbaijan 18 0 (0.0) (0.0) % 83% Oct-18 Belarus (38.0) B3,D8 100% 75 (1.0) 2B 100% 100% 83% Dec-18 Belgium (36.0) B3,D8 71% (7.0) % 33% Oct-18 Bosnia and Herzegovina (35.0) B3 67% 85 (5.0) % 92% Dec-18 Bulgaria (10.0) B3,D8 20% (0.0) % 83% Dec-18 Croatia 75 - B3,D8 86% 25 0 (0.0) % 8% Jun-18 Cyprus (9.0) (0.0) % 33% Sep-18 Czech Republic (35.0) D8 33% 25 7 (28.0) % 100% Dec-18 Denmark (.0) B3,D8 100% 3 2 (5.0) % 100% Dec-18 Estonia (10.0) (1.0) % 92% Dec-18 Finland (17.0) D8 3% (3.0) % 92% Dec-18 France (3.0) B3,D8 % (0.0) 2B 0% 92% 2% Nov-18 Georgia No Report Germany - - B3,D8 3% No Report Greece 52 (85.0) B3 7% % 8% Jun-18 Hungary (11.0) B3,D8 100% (0.0) % 92% Dec-18 Iceland No Report Ireland (8.0) B3,D8 100% (0.0) % 92% Dec-18 Israel (37.0) D8 92% (9.0) 2B 100% 100% 75% Dec-18 Italy (53.0) B3,D8 39% (5.0) % 83% Dec-18 Kazakhstan (77.0) B3,D8 80% (1.0) % 100% Dec-18 Kyrgyzstan (5.0) B3 11% (1.0) % 100% Dec-18 Latvia (9.0) B3,D8 62% (1.0) % 50% Dec-18 Lithuania (28.0) (2.0) % 83% Dec-18 Luxembourg 75 2 (3.0) B3,D8 100% % 100% Dec-18 Malta (1.0) B3,D8 25% (0.0) % 58% Sep-18 Monaco No Lab Montenegro No Report Netherlands (32.0) B3,D8 100% 60 0 (0.0) % 100% Dec-18 Norway - - B3,D8 100% No Report Poland - - B3,D8 0% No Report Portugal (15.0) B3,D8 22% 10 2 (20.0) % 83% Dec-18 Republic of Moldova (66.0) B3,D8 0% 27 0 (0.0) % 92% Dec-18 Romania (82.0) B3,D8 71% (1.0) % 75% Dec-18 Russian Federation (37.0) B3,D8 61% (1.0) % 92% Dec-18 San Marino No Lab Serbia (55.0) B3,D8 0% (1.0) % 100% Dec-18 Slovakia (31.0) B3,D8 0% 12 0 (0.0) % 92% Dec-18 Slovenia (6.0) B3 100% (0.0) % 92% Dec-18 Spain - - B3,D8,D 32% - - 2B 100% - - No Report Sweden (5.0) B3,D8 100% (0.0) % 58% Dec-18 Switzerland (36.0) B3,D8 91% 6 6 (100.0) % 92% Dec-18 Tajikistan 86 0 (0.0) (0.0) % 83% Dec (1.0) (0.0) % 0% May-18 Turkey (12.0) B3,D8 13% (2.0) % 50% Dec-18 Turkmenistan (0.0) (0.0) % 100% Dec-18 Ukraine (50.0) B3,D8 3% (3.0) % 75% Nov-18 United Kingdom (19.0) B3,D8 95% (1.0) % 100% Dec-18 Uzbekistan (12.0) D8 25% (0.0) % 92% Dec-18 Region (35%) - 52% (2%) - % 75.3% 61.8% 1 Data source: monthly aggregated or specimen-based data reported to WHO/Europe. 2 MeaNS: Timeliness of sequence reporting relates to the time between specimen collection and reporting to MeaNS. 3 RubeNS: Timeliness of sequence reporting relates to the time between specimen collection and reporting to RubeNS. Target (>=80%) not achieving are highlighted in red. NB: Specimen based data are not population based, and should not be interpreted as indicators for epidemiological surveillance. Laboratories may have received more than 1 clinical sample or may have conducted more than 1 test for a given case reported in Table 1.

6 Figure 1: Ten countries with the highest numbers of cases in the WHO European Region, January December 2018 (data as of 01 February 2019)* Ukraine Serbia Israel France Out of cases reported in 2018, 7588 (92%) cases were reported from these 10 countries. Italy Russian Federation Georgia Greece 2193 Albania 166 Romania Number of cases Figure 2: Map of incidence rate per million in the WHO European Region, January December 2018 (data as of 01 February 2019)* 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 borderlines for which there may not yet be full agreement. WHO All rights reserved. *Data source: Monthly aggregated and case based data reported by Member States to WHO/Europe or via ECDC/TESSy. Contact us: Vaccine preventable Diseases and Immuniza on Programme, WHO Regional Office for Europe Tel.: E mail: eu@who.int and/or eucddata@who.int Web site: h p:// World Health Organiza on, 2019.