Measles elimination status Rubella elimination status
Total population 2 082 957
< 1 year old 22 717
< 5 years old 115 793
Demographic information, 2018
Source: World Population Prospects: The 2019 Revision, New York, United Nations
Measles and rubella surveillance National case-based surveillance for measles and rubella
Lab confirmation for diagnosis of measles and rubella
Source: WHO/UNICEF Joint Reporting Form on immunization, 2018
Measles and rubella elimination country profile Republic of North Macedonia
Measles and rubella immunization schedule, 2018
Source: WHO/UNICEF Joint Reporting Form on immunization, 2018
MMR = measles-mumps-rubella vaccine; MCV1 = first dose measles-containing vaccine;
MCV2 = second dose measles-containing vaccine; RCV = rubella-containing vaccine
Measles and rubella cases and immunization coverage, 2009–2018
Source: WHO/UNICEF Joint Reporting Form on immunization, 2018 and WHO/UNICEF Estimates of National Immunization Coverage (WUENIC), 2018
MCV1 = first dose of measles-containing vaccine MCV2= second dose of measles-containing vaccine
Definition used for an outbreak
Source: Measles and rubella elimination Annual Status Update report, 2018
An increased number of cases of a particular communicable disease which exceeds the usual number of cases from the previous period regard- ing time and place
2017 eliminated
2018 eliminated
Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC
2017 eliminated
2018 eliminated
Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC
Confirmed measles cases by month of onset, 2014-2018
Source: CISID, 2018
Vaccine Schedule MCV1 MMR 12 months MCV2 MMR 6 years
Year of introduction
MCV2 1987
RCV 1982
Measles vaccination in school Yes
0 10 20 30 40 50 60 70 80 90 100
0 100 200 300 400 500 600 700 800
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
% coverage
Number of cases
Year
Measles Rubella Coverage MCV1 Coverage MCV2
0 10 20 30 40 50 60
J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D
2014 2015 2016 2017 2018
Number of cases
Month and year
Republic of North Macedonia
Informa�on on CRS, 2018
No cases reported
CRS = congenital rubella syndrome
Measles cases by first subna�onal level, 2018
Source:
Measles genotypes by first subna�onal level, 2018
Source: MeaNS, 2018
Sources of infec�on, 2018
Measles Rubella
Imported ND 0
Import-related ND 0
Endemic ND 0
Unknown/ Not
reported ND 0
Source:
Source:
Note: Excludes imported cases
1dot=1case
•
B3•
D8•
H1•
D40 10 20 30 40 50 60 70 80 90 100
<1 1-4 5-9 10-14 15-19 20-29 30 +
% of cases
Age group (years)
0 doses 1 dose 2 or more doses Unknown
2
Suspected measles
cases
Confirmed measles cases Discarded as measlesnon-
Measles
incidence Genotypes detected Laboratory Epi- linked Clinically Total
2014 126 49 20 47 116 10 56.2 D8
2015 2 0 0 0 0 2 0 NA
2016 3 0 0 0 0 3 0 NA
2017 25 18 0 1 19 6 9.2 ND
2018 96 ND ND ND 64 32 30.9 B3
Measles incidence, epidemiologic and virologic
characteristics, 2014-2018 Measles surveillance and laboratory performance indicators, 2014-2018
Source: Measles and rubella elimination Annual Status Update report, 2014-2018 Incidence calculated per 1 million population
ND = Data not available; NA= Not applicable
Source: Measles and rubella elimination Annual Status Update report, 2014-2018 ND = Data not available; NA= Not applicable
A proficient laboratory is WHO accredited and/or has an established quality assurance programme with oversight by a WHO accredited laboratory
Rubella incidence, epidemiologic and virologic
characteristics, 2014-2018 Rubella surveillance and laboratory performance indicators, 2014-2018
Source: Measles and rubella elimination Annual Status Update report, 2014-2018 Incidence calculated per 1 million population
ND = Data not available; NA= Not applicable
Source: Measles and rubella elimination Annual Status Update report, 2014-2018 ND = Data not available; NA= Not applicable
A proficient laboratory is WHO accredited and/or has an established quality assurance programme with oversight by a WHO accredited laboratory
Surveillance performance indicators and targets
a. Rate of discarded cases: at least 2 discarded measles or rubella cases per 100 000 population b. % cases with adequate laboratory investigation: ≥ 80%
c. % origin of infection known: ≥ 80%
d. Rate of viral detection: ≥ 80%
Measles and rubella elimination country profile Republic of North Macedonia
Discarded non- measles rate
% 1st sub- national unit
with ≥ 2 discarded cases
% cases with adequate laboratory investigation
% origin of infection
known
# specimen tested for measles
% positive for measles
Rate of viral detection
% WHO and proficient
labs
2014 ND ND 100% ND 119 44.5% ND ND
2015 ND ND NA NA 2 0% NA 100%
2016 1.0 3.2% NA NA 3 0% NA 100%
2017 0 3.2% 100% 100% 25 72% 100% 100%
2018 1.5 ND 82.8% 79.7% 95 ND 100% 100%
Suspected rubella
cases
Confirmed rubella cases Discarded non-as rubella
Rubella
incidence Genotypes detected Laboratory Epi- linked Clinically Total
2014 0 0 0 0 0 0 0 NA
2015 2 0 0 0 0 2 0 NA
2016 0 0 0 0 0 0 0 NA
2017 4 0 0 0 0 4 0 NA
2018 3 0 0 0 0 3 0 NA
Discarded non- rubella rate
% 1st sub- national unit
with ≥ 2 discarded
cases
% cases with adequate laboratory investigtion
% origin of infection
known
# specimen tested for rubella
% positive for rubella Rate of viral
detection
% WHO and proficient
labs
2014 NA NA NA NA 18 0% NA ND
2015 ND ND NA NA 711 0.1% NA 100%
2016 NA NA NA NA 0 0% NA ND
2017 0 3.2% 100% NA 4 0% NA 100%
2018 0 ND 100% NA 3 0% NA 100%
RVC comments, based on 2018 reporting
The RVC concluded that endemic transmission of both measles and rubella remained interrupted in North Macedonia in 2018 and confirmed that measles- and rubella-elimination have been sustained. The RVC is concerned about the increas- ing number of measles cases and outbreak in 2019. The RVC urges implementation of WHO strategies and recommen- dations to increase routine immunization coverage with both doses of MRCV, implement outbreak response measures, catch-up immunization activities, identify susceptible populations, improve the documentation of immunization status among HCWs and implement infection control measures and procedures in health care settings. To facilitate the assess- ment of measles epidemiology and elimination status, the RVC requests that the NVC provide more detailed analysis of outbreaks in future ASUs.
Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC
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