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Measles and rubella elimination country profile Denmark

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Measles elimination status Rubella elimination status

Total population 5 752 126

< 1 year old 61 105

< 5 years old 293 368

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 CRS

Lab confirmation for diagnosis of measles and CRS

Source: WHO/UNICEF Joint Reporting Form on immunization, 2018

Measles and rubella elimination country profile Denmark

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

Two or more measles or rubella cases which are temporarily related and epidemiological- ly or virologically linked, or both and where transmission took place in Denmark

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 15 months

MCV2 MMR 4 years

Year of introduction

MCV2 1987

RCV 1987

Measles vaccination in school No

2017 endemic

2018 endemic

Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC

0 10 20 30 40 50 60 70 80 90 100

0 10 20 30 40 50 60 70 80 90

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

% coverage

Number of cases

Year

Measles Rubella Coverage MCV1 Coverage MCV2

0 2 4 6 8 10 12

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

(2)

Measles and rubella elimination country profile Denmark

Information on CRS, 2018

No cases reported

Source: Measles and rubella elimination Annual Status Update report, 2018 CRS = congenital rubella syndrome

Measles cases by first subnational level, 2018

Source: Measles and rubella elimination Annual Status Update report, 2018

Measles genotypes by first subnational level, 2018

Source: MeaNS, 2018 Note: The dots in the maps are placed randomly within the administrative regions.

Map disclaimer: The boundaries and names shown and the designations used on the maps 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.

Sources of infection, 2018

Measles Rubella

Imported 4 0

Import-related 1 0

Endemic 0 0

Unknown/ Not

reported 3 0

Source: Measles and rubella elimination Annual Status Update report, 2018

Measles cases by age group and vaccination status, 2018

Source: Measles and rubella elimination Annual Status Update report, 2018 Note: Excludes imported cases

1dot=1case

B3

D8

H1

D9

0 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

(3)

Suspected measles

cases

Confirmed measles cases Discarded as measlesnon-

Measles

incidence Genotypes detected Laboratory Epi- linked Clinically Total

2014 162 25 2 0 27 138 3.6 B3

2015 186 9 0 0 9 177 1.4 D8,H1

2016 75 3 0 0 3 72 0 B3,D8

2017 123 4 0 0 4 119 0.3 D8

2018 193 8 0 0 8 185 0.7 D8

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 and communication with the country Incidence calculated per 1 million population

ND = Data not available; NA= Not applicable

* All suspected measles cases testing negative for measles are tested for rubella

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 Denmark

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 2.5 0% 100% 89% 682 3.5% 100% ND

2015 0.5 0% 100% 55% 697 1.9% 100% 100%

2016 1.3 ND 100% 100% 75 4.2% 0% 100%

2017 2.1 NA 100% 100% 123 3.3% 100% 100%

2018 3.2 NA 100% 62.5% 193 4.1% 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 0 0 0 0 0 0 0 NA

2016 0 0 0 0 0 0 0 NA

2017 119* 0 0 0 0 119 0 NA

2018 193* 0 0 0 0 193 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 0 0% 0 ND

2015 NA NA NA NA ND 0% 0 100%

2016 NA NA NA NA ND 0% 0 ND

2017 2.1 NA 100% NA 119 0% NA 100%

2018 3.3 ND 100% NA 193 0% NA 100%

RVC comments, based on 2018 reporting

The RVC is grateful to the Scandinavian Verification Committee for its comprehensive report and to the national health authorities and health system of Denmark for sustaining measles elimination and for their efforts to improve surveillance for rubella. The RVC recommends the implementation of WHO strategies and recommendations to increase coverage with both doses of MRCV and to establish operational and functional mandatory population-based rubella surveillance.

Source:European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: http://www.euro.who.int/8thRVC

© World Health Organization 2020. Some rights reserved.

This work is available under the CC BY-NC-SA 3.0 IGO license.

Document number: WHO/EURO:2020-1396-41146-55946

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