Global landscape of measles and rubella surveillance

Background: All six World Health Organization (WHO) regions have committed to eliminate measles, and three WHO regions have committed to eliminate rubella. One of the key tenets of measles and rubella elimination is to have a strong surveillance system in place. The presence of a case-based measles and rubella surveillance system that is national, population-based, provides laboratory confirmation, and directs action, is one of the requirements for elimination-standard surveillance.

Methods: In order to understand the global landscape for measles and rubella surveillance, a questionnaire was sent to all 194 WHO member states (herein referred to as countries) requesting information on how surveillance was conducted for measles, rubella, and congenital rubella syndrome. Data were supplemented with information provided to WHO through other reporting mechanisms and by national policy documents available to the public. Frequencies and percentages were calculated.

Results: Data were available to review from 164 (85%) countries, although not every country responded to every question. Case-based, population-based, national surveillance with laboratory confirmation was reported to be conducted in 136 (86%) of 158 countries for measles and 122 (77%) of 158 countries for rubella. Congenital rubella syndrome surveillance was reported to be conducted by 126 (77%) of 163 countries. Gaps were noted in the quality of measles-rubella surveillance conducted, and 26 (16%) of 158 countries reported not including all healthcare providers as mandatory reporters.

Conclusions: Many countries reported having some of the essential components in place to conduct elimination-standard surveillance for measles and rubella; however, in order to achieve elimination, the quality of surveillance needs to improve to detect all cases. In those countries without these essential components of elimination-standard surveillance, the first step is to implement these components.