Table II.

Surveillance Quality Indicators Used in the World Health Organization Measles Programmatic Risk Assessment

Surveillance Quality Indicators (Information Source(s))	Rationale	Cut-Off Criteria (Risk Points)	Comments
Nonmeasles discarded rate (case-based surveillance data)	Relates to surveillance sensitivity	≥2 per 100,000 (+0) <2 per 100,000 (+4) <1 per 100,000 (+8)	Assign risk point using annual measles case-based surveillance data from most recent year. For countries that have introduced rubella vaccine, use nonmeasles, nonrubella discarded rate.
Proportion of measles cases with adequate investigation (case-based surveillance data)	Relates to quality and sensitivity of surveillance	≥80% (+0) <80% (+4)	An adequate investigation is defined as a case investigated within 48 hours of notification that includes all 10 core variables: (1) case identification, (2) date of birth/age, (3) sex, (4) place of residence, ( 5) vaccination status or date of last vaccination, (6) date of rash onset, (7) date of notification, (8) date of investigation, (9) date of blood sample collection, and (10) place of infection or travel history.(15) If no investigations were conducted, then give maximum score.
Proportion of measles cases with adequate specimens collection (case-based surveillance data)	Relates to quality and specificity of surveillance	≥80% (+0) <80% (+4)	Adequate specimen collection is defined as serum collection within 28 days of rash onset. Exclude epidemiologically linked cases. If no specimens were collected, then give maximum score.
Proportion of measles cases with laboratory results available in a timely manner (case-based surveillance data)	Relates to laboratory surveillance system performance	≥80% (+0) <80% (+4)	Timeliness is defined as 10 days from the date of specimen collection to the date of laboratory report of results. If no specimens were received, then give maximum score.