Measles prevention: supplementary statement

Article Abstract:

Measles vaccine was introduced into the U.S. in 1963, when a goal to eradicate the disease by 1982 was established. Although the rate of measles has been reduced by 99 percent, the number of cases of measles has fluctuated between a low of 1,497 and a high of 6,282 in the years 1981 through 1986. Recently there have been two recent types of outbreaks in the U.S.: among unvaccinated preschool children (including those too young for vaccination) and among vaccinated school-age children. Large outbreaks of the first type have occurred within inner- city areas, where up to 88 percent of children who were old enough for vaccination were not vaccinated. In these areas surveys have shown that as many as 65 percent of two-year-old children had not been vaccinated. Among the school-age children, outbreaks of measles have occurred even when as many as 98 percent of the children have been immunized. Unlike the experience with preschool children, there has been no geographic regionalization with this class of measles epidemic. Rates of illness have been generally low in individual schools (attack rates of 1.0 to 5.0 percent), and the ability of vaccines to prevent illness has been high. Research has indicated that between 2 to 10 percent of all immunized children fail to produce protective antibodies (seroconvert), and this is directly related to the extent of these outbreaks. The age of the child at the time of immunization may play a role in failure to establish the necessary immunologic protection for measles. Based in part on these data, a new strategy for the treatment of measles has been added to achieve the measles elimination goal. The new policy includes a two-dose immunization policy in areas of risk for children of preschool age, or if not possible because of cost, advises an earlier time for inoculation. Changes in strategy for dealing with school-based outbreaks are also developed.

Case studies, column

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Progress toward global measles control and elimination, 1990-1996

Article Abstract:

Measles continues to be the eighth leading cause of death in young children worldwide despite the availability of an effective vaccine. Although the number of reported measles cases worldwide dropped from 4.4 million in 1980 to 0.8 million in 1996, many countries do not report measles cases. Consequently, the true number is estimated at 36.5 million cases in 1996. Almost two-thirds of the cases are in Africa. Sixteen of the 19 countries that report less than 50% vaccination rates are in Africa. Globally, vaccination rates have increased from 5% in 1977 to 81% in 1996.

Usage, International aspects, Measles vaccine, Measles vaccines

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Recommendations From Meeting on Strategies for Improving Global Measles Control, May 11-12, 2000

Article Abstract:

Participants at a conference sponsored by the World Health Organization, the CDC, and the United Nations Children's Fund developed an action plan to eliminate measles globally. A booster shot will probably be needed in addition to the initial vaccination. Vitamin A supplements may also be useful.

Conferences, meetings and seminars, World Health Organization

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