Can Measles Be Eradicated Globally?

By de Quadros, Ciro A. | Bulletin of the World Health Organization, February 2004 | Go to article overview

Can Measles Be Eradicated Globally?


de Quadros, Ciro A., Bulletin of the World Health Organization


Voir page 137 le resume en francais. En la pagina 137 figura un resumen en espanol.

Introduction

Measles is one of the most infectious diseases. Before measles vaccine was introduced, nearly everyone contracted the disease at some point in childhood. Humans are the only reservoir of measles, although other primates, such as monkeys, can also be infected by deliberate inoculation in the laboratory. The most infectious phase is the prodromal, before other symptoms appear, such as lever and exanthema. Communicability diminishes rapidly after exanthema appears (1).

An attenuated live measles virus vaccine was authorized for use in the USA in 1963 and was already widely disseminated in several parts of the world by the late 1970s. This vaccine gives protection for more than 20 years, but the immunity it confers is believed to last for life (2). Its effectiveness is 90-95%. Because maternal antibodies interfere with those produced by the vaccine, the effectiveness of the vaccine increases after the first six months of age, peaking at 95-98% between 12 and 15 months of age (3). By the late 1980s, most countries had incorporated measles vaccine into their routine immunization programmes, and coverage with this vaccine has increased considerably. By 1990, the reported global coverage of children by two years of age was about 70%.

Data from WHO indicate that measles causes 10% of deaths worldwide among under-5-year-olds. Globally, about 40 million cases of measles and 800 000 resulting deaths still occur every year, over half of them in Africa alone. Eradicating measles would therefore play an important role in improving children's survival.

Can measles be eradicated globally? Answering this requires reviewing the experiences with measles eradication in the WHO Region of the Americas. This article therefore briefly describes the strategies being implemented in the Americas to interrupt indigenous measles transmission and the results achieved so far.

The strategy

In 1994, on the same day that the International Commission for the Certification of Poliomyelitis Eradication declared the Region of the Americas polio free, the 24th Pan American Sanitary Conference established the goal of eradicating measles from the western hemisphere (4). The rationale for the strategy used to eradicate measles was based on the epidemiology of the disease before and after introduction of the vaccine. In the pre-vaccine era, measles epidemics occurred every few years as soon as a pool of susceptible children provided by every birth cohort was available to fuel transmission once the virus had been introduced into a given population. Introducing the vaccine and subsequently increasing vaccination coverage during the post-vaccine era elongated the periods between epidemics; in some instances this reached several years. For example, the maximum interepidemic period was 9 years in Chile and 12 years in the USA.

Furthermore, in the pre-vaccine era, some very young children contracted measles and nearly all children did so by age five years. When the vaccine was introduced and coverage increased, the age-specific incidence increased among older children, and even young adults and some older adults contracted measles (5).

Another important factor is that the vaccine effectiveness is not 100%. Many children therefore remain susceptible because they never received the vaccine, and a small proportion of those vaccinated were primary vaccination failures and also remain susceptible. The result is that susceptible children accumulate over a few years, even with a very good immunization programme. Thus, vaccine coverage is not equivalent to population immunity.

With dais background, the Pan American Health Organization (PAHO) recommended a strategy for its Member States that called for high vaccination coverage of the susceptible population at all times and effective surveillance to detect measles transmission and respond accordingly. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Can Measles Be Eradicated Globally?
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.