Author/Authors :
Bradley S Hersh، نويسنده , , Gina Tambini، نويسنده , , Ana Cristina Nogueira، نويسنده , , Peter Carrasco، نويسنده , , Ciro A de Quadros، نويسنده ,
Abstract :
Background
In 1994, ministers of health of countries of North and South America established the goal of measles eradication from the western hemisphere by 2000. To accomplish this goal, the Pan American Health Organization (PAHO) developed an enhanced measles vaccination strategy.
Methods
PAHOʹs measles eradication vaccination strategy has evolved into three principal components; a catch-up measles vaccination campaign, maintenance of high vaccination coverage (keep-up), and periodic follow-up measles vaccination campaigns. To monitor progress towards measles eradication, measles surveillance has been strengthened, including the laboratory investigation of suspected measles cases.
Findings
Both the catch-up and follow-up mass campaigns achieved high vaccination coverages in the respective targeted age groups. In 1996, only 2109 confirmed measles cases were reported in the Americas. In 1997, there was a resurgence of measles in the Americas, mostly as a result of a large measles outbreak with over 42000 cases, which occurred mainly among unvaccinated young adults in Sao Paulo State, Brazil. By 1998, there was a reduction in the number of reported confirmed measles cases, with a total of 14474 cases. Reduction of cases continued to the end of 1999, with a total of only 2828 confirmed cases.
Interpretation
PAHOʹs measles eradication strategy has been effective in interrupting transmission and maintaining the absence of measles virus circulation in most parts of the Americas. The PAHO experience provides strong evidence that with full implementation of an appropriate vaccination strategy, measles transmission can be effectively interrupted.