Measles Technical Working Group: strategies for measles control and elimination : report of a meeting, Geneva, 11-12 May 2000

Title from PDF t.p. (viewed Aug. 31, 2004)."WHO/V&B/01.37.""Document produced by the Expanded Programme on Immunization of the Department of Vaccines and Biologicals."--PDF t.p. verso."In May 2000 WHO, UNICEF and the United States Centers for Disease Control and Prevention (CDC), cosponsored a meeting to bring together the representatives of international agencies, countries and academics with experience in measles control and elimination to review the strategies required to achieve measles mortality and morbidity reduction goals." - p. viiMode of access: Internet

Advances in global measles control and elimination: summary of the 1997 International Meeting

A meeting concerning advances in measles control and elimination, the third in a series, was held in Atlanta during August 1997. The meeting was cosponsored by CDC, the Pan American Health Organization, the World Health Organization, and the United Nations Children's Fund. Meeting participants concluded that substantial progress has been made toward controlling measles. Measles transmission has been interrupted in several countries, reinforcing the view that measles eradication is technically feasible using existing vaccines and intervention strategies. However, measles still accounts for 10% of global mortality from all causes among children aged <5 years (i.e., approximately 1 million deaths annually). Progress toward measles control varies substantially among countries and regions. Intensified efforts are necessary to implement appropriate control and elimination strategies, including supplementary vaccination campaigns, expansion of routine vaccination services, and surveillance. These strategies and estimates of the resources required to implement them will require adjustment based on accumulating experience. Programmatic and financial obstacles must be overcome if the final goal of measles eradication is to be achieved.Meeting participants -- Introduction -- Global experience with measles control -- Measles surveillance -- Vaccine safety -- Research -- Economic implications of measles elimination -- Next steps -- ReferenceJuly 24, 1998Summary of the 3rd Meeting on Advances in Measles Control and Elimination, held in Atlanta from August 27-29, 1997.Staff members of the following organizations prepared this report: Expanded Programme on Immunization, World Health Organization; Special Program for Vaccines and Immunization, Pan American Health Organization; National Immunization Program, Centers for Disease Control and Prevention; Task Force for Child Survival and DevelopmentIncludes bibliographical references

Measles transmission from an anthroposophic community to the general population, Germany 2008

<p>Abstract</p> <p>Background</p> <p>In Germany, measles vaccination coverage with two doses is not yet sufficient to prevent regional outbreaks. Among the 16 German federal states, vaccination coverage was lowest in Bavaria with 85% in 2008. From March to mid-April 2008, four neighbouring Bavarian counties reported 55 measles-cases mostly linked to an ongoing measles outbreak in an anthroposophic school in Austria. We investigated this outbreak to guide future public health action.</p> <p>Methods</p> <p>We applied the German national case-definition for measles and collected data using the national surveillance system and a questionnaire. Measles cases with disease onset a maximum of 18 days apart and spatial contact (e.g. same household, same school) were summed up in clusters. Two different interventions, which were implemented in schools and kindergartens in Bavaria, were compared by their impact on the size and duration of measles clusters. Susceptible persons were excluded from schools or kindergartens either with the first (intervention A) or second (intervention B) measles case occurring in the respective institution.</p> <p>Results</p> <p>Among the 217 Bavarian measles cases identified from March-July 2008, 28 (13%) cases were attendees of the anthroposophic school in Austria. In total, vaccination status was known in 161 (74%) cases and 156 (97%) of them were not vaccinated. The main factor for non-vaccination was "fear of vaccine-related adverse events" (33%). Twenty-nine (18%) of 161 cases suffered complications. Exclusively genotype D5 was detected. Overall, 184 cases could be epidemiologically grouped into 59 clusters. Of those, 41 clusters could be linked to households and 13 to schools or kindergartens. The effect of intervention A and B was analysed in 10 school or kindergarten clusters. Depending on the respective intervention A or B, the median number of cases per cluster was 3 versus 13 (p = 0.05), and the median duration of a cluster was 3 versus 26 days (p = 0.13).</p> <p>Conclusions</p> <p>Introduction of measles virus into a pocket of susceptible persons (e.g. vaccination opponents or sceptics) may lead to large outbreaks in the general population, if the general population's vaccination coverage is below the WHO recommended level. Education on the safety of measles vaccine needs to be strengthened to increase measles vaccination coverage. Early intervention may limit spread in schools or kindergartens. Suspected measles has to be reported immediately to the local health authorities in order to allow intervention as early as possible.</p