Progress Toward Measles Control - African Region, 2001-2008 by ProQuest

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In 2001, the countries of the World Health Organization African Region became part of a global initiative with a goal of reducing the number of measles deaths by 50% by 2005, compared with 1999. Here, a report that summarizes the progress made during 2001-2008 toward improving measles control in AFR is presented. Supplemental immunization activities provide a second opportunity for measles immunization to all children, including those not vaccinated; approximately 15% of children vaccinated with a single dose at age 9 months will not develop immunity to measles. A CDC editorial note is also presented.

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									1036                                                                        MMWR                                          September 25, 2009


                         Acknowledgments                                         estimated MCV1 coverage increased from 57% to 73%, SIAs
 This report is based, in part, on contributions by K Bisgard, DVM,              vaccinated approximately 398 million children, and reported
Office of Workforce and Career Development, CDC.                                 measles cases decreased by 93%, from 492,116 in 2001 to
References                                                                       32,278 in 2008. By 2005, global measles deaths had decreased
 1. CDC. Final 2000 reports on notifiable diseases. MMWR 2001;50:712.            by 60%, and the AFR goal had been achieved (3); AFR adopted
 2. CDC. Final 2007 reports of nationally notifiable infectious diseases.
    MMWR 2008;57:906.                                                            a new goal to reduce deaths by 90%, compared with 2000,
 3. Demma LJ, Holman RC, McQuiston JH, et al. Human monocytic                    and that goal was achieved in 2006 (3,4). However, inaccu-
    ehrlichiosis and human granulocytic anaplasmosis in the United States,       racies in reported vaccination coverage exist, surveillance is
    2001–2002. Am J Trop Med Hyg 2005;73:400–9.
 4. Rand PW, Lacombe EH, Dearborn R, et al. Passive surveillance in
                                                                                 suboptimal, and measles outbreaks continue to occur in AFR
    Maine, an area emergent for tick borne diseases. J Med Entomol               countries. Further progress in measles control will require full
    2007;44:1118–29.                                                             implementation of recommended strategies, including valida-
 5. Council of State and Territorial Epidemiologists. Revision of the national   tion of vaccination coverage.
    surveillance case definition for ehrlichiosis (ehrlichiosis/anaplasmosis).
    Available at http://www.cste.org/ps/2007ps/2007psfinal/id/07-id-03.pdf.         Since the 1980s, AFR countries have reported measles vac-
 6. Wong S, Brady G, Dumler JS. Serologic responses to Ehrlichia equi,           cination coverage and the number of measles cases each year
    Ehrlichia chaffeensis, and Borrelia burgdorferi in patients from New York    to the WHO African Regional Office (AFRO), using the
    State. J Clin Microbiol 1997;35:2198–205.
 7. Childs JE, Sumner JW, Massung RF, et al. Outcome of diagnostic               WHO and United Nations Children’s Fund (UNICEF) Joint
    tests using samples from patients with culture-proven human mono-            Reporting Form. These data are collected through adminis-
    cytic ehrlichiosis: implications for surveillance. J Clin Microbiol          trative reports from routine vaccination programs and SIAs
    1999;37:2997–3000.
 8. Comer JA, Nicholson WL, Olson JG, et al. Serologic testing for human
                                                                                 and routine surveillance systems that provide aggregated case
    granulocytic ehrlichiosis at a national referral center. J Clin Microbiol    counts based on clinical diagnosis. Estimates of routine cov-
    1999;37:558–64.                                                              erage with MCV1 are based on review of coverage data from
 9. Steiner FE, Pinger RR, Vann CN, et al. Infection and co-infection            administrative records, surveys, national reports, and consulta-
    rates of Anaplasma phagocytophilum variants, Babesia spp., Borrelia
    burgdorferi, and the rickettsial endosymbiont in Ixodes scapularis from      tion with local and regional experts. Coverage achieved during
    sites in Indiana, Maine, Pennsylvania, and Wisconsin. J Med Entomol          nationwide SIAs against measles are reported on the basis of
    2008;45:289–97.                                                              the reported number of doses administered, divided by the
10. CDC. Diagnosis and management of tickborne rickettsial diseases: Rocky
    Mountain spotted fever, ehrlichiosis, and anaplasmosis—United States.        target population.
    MMWR 2006;55(No. RR-4).                                                         In 1999, as part of the measles mortality reduction strat-
                                                                                 egy, case-based surveillance with laboratory testing for all
                                                                                 suspected measles cases was introduced with support from
                                                                                 WHO AFRO. A suspected measles case is defined as 1) any
  Progress Toward Measles Control                                                person with generalized maculo-papular rash and fever plus
                                                                                 cough or coryza or conjunctivitis or 2) any person in whom a
   — African Region, 2001–2008                                                   clinician suspects measles. Each suspected measles case should
   In 2001, the countries of the World Health Organization                       be reported using an individual case-investigation form, and a
(WHO) African Region (AFR) became part of a global initia-                       blood specimen should be collected and sent to the laboratory
tive with a goal of reducing the number of measles deaths by                     for measles-specific immunoglobulin M testing. Laboratory
50% by 2005, compared with 1999. Recommended strategies                          confirmation of individual cases is discontinued after an out-
for measles mortality reduction included 1) increasing rou-                      break has been confirmed as measles. An outbreak is confirmed
tine coverage for the first dose of measles-containing vaccine                   when three or more measles laboratory-confirmed cases are
(MCV1) for all children, 2) providing a second opportunity                       detected in a health facility or district in 1 month; subsequent
for measles vaccination through supplemental immunization                        cases are confirmed by epidemiologic link. An epidemiologic
activities (SIAs), 3) improving measles case management, and                     link is defined as a suspected measles case that did not have a
4) establishing case-based surveillance with laboratory confir-                  specimen collected for laboratory testing and is linked in per-
mation of all suspected measles cases (1). Before introduction                   son, place, and time to a laboratory-confirmed case (i.e., in a
of MCV throughout AFR, a
								
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