Lessons from worldwide measles out-breaks in 2011-2012 and prevailing challenges in eliminating measles

Abstract

Measles is a leading cause of under-five mortality among vaccine preventable diseases in today’s developing world. In fact, Tanzania has been experiencing measles out-breaks almost every year. Since last year, the world has experienced several out-breaks in several areas including many developed countries with high routine immunization coverage above 95%. The affected people age ratio of children and adults was almost 50%. In Tanzania, children are immunized against measles at 9 months in the routine Expanded Program of Immunization (EPI). Adults are not re-immunized against measles since MMR is not in the national policy.
The Government of Tanzania has also conducted integrated measles campaign in September 2009 and November 2011 to offer an opportunity for a second chance booster dose to children aged 0 to 60 months. The 2009 campaign consisted of measles immunization along with Vitamin A supplementation and deworming while last year measles and polio vaccines were delivered along with Vitamin A and de-worming. Increasing number of unvaccinated and non immunized people is perceived to be the cause of cyclical out-breaks worldwide. Most of the developed western countries have routine immunization coverage above 98% with additional
measles protection opportunity with MMR vaccine coverage above 90% on their national routine immunization programs. Emerging measles cases in developed countries with high routine immunization coverage and where measles was either eliminated or was expected to be eliminated have brought emerging challenges, new lessons and new questions to the globe and thus need new approaches and new strategies to develop against this serious problem.

KEY WORDS: Measles, Out-breaks, Challenges, Lessons