Hib vaccination of all children under 2 years of age in Cuba greatly reduced the incidence of Hib meningitis, as measured by the National Bacterial Meningitis Reporting System.

Our results suggest that in a country with high population immunity, vaccine-derived virus is unlikely to establish ongoing circulation.

Vaccination with two or three doses of IPV resulted in a rate of seroconversion of at least 90%, except for seroconversion against type 2. The viral titer of OPV shed in the stool after OPV challenge was reduced in both groups receiving IPV. (ClinicalTrials.gov number, NCT00260312 [ClinicalTrials.gov].).

The vaccine against measles came into use in Cuba in 1971. During the seventies, a new early strategy for measles control was established, and it was followed by further efforts in the early eighties. Despite improvements to the control program, disease outbreaks continued to occur. In 1986, after examining the experience acquired through the control initiatives that were already in place, a new measles vaccination strategy was adopted. In time, the new vaccination strategy against measles came to have three main components: first, a single vaccination "catching-up" campaign targeting children 1 to 14 years of age. Second, efforts were made to achieve and maintain high vaccine coverage through mandatory vaccination services for 12-month-old children ("maintenance vaccination"). Finally, periodic "follow-up" campaigns were carried out for children 2 to 6 years of age. Steps were taken, for the purpose of monitoring the progress made so far toward eliminating measles, to strengthen disease surveillance systems, including the screening of suspected cases. The "catching-up" and "follow-up" campaigns both achieved greater than 98% coverage within targeted age groups. The routine vaccination program has also maintained high coverage. The high population immunity against measles that has been attained through these vaccination strategies has resulted in a rapid decrease in the incidence of the disease. From 1989 to 1992, less than 20 laboratory-confirmed cases were reported annually. In Cuba, the last case confirmed through serologic screening was reported in July 1993. Cuba's strategy for measles elimination has interrupted disease transmission and kept the causal virus from circulating on the island. Cuba's experience with measles elimination suggests that if an appropriate vaccination strategy is applied, measles can be globally eradicated.

Vaccination with the measles, mumps and rubella vaccine decreased the mumps incidence in Cuba, but in 2006 and 2007 an outbreak with more than 1000 laboratory confirmed cases occurred, mainly among high school and university students. The objective of the study was to investigate mumps epidemiology in Cuba between 2004 and 2015 and provide an in-depth laboratory characterization of selected samples from mumps patients. Samples from 116 cases (throat swabs, urines, paired acute and convalescent serum samples) were tested for mumps-specific IgM antibodies by ELISA, in a hemagglutination inhibition assay (HIA) or by RT-PCR. IgM antibodies were found in 80.2% of cases. 48.3% of first sera were positive, 30 of which were collected within two days after symptom onset. Testing of all 116 paired sera by HIA showed seroconversion in 55.2% individuals and an at least fourfold increase in antibodies in 44.8% of cases. In 18 out of the 111 vaccinated people (16.2%) no IgM antibodies were detected, neither in the acute nor the convalescent sera, but 14 of them showed seroconversion by HIA and 4 had an at least fourfold increase of hemagglutinin antibody titers. In the RT-PCR, 23 acute phase sera, 4 throat swabs and 5 urines were positive. Detection of mumps-specific IgM antibodies by ELISA and additional diagnostic methods may be required in settings with high vaccination coverage rates.

médico especialista en medicina general integral y epidemiología, con master en epidemiología.Profesor asistente e investigadora auxiliar, Ins-

No abstract

Cuba eliminated polio in 1962 and was among the ¿ rst countries to do so. Since then, only 20 cases of vaccine-derived paralytic poliomyelitis have been reported. Because Cuba used oral poliovirus vaccine exclusively in two mass campaigns usually in February and April each year, Sabin viruses were detected only within approximately 6-8 weeks after each annual campaign. This made Cuba a very attractive site to study the epidemiology of poliomyelitis in a tropical country without risk of secondary transmission of Sabin viruses for a large part of each year, an advantage over countries that used oral poliovirus vaccine continuously throughout the year in routine immunization programs. This report summarizes the unique scienti¿ c collaboration between Cuba's Ministry of Public Health and WHO, with participation by US scientists, in the global effort to eradicate polio.