La eliminación del sarampión en Cuba

Abstract

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.

Identification of human parvovirus B19 among measles and rubella suspected patients from Cuba

“…The country reported measles and rubella elimination in 1983 and 2004, respectively, as part of the PAHO/WHO strategy . Sensitive rash and fever disease surveillance and laboratory investigation of every suspected case are well‐established, While outbreaks of dengue are reported occasionally, little is known about the incidence of B19V and HHV6 in Cuba.…”

Simulación del nivel de eliminación de sarampión y rubéola según la estratificación e interacción social

“…En Estados Unidos, donde se documentó la interrupción de la transmisión sostenida de rubéola en 2004, a pesar de los esfuerzos planeados para incrementar los niveles de inmunización entre los años 1980 y 1990, se presentaron brotes de rubéola en comunidades cerradas en donde el número promedio de contactos habituales podría ser mayor, como escuelas, universidades, bases militares, hospitales, prisiones, sitios de trabajo, comunidades de inmigrantes y entre individuos quienes rechazan la vacunación (22). Una experiencia similar, se ha descrito en la eliminación de sarampión y rubéola en otros países (23,24).…”

La salud en Cuba y los objetivos de desarrollo del milenio

“…Las enfermedades infecciosas prevenibles han desaparecido prácticamente como causa de muerte en Cuba (13), ya que posee uno de los programas de vacunación más activos y completos del mundo (21). Sin embargo, la situación geográfica y climática de la Isla y su creciente intercambio con países en los que diversas enfermedades tropicales Rev Panam Salud Publica/Pan Am J Public Health 21 4 son endémicas crean las condiciones propicias para la reemergencia de algunas de ellas.…”