Measles and Rubella Elimination Initiatives in the Americas: Lessons Learned and Best Practices

Castillo‐Solórzano, Carlos; Marsigli, Christina; Danovaro-Holliday, M. Carolina; Ruiz-Matus, Cuauhtémoc; Tambini, Gina; Andrus, Jon Kim

doi:10.1093/infdis/jir216

Cited by 28 publications

(21 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Analysis of notification data indicates that Bavaria was hit by a major measles outbreak every two–three years between 2001 and 2013 27 , 28 . The absence of characteristically prolonged interepidemic spacing intervals suggests that Bavaria has probably not yet reached a pre-elimination phase 29 . In contrast, we found that measles incidence in the western area followed a constantly decreasing trend between 2007 and 2011.…”

Section: Discussioncontrasting

confidence: 55%

Measles incidence and reporting trends in Germany, 2007–2011

Takla

Wichmann

Rieck

et al. 2014

Bull. World Health Organ.

View full text Add to dashboard Cite

ObjectiveWe aimed to quantify progress towards measles elimination in Germany from 2007 to 2011 and to estimate any potential underreporting over this period.MethodsWe determined the annual incidence of notified cases of measles – for each year – in northern, western, eastern and southern Germany and across the whole country. We then used measles-related health insurance claims to estimate the corresponding incidence.FindingsIn each year between 2007 and 2011, there were 6.9–19.6 (mean: 10.8) notified cases of measles per million population. Incidence decreased with age and showed geographical variation, with highest mean incidence – 20.3 cases per million – in southern Germany. Over the study period, incidence decreased by 10% (incidence rate ratio, IRR: 0.90; 95% confidence interval, CI: 0.85–0.95) per year in western Germany but increased by 77% (IRR: 1.77; 95% CI: 1.62–1.93) per year in eastern Germany. Although the estimated incidence of measles based on insurance claims showed similar trends, these estimates were 2.0- to 4.8-fold higher than the incidence of notified cases. Comparisons between the data sets indicated that the underreporting increased with age and was generally less in years when measles incidence was high than in low-incidence years.ConclusionGermany is still far from achieving measles elimination. There is substantial regional variation in measles epidemiology and, therefore, a need for region-specific interventions. Our analysis indicates underreporting in the routine surveillance system between 2007 and 2011, especially among adults.

show abstract

Section: Discussioncontrasting

confidence: 55%

Measles incidence and reporting trends in Germany, 2007–2011

Takla

Wichmann

Rieck

et al. 2014

Bull. World Health Organ.

View full text Add to dashboard Cite

show abstract

“…Immunization coverage in the Mesoamerican region is generally high, but this study highlights the importance of studying not only coverage, but also effective coverage [Santos, ]. While studies of population measles serology in Mesoamerica have existed for more than 40 years [Golubjatnikov et al, ; Golubjatnikov et al, ], and while the importance of serosurveys in tracking progress toward elimination is well‐established [Castillo‐Solorzano et al, , ], there has been little expansion or incorporation of serosurveys in routine monitoring. The procedures described herein can be incorporated into existing data collection protocols in resource‐limited settings to monitor measles exposures, herd immunity, and effectiveness of immunization programs.…”

Section: Discussionmentioning

confidence: 99%

Use of a commercial ELISA for the detection of measles-specific immunoglobulin G (IgG) in dried blood spots collected from children living in low-resource settings

et al. 2015

View full text Add to dashboard Cite

Seroepidemiological monitoring of population immunity to vaccine-preventable diseases is critical to prevent future outbreaks. Dried blood spots (DBS), drops of capillary blood dried on filter paper, are an affordable, minimally invasive alternative to venipuncture for collecting blood in field settings. However, few proven methods exist to analyze DBS for the presence of protective antibodies. This study validates a novel technique for measuring measles-specific immunoglobulin G (IgG) in capillary DBS using a commercial ELISA. The predictive performance of a new method for analyzing DBS was tested by comparing matched serum and DBS samples from 50 children. The accuracy, precision, and reliability of the procedure were evaluated, and the optimal cut points to classify positive and negative samples were determined. The method was then applied to 1,588 DBS collected during a large survey of children in Mexico and Nicaragua. Measles-specific IgG in serum samples were 62% negative, 10% equivocal, and 28% positive. In comparisons with matched serum, DBS results were 100% sensitive and 96 · 8% specific, and agreed in 46 of 50 (92%) cases. The inter-assay and intra-assay coefficients of variation from kit-provided controls were greater than desired (24.8% and 8.4%, respectively). However, in predictive simulations the average misclassification was only 3.9%. Procedures were found to be acceptable to surveyors and participants. Analyzing DBS collected in low-resources settings is a feasible and accurate means of measuring population immunity to measles and should be used to generate objective measures of health status and health system performance.

show abstract

“…However, the large burden of disease among young adults, which we see in this study, suggests that an SIA targeting adults aged 20-40 years could be useful. Previous research on measles elimination in the Americas has shown that SIAs for adults have been important in closing immunity gaps and moving towards elimination [29]. Moreover, given that the WHO WPR has also adopted a resolution for members to accelerate control of rubella, combining measles and rubella vaccines in SIAs for adults and other age groups would be a cost-effective mechanism to regionally eliminate both diseases [30].…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of measles in Tianjin, China, 2005–2014

Wang

Boulton

Montgomery

et al. 2015

Vaccine

View full text Add to dashboard Cite

Background Measles incidence in China has declined over the last decade and elimination is targeted by 2020. Despite increases in routine immunization services and supplementary immunization activities (SIAs), periodic outbreaks continue to occur. In this paper, we examine measles epidemiology during 2005 to 2014 in Tianjin, China. Methods Measles case data were extracted from a web-based communicable disease surveillance system. We examined the socio-demographic characteristics of measles case-patients, including age, sex, urbanicity, residency status, and vaccination history. Demographic characteristics of cases were compared to the general population. Results From January 1, 2005 through December 31, 2014, 12,466 measles cases in Tianjin were reported. Among cases, 7,179 (57.6%) were male, and 5,287 (42.4%) were female. Over time, more cases occurred in adults, and for the 2,711 cases in 2014, the majority were either infants <1 year (558, 20.58%) or adults ≥20 years (2,043, 75.36%). Municipal-wide SIAs in Tianjin occurred in 2008 and 2010 with reductions in measles cases the following year for both (189 cases in 2009, and 37 cases in 2011). The number of cases rebounded to pre-SIA levels or higher within 1-3 years following each SIA: 1,990 cases in 2010 and 2,711 cases in 2014. Vaccination status was reported as “none” or “unknown” for 84% of all reported measles cases. Conclusions Despite the general decline in cases, measles outbreaks continue to occur. Although the SIAs reduce numbers in their immediate aftermath, case counts rebound 1-3 years after the intervention. Continued monitoring of cases through disease surveillance activities accompanied by targeted immunization activities, including to adults, can help ensure progress toward elimination.

show abstract

Measles and Rubella Elimination Initiatives in the Americas: Lessons Learned and Best Practices

Cited by 28 publications

References 9 publications

Measles incidence and reporting trends in Germany, 2007–2011

Measles incidence and reporting trends in Germany, 2007–2011

Use of a commercial ELISA for the detection of measles-specific immunoglobulin G (IgG) in dried blood spots collected from children living in low-resource settings

The epidemiology of measles in Tianjin, China, 2005–2014

Contact Info

Product

Resources

About