Progress toward measles elimination--Western Pacific Region, 2009-2012

Abstract

In 2005, the World Health Organization (WHO) Regional Committee for the Western Pacific Region (WPR) resolved that WPR should aim to eliminate measles by 2012. The recommended measles elimination strategies in WPR include 1) achieving and maintaining high (≥95%) coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services and by implementing supplementary immunization activities (SIAs), when required; 2) conducting high-quality, case-based measles surveillance; 3) ensuring high-quality laboratory surveillance, with timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus for genotyping and molecular analysis; and 4) establishing and maintaining measles outbreak preparedness for rapid response and ensuring appropriate case management. This report updates the previous report and describes progress toward eliminating measles in WPR during 2009-2012. During this period, measles incidence reached a historic low, decreasing by 83%, from 34.0 to 5.9 cases per million population. However, to achieve measles elimination in WPR, additional efforts are needed to strengthen routine immunization services in countries and areas with <95% coverage with the routine first (MCV1) or second dose of MCV (MCV2), to introduce a MCV2 dose in the four remaining countries and areas that do not yet have a routine 2-dose MCV schedule, and to use SIAs to close immunity gaps among measles-susceptible populations in countries and areas that have ongoing measles virus transmission.

FIGURE

Confirmed measles cases,* by month of rash onset — World Health Organization Western Pacific Region (WPR), 2009–2012 Abbreviation: SIA = supplementary immunization activity. * Confirmed measles cases reported by countries and areas to World Health Organization. A case of measles is confirmed by serology when measles-specific immunoglobulin M antibody is detected in a person who was not vaccinated in the previous 30 days. A case of measles is confirmed by epidemiologic linkage when linked in time and place to a laboratory-confirmed measles case but lacks serologic confirmation. During 2009–2012, a case of measles meeting the case definition but without a specimen collected could be reported as clinically confirmed. ^† SIA conducted in China in which approximately 100 million children aged 8–179 months were vaccinated against measles, with targeted age group varying by province.