Progress toward measles elimination--Eastern Mediterranean Region, 2008-2012

Abstract

In 1997, the 22 countries in the World Health Organization (WHO) Eastern Mediterranean Region (EMR) adopted a goal of measles elimination by 2010. To achieve this goal, the WHO Regional Office for the Eastern Mediterranean Region (EMRO) developed a four-pronged strategy: 1) achieve ≥ 95% vaccination coverage of children with the first dose of measles-containing vaccine (MCV1) in every district of each country through routine immunization services, 2) achieve ≥ 95% vaccination coverage with the second dose of measles-containing vaccine (MCV2) in every district of each country either through a routine 2-dose vaccination schedule or through supplementary immunization activities (SIAs), 3) conduct high-quality, case-based surveillance in all countries, and 4) provide optimal clinical case management, including supplementing diets with vitamin A. Although significant progress was made toward measles elimination in the EMR during 1997-2007, the measles elimination goal was not reached by the target date of 2010, and the date was revised to 2015. This report updates previous reports and summarizes the progress made toward measles elimination in EMR during 2008-2012. From 2008 to 2012, large outbreaks occurred in countries with a high incidence of measles, and reported annual measles cases in EMR increased from 12,186 to 36,456. To achieve measles elimination in EMR, efforts are needed to increase 2-dose vaccination coverage, especially in countries with high incidence of measles and in conflict-affected countries, and to implement innovative strategies to reach populations at high risk in areas with poor access to vaccination services or with civil strife.

FIGURE

Number of reported measles cases,* by country’s measles status, and estimated percentage of children who received their first dose of measles-containing vaccine^† — World Health Organization (WHO) Eastern Mediterranean Region, 2008–2012 * Confirmed cases of measles reported to WHO and the United Nations Children’s Fund (UNICEF) through the Joint Reporting Form Regional Office for the Eastern Mediterranean Region. ^† By age 12 months or later if first dose was scheduled after age of 12 months. Data are from WHO and UNICEF estimates. ^§ Countries with high incidence or outbreaks were Afghanistan, Djibouti, Iraq, Pakistan, Somalia, South Sudan, Sudan, and Yemen.