189205 Global measles control: Current status and implications for measles control in the United States

Tuesday, October 28, 2008: 2:35 PM

Amra Uzicanin, MD , Global Immunization Division, CDC, Atlanta, GA
Amy A. Parker, MSN, MPH , Division of Viral Diseases, CDC, Atlanta, GA
Brent Burkholder, MD, MA , Global Immunization Division, CDC, Atlanta, GA
Stephen L. Cochi, MD, MPH , Global Immunization Division, CDC, Atlanta, GA
Before live attenuated measles vaccine became available in the early 1960s, measles caused an estimated 135,000,000 cases and >6,000,000 deaths annually worldwide. Following worldwide introduction of routine measles immunization during 1970-1980s, global measles disease burden declined, with an estimated 1,900,000 deaths in 1987.

In 1994, the Pan-American Health Organization (PAHO) resolved to eliminate indigenous measles from the Americas by 2000; this goal was achieved by late 2002 through a combination of routine and supplemental immunization activities (SIAs) and improved measles surveillance. Three additional regions established a measles elimination goal: the European (EUR) and the Eastern Mediterranean Region (EMR) by 2010, and the Western Pacific Region (WPR) by 2012. However, measles continues to widely circulate in each of these three regions; in 2007, a total of 11,071, 4,557, and 1,374 cases were reported by EMR, EUR and WPR, respectively, compared to 167 cases reported by PAHO.

As recently as 2000, measles caused an estimated 757,000 deaths worldwide. By 2006, increased routine measles vaccination coverage, combined with the estimated 478,000,000 children vaccinated through SIAs, primarily in the African region, reduced the estimated number of global measles deaths to 242,000.

In the US, measles was declared eliminated in 2000. However, during 2000-2007 a total of 501 measles cases, including two deaths, were reported, and 39 measles outbreaks occurred in 16 states. Since 2004, all US outbreaks have been traced to an imported source, suggesting that the risk of measles remains high as long as measles remains endemic in other parts of the world.

Learning Objectives:
After this presentation, the attendees will be able to: 1. Describe the clinical features of measles and the current status of global measles control; 2. Recognize the difference between the global measles mortality reduction goal and regional goals to eliminate indigenous measles virus transmission; 3. Articulate the implications of global measles control for sustaining measles elimination in the United States and define strategies for reducing risk of measles in the US population.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a medical doctor / epidemiologist working at the CDCís Global Immunization Division (GID) since 2000 on issues related with global vaccine-preventable disease control with emphasis on the global measles control and the efforts to eliminate measles and rubella in several regions of the world, including Europe and the Americas. As an alumna of the CDCís Epidemic Intelligence Service (EIS) program in the EIS class of 1998, I have been responsible for teaching and mentoring of the subsequent classes of EIS officers both as the primary and secondary supervisor. In addition, I have been teaching in a number of other CDC-supported programs, including the ongoing trainings for the Stop Transmission of Polio (STOP) volunteers. I currently serve as the Science, Policy and Research Coordinator for the GIDís Disease Elimination and Eradication Branch, and in that capacity I lead and coordinate Branchí efforts to develop and implement policies and strategies relevant for achieving the global and regional vaccine-preventable disease control goals and to establish research and evaluation agenda in collaboration with external partners, including World Health Organization and Pan-American Health Organization.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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