Progress Toward Regional Measles Elimination — Worldwide

Measles is a highly contagious viral disease transmitted via aerosolized respiratory droplets of infected persons. Initial symptoms 10–12 days after infection include fever, runny nose, and bloodshot eyes. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards. Measles infection is systemic, effecting organs throughout the body. There is no specific treatment and it can be severe, particularly in malnourished children and people with reduced immunity. Measles complications include blindness, encephalitis, severe diarrhoea, ear infection, pneumonia and death. During 2000-2014, the number of estimated measles deaths decreased 79% from 546,800 to 114,900, and 17.1 million lives were saved, largely due to increased vaccination coverage. However, progress toward increasing immunization coverage has recently stagnated. During 2000-2010, global estimated coverage with the first dose of the measles vaccine increased from 72% to 85%, but has remained unchanged. All countries include at least one dose of measles-containing vaccine in their routine vaccination schedule; however, only 122 (63%) have ≥90% coverage. Additionally, nearly half of the world’s children do not receive the recommended routine second dose of the vaccine. In 2014, supplemental mass vaccination campaigns with support from the Measles & Rubella Initiative and Gavi, the Vaccine Alliance, reached approximately 221 million children in 29 countries. Since 2000, supplemental campaigns have reached 2 billion children with measles vaccination. In part due to these campaigns in the Democratic Republic of the Congo and Nigeria, cases dropped in the African Region from >171,000 in 2013 to <74 000 in 2014. The WHO Eastern Mediterranean, European and the South-East Asia regions also had decreases in measles incidence in 2014. However, due to gaps in vaccination coverage, measles outbreaks continue to occur. The Americas and Western Pacific regions had increased numbers of cases in 2014, due to large outbreaks in China, the Philippines, and Viet Nam. Measles outbreaks sustain transmission of the virus and lead to importations into other countries and regions. Because measles is highly infectious, sustained efforts are needed to achieve and maintain high two-dose vaccination coverage. In addition to strengthening vaccination policies and practices, research and innovations are needed to advance technologies, such as microarray skin vaccination that will enable efforts to reach more of the world’s children with vaccination and eventually eradicate measles.