PAHO urges strong surveillance, vaccination coverage after recent measles outbreaks

Following recent measles outbreaks in the United States of America and Brazil, the Pan American Health Organisation/World Health Organisation (PAHO/WHO) has urged countries to maintain high levels of measles vaccination coverage at national and local levels.

In an epidemiological alert issued on Monday, PAHO/WHO said measles elimination is facing “major challenges,” while noting the ongoing importation of measles in some countries. As a result, it urged countries to strengthen measles surveillance activities and to take appropriate measures to protect residents in the Americas against measles and rubella.

The alert reported a total of 147 confirmed measles cases in four countries in the Americas up to Sunday; these include 121 cases in the United States, 21 in Brazil, four in Canada and one in Mexico. The cases in Brazil, the alert said, are part of a larger outbreak which began in early 2013 and has sickened more than 700 people in 31 municipalities.

In a news release issued on Tuesday, PAHO/WHO said the recent outbreaks suggest immunisation rates in some areas have dropped below levels needed to prevent the spread of cases imported into the Americas.

“Maintaining high levels of vaccine coverage is key to preventing and halting outbreaks and to protect our populations from the constant threat of imported cases,” Dr Cuauhtemoc Ruiz, Head of PAHO/WHO’s immunisation programme, was quoted as saying in the release.

Although countries in the Americas have reported cases imported from other regions over the last decade, Ruiz said, they have not led to significant outbreaks. “The current outbreaks point to gaps in immunisation that could allow measles and other vaccine-preventable diseases to take hold again and begin spreading in our hemisphere,” he, however, added.

PAHO/WHO said the measles vaccine has been used for more than 50 years and has proven to be safe and effective. It credited the vaccine with preventing an estimated 15.6 million deaths between 2000 and 2013.

It added that children should have two doses of the vaccine before their fifth birthday, with levels of coverage of those doses to be maintained at 95% or more to prevent spread of imported cases. Currently, 92% of one-year-olds in the Americas are estimated to have receive the first dose of the measles vaccine, it noted.

As a result of the recent outbreaks, PAHO/WHO has urged health authorities in member countries to:

Maintain high levels of measles vaccination coverage at the national and local levels.

Advise travellers going to regions with measles circulation to be sure to have current measles vaccines (not applicable to infants under 6 months who should not be vaccinated).

Inform travellers of measles symptoms and necessary steps to follow if infection is suspected.

Require proof of measles immunity from healthcare workers (inclusive of medical, administrative and security personnel) and advise tourism and transportation personnel to be fully immunised.

Sensitise private sector health personnel to report suspected cases immediately

If imported measles are detected, conduct contact tracing and, depending on contacts’ travel history, inform health authorities abroad about the possible location of contacts in their countries.

According to PAHO/ WHO, currently an international verification committee has been compiling evidence to support a formal declaration of the Americas region as measles-free. It said this would make the Americas the world’s first region to eliminate measles and the achievement would be on par with similar achievement such as the elimination of smallpox in the 1970s and polio in the 1990s.

The release further noted that the region is also on track to be certified as rubella free. It added that these achievements were made possible due to the region’s high immunisation levels through routine programmes and mass vaccination campaigns, such as the annual Vaccination Week in the Americas which PAHO/ WHO has spearheaded for the past 13 years.




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