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  • Title: Measles elimination by the year 2000.
    Journal: EPI Newsl; 1994 Oct; 16(5):1-2. PubMed ID: 12288433.
    Abstract:
    The 24th Pan American Sanitary Conference (PASC), which was held in Washington, D.C. in September 1994, targeted Year 2000 for elimination of measles in the Americas based on the success of a PAHO strategy. This article gives a brief history of measures taken in the Americas to eliminate measles. After a vaccine was licensed in 1963, the reported number of cases dropped between 1964 and 1969. A 10-year plan developed by the Ministers of Health in 1970 set a goal of reducing measles mortality to 1.0 cases per 100,000 in 1980. Since sound control strategies were not implemented, this goal was not met (except in the Bahamas, Barbados, Canada, Cuba, and the United States). Although coverage improved with the introduction of the EPI in 1977, it was not uniform. By the end of 1980, 67% of children aged 12-23 months in Costa Rica (the high) were vaccinated; however, only 31% in Santo Domingo in the Dominican Republic (the low) were. Because of the use of measles vaccines in national immunization programs, 53% of children under 12 months of age by 1984 and 76% by 1990 were vaccinated. However, by 1984, measles outbreaks were occurring in cycles every 3-4 years; this was due to accumulation of large pools of susceptibles over a period of time. Epidemics were appearing in countries with measles coverage rates greater than 95% (the United States) and were seen in older age groups. In order to eliminate the pockets of susceptibles, Cuba launched a program in 1986, with the support of PAHO, in which all children between 9 months and 14 years of age, regardless of their previous vaccination or disease histories, were vaccinated. Thereafter, each new cohort of newborns was vaccinated. By 1992-1994, almost every country in the region adopted the PAHO strategy; the number of cases decreased dramatically. The chart included in the paper depicts the number of measles cases for the Americas from 1960-1994 with accompanying notes on actions taken.
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