Case based measles surveillance in Pune evidence to guide current and future measles control and elimination efforts in India.

Wednesday, 11th of November 2015

BACKGROUND

According to WHO estimates 35% of global measles deaths in 2011 occurred in India. In 2013 India committed to a goal of measles elimination by 2020. Laboratory supported case based measles surveillance is an essential component of measles elimination strategies. Results from a case-based measles surveillance system in Pune district (November 2009 through December 2011) are reported here with wider implications for measles elimination efforts in India.

METHODS

Standard protocols were followed for case identification investigation and classification. Suspected measles cases were confirmed through serology (IgM) or epidemiological linkage or clinical presentation. Data regarding age sex vaccination status were collected and annualized incidence rates for measles and rubella cases calculated.

RESULTS

Of the 1011 suspected measles cases reported to the surveillance system 76% were confirmed measles 6% were confirmed rubella and 17% were non-measles non-rubella cases. Of the confirmed measles cases 95% were less than 15 years of age. Annual measles incidence rate was more than 250 per million persons and nearly half were associated with outbreaks. Thirty-nine per cent of the confirmed measles cases were vaccinated with one dose of measles vaccine (MCV1).

CONCLUSION

Surveillance demonstrated high measles incidence and frequent outbreaks in Pune where MCV1 coverage in infants was above 90%. Results indicate that even high coverage with a single dose of measles vaccine was insufficient to provide population protection and prevent measles outbreaks. An effective measles and rubella surveillance system provides essential information to plan implement and evaluate measles immunization strategies and monitor progress towards measles elimination.

Please find more graphic analysis in the weblink below

http://www.ncbi.nlm.nih.gov/pubmed/25290339

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