Measles epidemic in Brazil in the post-elimination period: Coordinated response and containment strategies.

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Vaccine. 2017 Feb 27. pii: S0264-410X(17)30217-7. doi: 10.1016/j.vaccine.2017.02.023. [Epub ahead of print]

Measles epidemic in Brazil in the post-elimination period: Coordinated response and containment strategies.

Lemos DR¹ Franco AR² de Sá Roriz ML³ Carneiro AK⁴ de Oliveira Garcia MH⁵ de Souza FL⁶ Duron Andino R⁷ de Góes Cavalcanti LP⁸.

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Abstract

The measles virus circulation was halted in Brazil in 2001 and the country has a routine vaccination coverage against measles mumps and rubella higher than 95%. In Ceará the last confirmed case was in 1999. This article describes the strategies adopted and the effectiveness of surveillance and control measures implemented during a measles epidemic in the post-elimination period. The epidemic started in December 2013 and lasted 20 months reaching 38 cities and 1052 confirmed cases. The D8 genotype was identified. More than 50000 samples were tested for measles and 86.4% of the confirmed cases had a laboratory diagnosis. The beginning of an campaign vaccination was delayed in part by the availability of vaccine. The classic control measures were not enough to control the epidemic. The creation of a committee of experts the agreement signed between managers of the three spheres of government the conducting of an institutional active search of suspected cases vaccination door to door at alternative times the use of micro planning a broad advertising campaign at local media and technical operative support contributed to containing the epidemic. It is important to recognize the possibility of epidemics at this stage of post-elimination and prepare a sensitive surveillance system for timely response.