The Pediatric Infectious Disease Journal
July 2012 – Volume 31 – Issue 7  pp: A7-A8,667-794,e92-e98
http://journals.lww.com/pidj/pages/currenttoc.aspx

ESPID Reports and Reviews
Current Measles Outbreaks: Can We Do Better for Infants at Risk?
Machaira, Maria; Papaevangelou, Vassiliki
Pediatric Infectious Disease Journal. 31(7):756-758, July 2012.
doi: 10.1097/INF.0b013e31825ad11b

Extract
The implementation of measles vaccination policies worldwide has decreased the mortality rate attributed to measles by 78% between 2000 and 2008.1 Routine measles vaccination coverage in Europe and Central Asia has increased to 93%, thus resulting steadily in <1000 deaths per year from 1999 to 2004. During the same period, the most significant reduction in mortality has been observed in the sub-Saharan African region (from 530,000 to 216,000 deaths per year) due to the increase in measles vaccination coverage (from 49% to 65%).2 However, outbreaks continue to occur highlighting the major obstacles to measles eradication, phenomena that are directly associated with pockets of susceptible children and adults due to accumulation of subjects with suboptimal vaccination coverage. Moreover, globalization, including enhanced travel and migration of population groups, impedes the elimination of measles.3,4 Recent data support that infants too young to get immunized are at increased risk due to earlier loss of maternal antibodies in offspring of vaccinated mothers.5 Moreover, current outbreaks have shown that although the majority of cases involve susceptible young adults, there has been an increase in the percentage of infants affected.6,7 In Germany, the age-specific incidence of measles has increased between 2001 and 2006, while in France an increase in the percentage of infants affected was observed between 2008 and 2010.8,9 Table 1 summarizes the most recent measles outbreaks over the past couple of years in the developed world and the percentage of infants involved. This article reviews the window of susceptibility for infection during infancy, occurring from the loss of passively acquired maternal antibodies through the first dose of recommended vaccination, and also identifies potential solutions in light of current global epidemics…