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Measles eradication: is it in our future?
W A Orenstein1, P M Strebel, M Papania
1National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga. 30333, USA.
Abstract:
Measles eradication would avert the current annual 1 million deaths and save the $1.5 billion in treatment and prevention costs due to measles in perpetuity. The authors evaluate the biological feasibility of eradicating measles according to 4 criteria: (1) the role of humans in maintaining transmission, (2) the availability of accurate diagnostic tests, (3) the existence of effective vaccines, and (4) the need to demonstrate elimination of measles from a large geographic area. Recent successes in interrupting measles transmission in the United States, most other countries in the Western Hemisphere, and selected countries in other regions provide evidence for the feasibility of global eradication. Potential impediments to eradication include (1) lack of political will in some industrialized countries, (2) transmission among adults, (3) increasing urbanization and population density, (4) the HIV epidemic, (5) waning immunity and the possibility of transmission from subclinical cases, and (6) risk of unsafe injections. Despite these challenges, a compelling case can be made in favor of measles eradication, and the authors believe that it is in our future. The question is when.
Insights
Measles eradication is biologically feasible, offering a future free from millions of deaths and billions in costs. Despite challenges like political will and transmission dynamics, global measles elimination is achievable.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Vaccinology
Background:
- Measles currently causes approximately 1 million deaths annually.
- Global measles control efforts face significant economic burdens related to treatment and prevention.
Purpose of the Study:
- To evaluate the biological feasibility of global measles eradication.
- To assess the criteria necessary for successful measles elimination.
Main Methods:
- Analysis of four key criteria for eradication: human role in transmission, diagnostic accuracy, vaccine efficacy, and geographic elimination.
- Review of successful measles transmission interruption in various regions.
Main Results:
- Measles eradication is biologically feasible, supported by successful elimination in the Western Hemisphere and other regions.
- Identified impediments include political will, adult transmission, urbanization, HIV, waning immunity, and unsafe injections.
Conclusions:
- Despite significant challenges, a strong case supports the pursuit of global measles eradication.
- Measles eradication is considered an achievable future goal, contingent on addressing identified obstacles.