Progress in accelerated measles control in the People's Republic of China, 1991-2000

Measles incidence decreased dramatically following widespread use of measles vaccine in China in 1965. To evaluate continued progress in accelerated measles control, data on measles cases reported to the National Notifiable Disease Reporting System during 1991 to 2000 were analyzed. From 1991-1995 to 1996-2000, average annual measles incidence decreased from 9.0 to 5.7 cases per 100,000 population, mortality rates fell from <0.3 to 0.1 deaths per million population, and the percentage of China's total population residing in provinces with a measles incidence of <2 cases per 100,000 population and having a measles elimination goal increased from 21% to 29%. Incidence rates were highest in western provinces and in infants and young children. Additional attention must be focused on western provinces and toward ensuring that all infants are immunized. Achieving high routine two-dose coverage with measles vaccine and enforcing school entry requirements may be highly effective strategies to support further gains in measles control.