Progress in measles control--Zambia, 1999-2004

Zambia, a southern African country with estimated population of 11.6 million in 2005, reported 1,698-23,518 measles cases annually during 1991-1999. During that period, measles was considered one of the five major causes of morbidity and mortality among children aged <5 years. During 1999-2004, the challenge of controlling measles led Zambia to try several strategies in succession. In addition to a single dose of measles vaccine offered at age 9 months through routine services, in 1999, measles supplemental immunization activities (SIAs) targeting children aged 9 months-4 years were held in four urban centers. Those activities were followed in 2000 by a subnational measles SIA targeting children aged 9 months-4 years in approximately half of the country's 72 districts. In 2003, Zambia adopted a strategy of accelerated measles control that included strengthening routine vaccination, providing a second opportunity for measles immunization for all children, and conducting case-based surveillance. As part of this strategy, a nationwide measles SIA targeting all children aged 6 months-14 years was conducted in 2003. This report summarizes progress in measles control in Zambia during 1999--2004, as measured through surveillance data, which demonstrates a marked reduction in measles transmission after the 2003 SIA.