Prevention of measles in Israel: short- and long-term intervention strategies

Measles morbidity and mortality have declined in Israel since the introduction of routine vaccination in 1967. The reported incidence of civilian cases of measles declined from 50/100,000 in 1968-72, to 27/100,000 in 1983-87. There was also a decrease from 108 to 49 measles deaths, and from 84 to 29 cases of subacute sclerosing panencephalitis in these respective periods. The measles epidemic in 1982 included 7,864 reported civilian cases with an additional 3,000 cases in the Israel Defense Forces. The 1985-86 epidemic included 4,956 reported civilian cases. Current immunity levels leave large numbers (15-20%) of children and young persons susceptible to the disease and its transmission. Despite the long-standing childhood immunization program, the goal of complete control over and elimination of the disease will not be achieved in the near future by current immunization policies. The 3-4 year cycle of measles epidemics may be expected to cause large-scale morbidity and some mortality in the 1990-92 period. Short- and long-term measles control policies for this preventable disease are discussed.