Progress toward measles and rubella elimination in Egypt

Area of Science:

• Public Health
• Epidemiology
• Vaccinology

Background:

• Measles and rubella were endemic in Egypt, causing frequent outbreaks before widespread vaccination.
• Initial measles vaccination efforts increased coverage but failed to prevent recurrent outbreaks.
• Introduction of the measles-mumps-rubella (MMR) vaccine and targeted campaigns reduced measles cases significantly.

Purpose of the Study:

• To evaluate the impact of vaccination strategies on measles and rubella elimination in Egypt.
• To assess progress towards the 2010 goal of eliminating measles, rubella, and congenital rubella syndrome (CRS).

Main Methods:

• Analysis of vaccination coverage data from 1977 to 2010.
• Review of measles and rubella case reporting and outbreak surveillance.
• Implementation of national immunization campaigns targeting specific age groups.

Main Results:

• Measles vaccination coverage rose from <50% to >90% by 1999, yet outbreaks persisted.
• A nationwide measles-rubella campaign in 2008-2009 achieved >95% coverage in individuals aged 2-20.
• Record low measles and rubella cases were reported in 2009-2010 following intensive immunization efforts.

Conclusions:

• Egypt is nearing measles and rubella elimination due to sustained high vaccination coverage and targeted campaigns.
• Continued high coverage (>95%) with two doses of measles-rubella vaccine is crucial for maintaining elimination.
• Strengthening measles-rubella and developing CRS surveillance are essential next steps.