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Measles in Israel, the West Bank, and Gaza: continuing incidence and the case for a new eradication strategy

T H Tulchinsky1, Y Abed, G Ginsberg

  • 1Department of Epidemiology, Ministry of Health, Jerusalem, Israel.

Reviews of Infectious Diseases
|September 1, 1990
PubMed

Insights

Measles outbreaks persist in Israel, Gaza, and the West Bank despite high infant immunization rates. Expanded vaccination strategies, including two-dose regimens and booster campaigns, are crucial for measles eradication.

Area of Science:

  • Public Health
  • Epidemiology
  • Immunization Programs

Background:

  • Measles causes significant morbidity and mortality in Israel, Gaza, and the West Bank.
  • Infant immunization programs were established between 1967 and 1976, reaching over 90% coverage by the 1980s.
  • Despite high coverage, measles epidemics intensified in the 1980s, occurring more frequently and affecting older populations.

Purpose of the Study:

  • To analyze measles epidemic patterns in Israel, Gaza, and the West Bank.
  • To evaluate the effectiveness of current immunization strategies.
  • To propose enhanced strategies for measles control and eradication.

Main Methods:

  • Analysis of historical measles epidemic data and immunization coverage rates.
  • Comparison of traditional infant immunization with alternative strategies.
  • Cost-benefit analysis of proposed immunization interventions.

Main Results:

  • Measles epidemics shifted from 5-7 year cycles to 2-4 year cycles in the 1980s.
  • Epidemics increasingly affected older age groups.
  • Alternative immunization strategies, including two-dose regimens and booster campaigns, demonstrated significant cost-benefits.

Conclusions:

  • Traditional infant immunization alone is insufficient for measles eradication.
  • A two-dose immunization strategy is a minimal requirement for measles control.
  • Booster doses for school-aged children may be necessary to achieve eradication.
  • International public health collaboration is essential for controlling measles in diverse settings.

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