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[Current situation of measles in Japan, 2017]
1Infectious Disease Surveillance Center, National Institute of Infectious Diseases.
Abstract:
A large-scale national measles epidemic occurred among mainly in teenagers and young adults in 2007. MHLW announced ''Special infectious disease prevention guidelines for measles'' (issued on 28 December 2007; Revised issued on 30 March 2013), and Japan decided the elimination target year was fiscal year (FY) 2015. In 2008, it continued to be a large-scale nation epidemic exceeding 10,000 cases, and a large number of 0 to 1 year old infants, teenagers and young adults were suffering. Many cases were unvaccinated, single dose vaccination or unknown vaccination history. The number of measles cases has declined dramatically since 2009, and the measles virus of genotype D5, which was the indigenous strain in Japan, was not detected at the end of May 2010. Regional epidemics were approved in 2011 and 2014, starting from imported cases from overseas, but it ended early. Since 2006, a two-dose routine vaccination regimen of measles rubella combined (MR) vaccine has started, moreover in the 5 years from fiscal 2008, the second dose of MR vaccine for junior high school students and high school students was periodically inoculated and immunization strengthened for teens was done. As a result, antibody positive rate of 95% or more is maintained in all age groups over 2 years old. In March 2015, Japan's measles elimination was certified by the WHO Western Pacific Regional Office. In 2017, outbreaks occurred in adults originating from imported cases from Asia or Europe, but early termination declarations have been made by aggressive measures by local public health centers/institutes. The annual number of reported cases after measles elimination certification is less than 200 cases.
Insights
Japan achieved measles elimination by strengthening vaccination programs, particularly for teenagers and young adults, leading to sustained high antibody rates. This success was recognized by the WHO in 2015.
Area of Science:
- * Public Health
- * Infectious Disease Epidemiology
- * Vaccinology
Background:
- * A significant measles epidemic in Japan in 2007 primarily affected teenagers and young adults.
- * Low vaccination rates and unknown histories contributed to the widespread transmission of the indigenous D5 measles virus strain.
Purpose of the Study:
- * To detail Japan's strategy and success in achieving measles elimination.
- * To document the timeline and interventions leading to WHO certification.
Main Methods:
- * Implementation of a two-dose measles-rubella (MR) combined vaccine regimen nationwide since 2006.
- * Targeted supplementary immunization campaigns for junior and high school students from FY2008.
- * Strengthened surveillance and rapid response to imported cases.
Main Results:
- * Dramatic decline in measles cases post-2009; indigenous D5 strain undetected by May 2010.
- * Maintenance of over 95% antibody-positive rates across age groups over two years old.
- * WHO Western Pacific Regional Office certified measles elimination in March 2015.
- * Post-elimination, annual reported cases remained below 200, with early termination of outbreaks from imported cases.
Conclusions:
- * Sustained, high vaccination coverage, especially in adolescents, is critical for measles elimination.
- * Robust public health strategies effectively control imported measles cases and prevent resurgence.
- * Japan's experience provides a model for achieving and maintaining measles-free status.
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