Measles surveillance in the English-speaking Caribbean and Suriname: a key strategy in the campaign to eliminate indigenous measles by 1995 - abstract

ABSTRACT

In 1988, the Caribbean Health Ministers declared the goal of indigenous measles elimination by 1995 in the light of the success of measles vaccination programmes, introduced in 1982, in decreasing disease occurrence. Prior to 1982, measles occurred continuously in larger territories and Caribbean-wide epidemic activity occurred every 3 to 4 years; the last epidemic being in 1989/90. One of the key strategies for measles elimination was a mass immunization campaign conducted in May - June 1991 with a 91.4 per cent vaccination uptake rate among the target population aged 9 months - 15 years. Nine countries achieved coverage rates of > 95 per cent. This was followed by the introduction of an active and sensitive surveillance system on 1st September, 1991 and up to October 31, 1992, 504 suspected cases of measles were reported. However, there were only two (2) confirmed cases (from Barbados - one indiginous and one imported) and 124 compatible cases. Thus, in the 14 months since the launch of the new surveillance system, one case of indigenous measles has been indentified. Logically, the combination of widespread epidemic activity in 1989/90, followed by a very successful mass vaccination campaign in 1991, has enormous potential for breaking all chains of transmission in a population. Continued high-quality surveillance will be necessary to certify elimination but transmission appears to have been interrupted throughout the English-speaking Caribbean. If this is possible in the Caribbean, across a wide variety of territories, then global eradication is one step closer to being a reality (AU)