Eurosurveillance, Volume
8, Issue
6,
01 June 2003
Short report
WHO European Region's strategy for elimination of measles and congenital rubella infection
F X Hanon1, J. Spika John, S. Wassilak Steven, N Emiroglu
Citation style for this article: Hanon FX, Spika John J, Wassilak Steven S, Emiroglu N. WHO European Region's strategy for elimination of measles and congenital rubella infection. Euro Surveill. 2003;8(6):pii=415. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=415
Date of submission:
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F-X. Hanon, J. Spika John, S. Wassilak Steven, N. Emiroglu
World Health Organization Regional Office for Europe, Copenhagen, Denmark
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The WHO strategy for measles elimination in Europe
includes the strengthening of surveillance and immunisation programmes
in collaboration with European specific networks (EUVAC.NET and CCEE-Baltic)
and Member States.
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The WHO Regional Office for Europe has developed a
strategic approach to halt the indigenous transmission of measles in its
51 Member States by 2010, and to prevent congenital rubella infection
(<1 case of congenital rubella syndrome per 100 000 live births) (1,2).
The strategy included the strengthening of routine immunisation programmes
(high levels of immunisation with two doses of measles vaccine) throughout
the Region. To address susceptible cohorts remaining from periods with
sub-optimal immunization, WHO supported national vaccination campaigns
for measles and rubella during 2000-2002 in Albania, Kyrgyz Republic and
the Republic of Moldova. This included training of local staff and strengthening
national surveillance, which also has a long-term impact on the quality
of public health infrastructures.
Strengthening the surveillance is a critical component of the strategic
plan. Performance and outcome indicators, which will be used to monitor
success at the country and Regional levels include the number of cases,
the size of clusters, vaccine-related events (e.g., coverage and adverse
events following immunization), the proportion of suspected cases with
laboratory testing and the completeness and timeliness of reporting. Towards
strengthening the collection and feedback of regional surveillance data,
WHO in 2002-2003 has been collecting revised data on the yearly number
of cases and vaccination coverage rates in Member States for the period
1990-2002. Since January 2002, WHO has requested monthly reporting of
measles cases by age and vaccination status; the Regional Office has also
developed a minimum set of variables for investigation and analysis and
has accepted case-based data. This information has been used in the first
two issues of the WHO EURO Measles Quarterly (http://www.euro.who.int/vaccine
).
The essential matching piece to enhancing epidemiological surveillance
is strengthening the laboratory capacity for confirmation of suspected
measles cases and the monitoring of measles virus genotypes. Within the
European Region, WHO has been identifying and assessing national measles
laboratories, providing training, equipment and supplies as needed to
ensure high quality, and forming a regional network of reference laboratories.
Molecular characterisation of measles viruses will become more critical
as measles incidence decreases, helping to identify imported cases and
unravelling the chains of transmission.
Supporting regional and sub regional surveillance activities is a key
element of the WHO strategy given the Regional diversity and the desire
to encourage working partnerships. Formal collaborations exist with two
networks, EUVAC.NET (western Europe) and CCEE-Baltic (Central Eastern
European countries, the Baltic states, and Turkey) that focus on measles.
Through these collaborations and active participation of Member States
in such networks, WHO hopes to achieve a standardised format for data
collection and improve the completeness, timeliness and quality of routine
reporting for optimal monitoring of progress. The WHO European Region
is well on its way to achieving targets for measles and rubella prevention
and strengthening the control of vaccine preventable diseases in childhood.
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References
1. The European health report 2002, World Health Organization, 2002
2. Strategic plan for measles and congenital rubella infection in the
European Region of WHO. Copenhagen, World Health Organization, 2003.
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