Eradicating measles: a feasible goal?

Abstract

Measles has been the greatest cause of vaccine-preventable mortality in the world, killing approximately 6 million individuals annually prior to the advent of vaccination. Measles vaccines, first available in 1963, offer the opportunity to prevent this terrible burden. Measles is no longer an endemic disease in the Western hemisphere or the Americas, demonstrating the feasibility of interrupting transmission globally. Worldwide efforts to reduce measles mortality have resulted in an estimated 60% decrease in measles deaths from 1999–2005. Measles meets biologic criteria to be considered a potentially eradicable disease: first, humans are necessary for maintaining transmission; second, accurate diagnostic tests are available; third, there is an effective intervention and, last, sustained transmission has been terminated in large geographic areas. Nevertheless, there are substantial hurdles to eradication, including obtaining and sustaining the political will and resources necessary, and overcoming problems such as lack of security in some countries, concerns about measles vaccine safety and urban crowding.