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Measles vaccination effectively prevents measles, a highly contagious disease that can cause severe complications and death and requires high population immunity to interrupt transmission. This report describes progress in measles elimination during 2000-2023. During 2000-2023, an estimated 60.3 million deaths due to measles were averted by vaccination. Despite commitment by all 6 WHO regions to eliminate measles, however, no region has successfully achieved and maintained measles elimination as of the end of 2023. During the coronavirus disease 2019 (COVID-19) pandemic, estimated worldwide coverage with a first dose of measles-containing vaccine (MCV1) decreased to 81%, the lowest rate since 2008. MCV1 coverage improved to 83% in 2022 but was unchanged in 2023. During 2022-2023, the estimated number of measles cases increased by 20% globally, from 8 645 000 to 10 341 000; and the number of countries that experienced large or disruptive outbreaks increased from 36 to 57. The estimated number of deaths due to measles decreased by 8% as compared with 2022, from 116 800 to 107 500 in 2023, because of an increased number of cases in countries with a lower risk for death. The stagnation in MCV1 coverage means that millions of children remain unprotected, leading to increases in the numbers of cases and outbreaks. Measles-containing vaccine (MCV) coverage is lower and measles incidence is higher in low-income countries and in fragile, conflict-affected and vulnerable (FCV) settings, which exacerbates inequity. Urgent, targeted efforts are necessary to ensure that all children receive 2 MCV doses and that surveillance is strengthened, hastening progress towards measles elimination. La vaccination contre la rougeole permet de prevenir efficacement cette maladie tres contagieuse qui peut entrainer des complications severes et la mort, et dont l'interruption de la transmission necessite une forte immunite collective. Le present rapport decrit les progres accomplis vers l'elimination de la rougeole au cours de la periode 2000-2023. On estime que 60,3 millions de deces dus a la rougeole ont ete evites grace a la vaccination entre 2000 et 2023. Malgre l'engagement des 6 Regions de l'OMS a eliminer la rougeole, aucune d'entre elles n'a reussi a atteindre et a maintenir cet objectif a la fin de l'annee 2023. Le present rapport decrit les progres accomplis vers l'elimination de la rougeole au cours de la periode 2000-2023. Pendant la pandemie de maladie a coronavirus 2019 (COVID-19), la couverture mondiale estimee par la premiere dose de vaccin a valence rougeole (MCV1) est tombee a 81%, le taux le plus bas depuis 2008. Elle a progresse en 2022 pour atteindre 83%, mais est restee inchangee en 2023. En 2022-2023, le nombre estime de cas de rougeole a augmente de 20% a l'echelle mondiale, passant de 8 645 000 a 10 341 000, et le nombre de pays confrontes a des flambees epidemiques de grande ampleur ou perturbatrices est passe de 36 a 57. Le nombre estime de deces dus a la rougeole a diminue de 8% par rapport a 2022, passant de 116 800 a 107 500 en 2023, en raison d'une augmentation du nombre de cas dans des pays ou le risque de deces est plus faible. La stagnation de la couverture par la MCV1 signifie que des millions d'enfants restent sans protection, ce qui entraine une augmentation du nombre de cas et de flambees epidemiques. La couverture par le vaccin antirougeoleux (MCV) est plus faible et l'incidence de la rougeole plus elevee dans les pays a faible revenu et dans les zones en situation de fragilite, de conflit ou de vulnerabilite, ce qui exacerbe les inegalites. Afin d'accelerer les progres vers l'elimination de la rougeole, il est urgent de deployer des efforts cibles pour que tous les enfants recoivent 2 doses de vaccin MCV et pour renforcer la surveillance., Introduction Measles is a highly contagious disease that can cause severe complications and death. (1) Vaccination is highly effective in preventing measles and, during the past 50 years, has saved [...]

Measles is a highly contagious, vaccine-preventable disease that requires high population immunity in order for transmission to be interrupted. All 6 WHO regions have committed themselves to eliminating measles; however, no region has achieved and sustained elimination. This report describes progress in measles elimination during 2000-2022. Estimated coverage with the first dose of measles-containing vaccine (MCV) worldwide increased from 72% to 86% between 2000 and 2019 and then decreased to 81% in 2021 during the coronavirus disease 2019 (COVID-19) pandemic, the lowest coverage rate since 2008. In 2022, MCV1 coverage increased to 83%. Only 72 (50%) of 144 countries that reported measles cases achieved the measles surveillance indicator target of >2 discarded cases per 100 000 population in 2022. During 2021-2022, estimated measles cases increased by 18%, from 7 802 000 to 9 232 300, and the number of countries experiencing large or disruptive outbreaks increased from 22 to 37. The estimated number of measles deaths increased by 43% during 2021-2022, from 95 000 to 136 200. Nonetheless, an estimated 57 million measles deaths were averted by vaccination during 2000-2022. In 2022, measles vaccination coverage and global surveillance showed some recovery from the setbacks during the COVID-19 pandemic; however, coverage decreased in low-income countries, and, globally, years of suboptimal immunization coverage left millions of children unprotected. Setbacks in coverage during the COVID-19 pandemic must be reversed by renewed efforts to vaccinate all children with 2 MCV doses, strengthen surveillance, prevent outbreaks and accelerate progress towards elimination. La rougeole est une maladie a prevention vaccinale qui est hautement contagieuse et dont la transmission ne peut etre interrompue qu'en presence d'une forte immunite collective. Les 6 Regions de l'OMS se sont toutes engagees a eliminer la rougeole, mais a ce jour, aucune d'entre elles n'a atteint durablement cet objectif. Le present rapport decrit les progres accomplis vers l'elimination de la rougeole au cours de la periode 2000-2022. La couverture mondiale de la vaccination par la premiere dose de vaccin a valence rougeole (MCV) a progresse entre 2000 et 2019, passant de 72% a 86%, mais a ensuite recule pendant la pandemie de COVID-19 pour s'etablir a 81% en 2021, soit le taux le plus faible enregistre depuis 2008. En 2022, la couverture par le MCV1 est remontee a 83%. En 2022, seuls 72 (50%) des 144 pays ayant signale des cas de rougeole ont atteint la cible de l'indicateur de surveillance de la rougeole relatif au nombre de cas ecartes, a savoir >2 cas ecartes pour 100 000 habitants. Dans la periode 2021-2022, le nombre de cas de rougeole signales a augmente de 18%, passant de 7 802 000 a 9 232 300, et, le nombre de pays confrontes a des flambees epidemiques de grande ampleur ou perturbatrices de rougeole est passe de 22 a 37, et le nombre estime de deces dus a la rougeole a augmente de 43%, passant de 95 000 a 136 200. Neanmoins, on estime qu'entre 2000 et 2022, la vaccination a permis d'eviter 57 millions de deces dus a la rougeole. En 2022, on a constate des signes de relevement de la couverture vaccinale et de la surveillance mondiale de la rougeole apres les revers subis lors de la pandemie de COVID-19; la couverture vaccinale a toutefois diminuee dans les pays a faible revenu et, apres des annees de couverture sousoptimale, des millions d'enfants dans le monde restent sans protection contre la maladie. Il est urgent d'inverser le recul de la couverture enregistre pendant la pandemie de COVID-19 en redoublant d'efforts pour vacciner tous les enfants par 2 doses de MCV, renforcer la surveillance, prevenir les flambees epidemiques et accelerer les progres vers l'elimination., Introduction All 6 WHO regions have committed themselves to eliminating measles. (1) The Immunization Agenda 2030 (IA2030) 2 includes measles elimination as a core indicator of impact. IA2030 highlights the [...]

Unusually large outbreaks of mumps across the United States in 2016 and 2017 raised questions about the extent of mumps circulation and the relationship between these and prior outbreaks. We paired epidemiological data from public health investigations with analysis of mumps virus whole genome sequences from 201 infected individuals, focusing on Massachusetts university communities. Our analysis suggests continuous, undetected circulation of mumps locally and nationally, including multiple independent introductions into Massachusetts and into individual communities. Despite the presence of these multiple mumps virus lineages, the genomic data show that one lineage has dominated in the US since at least 2006. Widespread transmission was surprising given high vaccination rates, but we found no genetic evidence that variants arising during this outbreak contributed to vaccine escape. Viral genomic data allowed us to reconstruct mumps transmission links not evident from epidemiological data or standard single-gene surveillance efforts and also revealed connections between apparently unrelated mumps outbreaks.

All 6 WHO regions have committed themselves to eliminate measles. (1) The aim of the Immunization Agenda 2021-2030 (IA2030) (2) is to achieve regional targets as a core indicator of [...]

BACKGROUND: New methods to increase measles and rubella (MR) vaccination coverage are needed to achieve global and regional MR elimination goals. METHODS: Here, we developed microneedle (MN) patches designed to administer MR vaccine by minimally trained personnel, leave no biohazardous sharps waste, remove the need for vaccine reconstitution, and provide thermostability outside the cold chain. This study evaluated the immunogenicity of MN patches delivering MR vaccine to infant rhesus macaques. RESULTS: Protective titers of measles neutralizing antibodies (>120 mIU/mL) were detected in 100% of macaques in the MN group and 75% of macaques in the subcutaneous (SC) injection group. Rubella neutralizing antibody titers were >10 IU/mL for all groups. All macaques in the MN group were protected from challenge with wild-type measles virus, whereas 75% were protected in the SC group. However, vaccination by the MN or SC route was unable to generate protective immune responses to measles in infant macaques pretreated with measles immunoglobulin to simulate maternal antibody. CONCLUSIONS: These results show, for the first time, that MR vaccine delivered by MN patch generated protective titers of neutralizing antibodies to both measles and rubella in infant rhesus macaques and afforded complete protection from measles virus challenge.

In 2012, the World Health Assembly (WHA) endorsed the Global Vaccine Action Plan (GVAP), (1) with the objective of eliminating measles (2) in 5 of the 6 WHO regions by [...]

Point-of-care antigen testing provides results more quickly than real-time reverse transcription PCR (rRT-PCR). In August 2020, the US Food and Drug Administration granted emergency use authorization to the BinaxNOW COVID-19 [...]

With 762 laboratories, the Global Measles and Rubella Laboratory Network (GMRLN) is the largest laboratory network coordinated by the World Health Organization (WHO). Like the Global Polio Laboratory Network, the GMRLN has multiple tiers, including global specialized laboratories, regional reference laboratories, national laboratories, and, in some countries, subnational laboratories. Regional networks are supervised by regional laboratory coordinators reporting to a global coordinator at WHO headquarters. Laboratories in the GMRLN have strong links to national disease control and vaccination programs. The GMRLN's goal is to support member states in obtaining timely, complete, and reliable laboratory-based surveillance data for measles and rubella as part of the strategy for achieving measles and rubella elimination. Surveillance data are reported to the national program and are included in annual reports on the status of measles and rubella elimination to national verification committees for review by regional verification commissions. Quality within the GMRLN is ensured by monitoring performance through external quality assurance programs, confirmatory and quality control testing, accreditation, and coordination of corrective action and training where needed. The overall performance of the laboratories has remained high over the years despite many challenges, particularly the COVID-19 pandemic. The GMRLN is well-positioned to support high-quality laboratory-based surveillance for measles and rubella and to transition to supporting laboratory testing for other pathogens, including vaccine-preventable diseases. [ABSTRACT FROM AUTHOR]

Efforts to control and eliminate measles and rubella are aided by high-quality surveillance data—supported by laboratory confirmation—to guide decision-making on routine immunization strategies and locations for conducting preventive supplementary immunization activities (SIAs) and outbreak response. Important developments in rapid diagnostic tests (RDTs) for measles and rubella present new opportunities for the global measles and rubella surveillance program to greatly improve the ability to rapidly detect and respond to outbreaks. Here, we review the status of RDTs for measles and rubella Immunoglobulin M (IgM) testing, as well as ongoing questions and challenges regarding the operational use and deployment of RDTs as part of global measles and rubella surveillance. Efforts to develop IgM RDTs that can be produced at scale are underway. Once validated RDTs are available, clear information on the benefits, challenges, and costs of their implementation will be critical for shaping deployment guidance and informing country plans for sustainably deploying such tests. The wide availability of RDTs could provide new programmatic options for measles and rubella elimination efforts, potentially enabling improvements and flexibility for testing, surveillance, and vaccination. [ABSTRACT FROM AUTHOR]

More than 100 laboratories in the World Health Organization Global Measles and Rubella Laboratory Network (GMRLN) perform nucleic acid-based methods for case confirmation of measles or rubella infections and/or strain surveillance (genotyping). The quality of laboratory data is critical to ensure that diagnostic results and country reports to regional verification committees are based on accurate data. A molecular External Quality Assurance (mEQA) program was initiated by the US-CDC in 2014 to evaluate the performance of laboratories in the network. The inclusion of testing for measles and rubella viruses, with a focus on detection and genotyping, plus the diversity of assays and platforms employed required a flexible and comprehensive proficiency testing program. A stepwise introduction of new evaluation criteria gradually increased the stringency of the proficiency testing program, while giving laboratories time to implement the required changes. The mEQA program plays an important role in many processes in the GMRLN, including informing plans for the training of laboratory staff, access to reagents, and the submission of sequence data to global databases. The EQA program for Local Public Health Institutes in Japan is described as an example for national mEQA programs. As more laboratories initiate molecular testing, the mEQA will need to continue to expand and to adapt to the changing landscape for molecular testing. [ABSTRACT FROM AUTHOR]

Measles and rubella remain global health threats, despite the availability of safe and effective vaccines. Estimates of population immunity are crucial for achieving elimination goals and assessing the impact of vaccination programs, yet conducting well-designed serosurveys can be challenging, especially in resource-limited settings. In this review, we provide a comprehensive assessment of 130 measles and rubella studies published from January 2014 to January 2024. Methodologies and design aspects of serosurveys varied greatly, including sample size, assay type, and population demographics. Most studies utilized enzyme immunoassays for IgG detection. Sample sizes showed diverse sampling methods but favored convenience sampling despite its limitations. Studies spanned 59 countries, predominantly including adults, and revealed disparities in seroprevalence across demographics, regions, and notably among migrants and women. Age-related declines in antibodies were observed, particularly among infants, and correlations between vaccination status and seropositivity varied. We conclude with an outlook on measles and rubella serosurveillance, emphasizing the need for proper survey design and the advantages of standardized, multiplex serology assays. [ABSTRACT FROM AUTHOR]

Molecular surveillance of circulating measles variants serves as a line of evidence for the absence of endemic circulation and provides a means to track chains of transmission. Molecular surveillance for measles (genotyping) is based on the sequence of 450 nucleotides at the end of the nucleoprotein coding region (N450) of the measles genome. Genotyping was established in 1998 and, with over 50,000 sequence submissions to the Measles Nucleotide Surveillance database, has proven to be an effective resource for countries attempting to trace pathways of transmission. This review summarizes the tools used for the molecular surveillance of measles and describes the challenge posed by the decreased number of circulating measles genotypes. The Global Measles and Rubella Laboratory Network addressed this challenge through the development of new tools such as named strains and distinct sequence identifiers that analyze the diversity within the currently circulating genotypes. The advantages and limitations of these approaches are discussed, together with the need to generate additional sequence data including whole genome sequences to ensure the continued utility of strain surveillance for measles. [ABSTRACT FROM AUTHOR]

In 2010, the World Health Assembly (WHA) set the following 3 milestones for measles control to be achieved by 2015: 1) increase routine coverage with the first dose of measles-containing [...]

A 29-year-old pregnant woman developed progressively worsening encephalopathy, left hemiparesis, and hemodynamic instability over a 6-week period. Initial brain MRI and work-up for infectious and autoimmune causes were normal, although elevated IgG and oligoclonal bands were seen on analysis of the cerebrospinal fluid (CSF). After uncomplicated spontaneous delivery of a preterm healthy infant, her condition worsened. Repeat brain MRI demonstrated generalized volume loss and evidence of corticospinal tract degeneration. She underwent a brain biopsy, which showed characteristic viral inclusions of the type seen in subacute sclerosing panencephalitis (SSPE). The diagnosis was confirmed by immunohistochemistry and electron microscopy, and additional CSF analysis also showed markedly elevated IgG titer for measles. Sequence analysis of the nucleoprotein gene N-450 demonstrated a close relationship to the sequences of viruses in genotype D7. This case documents an ~ 6-month progression to death of SSPE in a pregnant woman.

Mongolia experienced a nationwide measles outbreak during 1 March 2015–31 December 2016, with 49,077 cases reported to the WHO; many were among vaccinated young adults, suggesting a possible role of vaccine failure. Advanced laboratory methods, coupled with detailed epidemiological investigations, can help classify cases as vaccine failure, failure to vaccinate, or both. In this report, we conducted a study of cases to identify risk factors for breakthrough infection for a subset of laboratory-confirmed measles cases. Of the 193 cases analyzed, only 19 (9.8%) reported measles vaccination history, and 170 (88%) were uncertain. Measles-specific IgG avidity testing classified 120 (62%) cases as low IgG avidity, indicating no prior exposure to measles. Ten of these cases with low IgG avidity had a history of measles vaccination, indicating primary vaccine failure. Overall, sixty cases (31%) had high IgG avidity, indicating breakthrough infection after prior exposure to measles antigen through vaccination or natural infection, but the IgG avidity results were highly age-dependent. This study found that among young children aged 9 months–5 years, breakthrough infection was rare (4/82, 5%); however, among young adults aged 15–25 years, breakthrough infection due to secondary vaccine failure (SVF) occurred on a large scale during this outbreak, accounting for the majority of cases (42/69 cases, 61%). The study found that large-scale secondary vaccine failure occurred in Mongolia, which highlights the potential for sustained outbreaks in post-elimination settings due to "hidden" cohorts of young adults who may have experienced waning immunity. This phenomenon may have implications for the sustainability of measles elimination in countries that remain vulnerable to the importation of the virus from areas where it is still endemic. Until global measles elimination is achieved, enhanced surveillance and preparedness for future outbreaks in post- or peri-elimination countries may be required. [ABSTRACT FROM AUTHOR]

Measles and rubella are vaccine-preventable viral diseases and can be prevented by safe, highly effective vaccination with measles- and rubella-containing vaccines. Given the myriad causes of febrile exanthems, laboratory surveillance for both measles and rubella is important to document the incidence of these diseases and to track the progress and maintenance of elimination in near- and post-elimination settings. Diagnostic challenges can hinder effective surveillance and classification challenges can hinder efforts to demonstrate achievement or maintenance of elimination. In this report, we review diagnostic and classification challenges for measles and rubella in near- and post-elimination settings. [ABSTRACT FROM AUTHOR]

In 2010, the World Health Assembly (WHA) set 3 milestones for measles control, to be achieved by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) [...]

All 6 WHO regions have established measles elimination goals, and 3 regions have a rubella elimination goal. Each region has established a regional verification commission to monitor progress towards measles [...]