The Elimination of Indigenous Measles Transmission in England and Wales

Abstract

Following a school-based measles-rubella vaccination campaign in November 1994, enhanced surveillance of measles, including IgM antibody testing of oral fluid from clinically diagnosed case-patients, was introduced in England and Wales. Between 1995 and 2001, 665 cases of measles were confirmed, including 371 (56%) confirmed only by IgM detection in oral fluid. Two hundred thirty-nine cases (36%) were sporadic and 426 (64%) were associated with 61 clusters. Fifty-four (23%) of the 239 sporadic cases and 26 (43%) of the 61 clusters were associated with a probable or possible importation of infection from overseas, and a wide variety of genotypes were identified in each calendar year. The effective reproduction number for measles over the period was estimated to be below 0.7. These data suggest that most measles in the United Kingdom is acquired following limited transmission from an imported infection, and they confirm that measles elimination has been achieved and sustained over this period.

Laboratory investigations are indispensable to monitor the progress of measles elimination—results of the German Measles Sentinel 1999–2003

“…In the non-invasive taken sample, virus as well as antibodies are detectable. In the UK, this method is used successfully for measles surveillance since mid-1990 (Brown et al, 1994;Ramsay et al, 1997Ramsay et al, , 2003.…”

Estimating the measles effective reproduction number in Australia from routine notification data

“…Canada and the United States of America both reported the interruption of indigenous measles transmission by 1998 and used the methods described by De Serres et al to assess elimination. 11,18 England and Wales also claimed elimination and used data from 1995 to 2001 on the distribution of outbreak sizes to estimate R. 19 In the Australian state of Victoria, R was estimated using notification data from 1998 to 2003 on the distribution of outbreak size (R = 0.87) and the generation of spread (R = 0.73). 20 More recently, data…”

Serological and molecular epidemiology of measles virus outbreaks reported in Ethiopia during 2000–2004

“…The sequences of the three cases that occurred in Diredawa town were South African like and the two that occurred in Addis Ababa were Sudan and India like. Sporadic cases due to genotype D4 were in the UK throughout 1995-2000 as well as USA and Canada [Ramsay et al, 2003;Rota et al, 2004;Tripples et al, 2004].…”

“…No further occurrence of D8 has been documented and it may be presumed that this was an imported case. The genotype D8 (previously named as genotype III) first identified in the UK in 1994 [Jin et al, 1997] has been circulating in South Asia, the Middle East, and the Balkans [Ramsay et al, 2003;Rota and Bellini, 2003].…”