The changing age ecology of measles and its implications on measles control

Abstract

World-wide an estimated two million children die from measles and its complications every year.1 Severe measles is limited geographically to developing countries where it is unquestionably one of the most prevalent and serious infectious diseases of childhood/ This gruesome epidemiological picture has provided a strong priori case for measles prevention through immunisation. In the City of Gweru in Zimbabwe, vaccination against measles was commenced in 1971, gained momentum in the late seventies and was accelerated and consolidated with the advent of the Expanded Programme on Immunisation (EPI) in 1982-83. In this paper we shall examine how, despite aggressive efforts aimed at controlling measles through vaccination, it would not be possible to interrupt measles transmission with the single nine months of age vaccination regime, due to the changing age epidemiology of the disease.