PAHO/WHO

In 2016, an international expert committee reviewed the epidemiological evidence presented by the member countries of the Pan American Health Organization/World Health Organization (PAHO/WHO) and determined that the Region of the Americas had eliminated endemic transmission of measles. This was announced at the 55^th Directing Council of PAHO in September 2016. 

Measles is the fifth disease to be eliminated from the Americas, following smallpox (1971), polio (1994), and rubella and congenital rubella syndrome (2015). In all five cases, the Region was the first in the world to achieve elimination. 

Facts about measles

• Measles is a very contagious viral disease that especially affects children and can cause severe health problems, including severe diarrhea, ear infections, blindness, pneumonia, and encephalitis (swelling of the brain). Some of these complications can lead to death.
• At the global level, measles continues to be one of the leading causes of death among young children, despite the fact that there is a safe and effective vaccine to prevent it. There is no specific antiviral treatment against the measles virus.
• Serious cases are especially frequent in malnourished young children, especially those whose immune systems are weakened. In populations with high levels of malnutrition and inadequate health care, measles can kill in up to 10% of cases.
• Measles is transmitted by airborne droplets from the nose, mouth, or throat of an infected person. The virus can stay active and contagious in the air or on surfaces for two hours.
• Symptoms tend to be high fever, runny nose, cough, red and watery eyes, small white spots on the inside of the cheeks, and widespread rash all over the body.
• Before widespread vaccination began in 1980, measles caused 2.6 million deaths a year throughout the world, 12,000 of them in the Americas.
• Between 1970 and 1979, Latin American countries reported about 220,000 cases of measles a year.
• There has been a 95% drop in cases over a 35-year period, from 4.5 million cases in 1980 to approximately 244,700 in 2015.

Facts about elimination

• Most PAHO/WHO member countries introduced the triple viral vaccine (MMR) against measles, mumps, and rubella between 1980 and the early 2000s.
• In 1994, the countries collectively set the goal of eliminating endemic transmission of measles by 2000, through the implementation of PAHO-recommended surveillance and immunization strategies.  By 2002, endemic transmission had ended in the Americas, but a decision to wait on certification was made so measles and rubella elimination could be jointly declared. A measles outbreak in 2013-2015 delayed this process. Rubella was certified as eliminated in 2015. The last case of endemic measles in the Americas in the post-elimination era was reported in July 2015 in Brazil.
• A dose of the vaccine to prevent measles, mumps, and rubella (MMR) costs $1.14, when purchased through the PAHO Revolving Fund (in 5-dose vials).
• WHO estimates that measles vaccination prevented 17.1 million deaths worldwide between 2000 and 2014 a decrease of 79%.
• Measles continues to circulate in other regions of the world, and countries in the Americas report sporadic imported cases.
• To maintain measles elimination, PAHO/WHO and the International Expert Committee for Measles and Rubella Elimination recommend that all countries in the Americas strengthen active surveillance and maintain high population immunity through vaccination.