Mathematical modeling and attempts to eliminate measles: a tribute to the late Professor George Macdonald.

In 1983, 5 years after the inception of an aggressive national measles elimination strategy, the United States experienced its lowest level of reported numbers of cases of measles. This accomplishment was the result of an effective vaccination strategy coupled with surveillance and control efforts by local, state, and national public health agencies. After 1983, however, the reported number of measles cases slowly increased until 1989, when the number exceeded that of 1979, the first full year of the National Measles Elimination Program. In 1990, we are experiencing epidemics throughout the United States and expect the reported number of cases of measles to exceed that of 1989. In this context, we felt it was timely to reflect on this experience in light of previous measles control efforts. In particular, we looked back to the contributions of Professor George Macdonald, which were critical to the successful elimination of measles from The Gambia in 1969. As we enter the last decade of this century, the sensible merging of mathematics and epidemiology in useful models, and the appropriate use of such models for planning, offers the best hope for achieving the elimination of measles either in this or the next century.