H F Gidding1, N V Martin2, V Stambos3, T Tran3, A Dey4, G K Dowse5, H A Kelly6, D N Durrheim7, S B Lambert8. 1. School of Public Health and Community Medicine, UNSW Medicine, Sydney, Australia; National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital Network, Westmead, New South Wales, Australia. Electronic address: hgidding@unsw.edu. 2. Office of Health Protection, Department of Health, Canberra, Australia. 3. Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia. 4. National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital Network, Westmead, New South Wales, Australia; The University of Sydney, New South Wales, Australia. 5. Communicable Disease Control Directorate, Department of Health, Perth, Western Australia, Australia. 6. Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia; Australian National University, Canberra, Australia. 7. School of Medicine and Public Health, University of Newcastle, New South Wales, Australia. 8. Queensland Children's Medical Research Institute, Children's Hospital and Health Service, Queensland Health, Australia; UQ Child Health Research Centre, The University of Queensland, Australia; Communicable Diseases Branch, Prevention Division, Queensland Health, Australia.
Abstract
BACKGROUND: The World Health Organization (WHO) Western Pacific Region (WPR) Guidelines on verification of measles elimination were established in 2012. This article outlines Australia's approach to addressing the guideline's five lines of evidence, which led to formal verification of elimination by the WHO Regional Verification Commission (RVC) in March 2014. METHODS: The criteria were addressed using national measles notifications, data from selected laboratories, the national childhood immunization register, and three national serosurveys (1998/1999, 2002, 2007). RESULTS: Australia met or exceeded all indicator targets with either national or sentinel data. Laboratory and epidemiological surveillance were of high quality, with 85% of cases documented as imported/import-related (target 80%); coverage with the first dose of measles vaccine was close to 94% in 2008-2012 and second dose coverage increased to 91% in 2012 (target >95%). There is ongoing commitment by the Australian Government to increase immunization coverage, and the absence of sustained transmission of any single measles genotype was demonstrated. CONCLUSIONS: This is the first documentation of the successful application of the WPR RVC guidelines. The indicators afford some flexibility but appear to provide appropriate rigor to judge achievement of measles elimination. Our experience could assist other countries seeking to verify their elimination status.
BACKGROUND: The World Health Organization (WHO) Western Pacific Region (WPR) Guidelines on verification of measles elimination were established in 2012. This article outlines Australia's approach to addressing the guideline's five lines of evidence, which led to formal verification of elimination by the WHO Regional Verification Commission (RVC) in March 2014. METHODS: The criteria were addressed using national measles notifications, data from selected laboratories, the national childhood immunization register, and three national serosurveys (1998/1999, 2002, 2007). RESULTS: Australia met or exceeded all indicator targets with either national or sentinel data. Laboratory and epidemiological surveillance were of high quality, with 85% of cases documented as imported/import-related (target 80%); coverage with the first dose of measles vaccine was close to 94% in 2008-2012 and second dose coverage increased to 91% in 2012 (target >95%). There is ongoing commitment by the Australian Government to increase immunization coverage, and the absence of sustained transmission of any single measles genotype was demonstrated. CONCLUSIONS: This is the first documentation of the successful application of the WPR RVC guidelines. The indicators afford some flexibility but appear to provide appropriate rigor to judge achievement of measles elimination. Our experience could assist other countries seeking to verify their elimination status.
Authors: Kristine Macartney; Heather F Gidding; Lieu Trinh; Han Wang; Aditi Dey; Brynley Hull; Karen Orr; Jocelynne McRae; Peter Richmond; Michael Gold; Nigel Crawford; Jennifer A Kynaston; Peter McIntyre; Nicholas Wood Journal: JAMA Pediatr Date: 2017-10-01 Impact factor: 16.193