INTERRUPTION OF MEASLES TRASMISSION:PROGRESS IN CATALONIA,SPAIN

A. Dominguez, N. Torner, J. Vidal, A. Martinez, L. Salleras

General Directorate of Public Health, Spain

Introduction: The elimination of community-transmitted measles in Catalonia by the end of the year 2000 is among the aims of the Health Plan of Catalonia. In 1998 a specific program for the elimination of measles by the end of the year 2000 was approved.

Methods: The main basis of the program were the administration of the second dose of the MeaslesMumpsRubeolla vaccine at 4 years instead of 11 years, and a selective “catch up” plan for administration of the second dose to the cohorts born between 1990 and 1993 ( 85% coverage reached), and the notification of a case within 24 hours of onset to the Public Health Department with active follow up of the case and its contacts. Blood and urine specimens were collected from the 4^th to 11^th day after onset and were laboratory tested for IgM type antibodies against the measles virus. If positive, the urine specimen was cultured to isolate the virus and obtain its genetic tag, in order to classify the case as imported or not.

Results: The number of suspected cases notified between January 1999 and November 2000 were 71, of which 64 (90 %) were laboratory tested with 20 positive IgM antibodies against measles. Three more cases were confirmed by epidemiological relation to an outbreak. Of the confirmed cases, 10 (44%) were proven to be imported by epidemiological evidence. All confirmed indigenous cases had correct vaccinational status with respect to measles according to their age.

Conclusion: No indigenous cases were confirmed since July 2000, when a sporadic case of dubious origen occurred. The percentage of discarted cases rose from 59% (26) in 1999 to 86% (19) in 2000. It is very important to keep a strict surveillance of the reported cases in order to achieve elimination of measles transmission.