title: Measles in Israel, the West Bank, and Gaza: continuing incidence and the case for a new eradication strategy.
abstract: Measles continues to occur in epidemic waves in Israel, Gaza, and the West Bank, causing morbidity and mortality. In Israel, immunization of infants against measles began in 1967, and 90% had been immunized by the mid-1980s. In Gaza and the West Bank, where immunization of infants against measles began in 1973 and 1976, respectively, the immunization rate reached 75% in the late 1970s and increased to greater than 90% in the 1980s. Measles epidemics, which previously had occurred in 5- to 7-year cycles, occurred every 2-4 years in the 1980s and affected individuals who were older than those affected in previous years. Israel's commitment to eradicating measles by 1992 will require a substantially expanded immunization program in comparison with the traditional program that requires immunization of infants alone. The benefits of several alternative immunization strategies considerably exceed their costs. A new, two-dose immunization will be needed as a minimal strategy, and a campaign for administering booster doses to school-aged children may be required as well to achieve control and eradication of measles. Measles is a serious but preventable public health problem; appropriate strategies must be devised by national and international public health officials to control the disease in developing and developed countries.
authors.affiliation: Department of Epidemiology, Ministry of Health, Jerusalem, Israel.
authors.forename: T H
authors.initials: TH
authors.lastname: Tulchinsky
authors.forename: Y
authors.initials: Y
authors.lastname: Abed
authors.forename: G
authors.initials: G
authors.lastname: Ginsberg
authors.forename: S
authors.initials: S
authors.lastname: Shaheen
authors.forename: J B
authors.initials: JB
authors.lastname: Friedman
authors.forename: M L
authors.initials: ML
authors.lastname: Schoenbaum
authors.forename: P E
authors.initials: PE
authors.lastname: Slater
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000914:Antibodies, Viral / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008457:Measles / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D008458:Measles Vaccine; D008459:Measles virus / Q000276:immunology; D008875:Middle Aged; D014611:Vaccination
chemical_list: D000914:Antibodies, Viral; D008458:Measles Vaccine