Towards elimination: measles susceptibility in Australia and 17 European countries.
OBJECTIVE
To evaluate age-specific measles susceptibility in Australia and 17 European countries.


METHODS
As part of the European Sero-Epidemiology Network 2 (ESEN2), 18 countries collected large national serum banks between 1996 and 2004. These banks were tested for measles IgG and the results converted to a common unitage to enable valid intercountry comparisons. Historical vaccination and disease incidence data were also collected. Age-stratified population susceptibility levels were compared to WHO European Region targets for measles elimination of < 15% in those aged 2-4 years, < 10% in 5-9-year-olds and < 5% in older age groups.


RESULTS
Seven countries (Czech Republic, Hungary, Luxembourg, Spain, Slovakia, Slovenia and Sweden) met or came very close to the elimination targets. Four countries (Australia, Israel, Lithuania and Malta) had susceptibility levels above WHO targets in some older age groups indicating possible gaps in protection. Seven countries (Belgium, Bulgaria, Cyprus, England and Wales, Ireland, Latvia and Romania) were deemed to be at risk of epidemics as a result of high susceptibility in children and also, in some cases, adults.


CONCLUSIONS
Although all countries now implement a two-dose measles vaccination schedule, if the WHO European Region target of measles elimination by 2010 is to be achieved higher routine coverage as well as vaccination campaigns in some older age cohorts are needed in some countries. Without these improvements, continued measles transmission and outbreaks are expected in Europe.
Andrews
Nick
N
Centre for Infections, Health Protection Agency, London, England. nick.andrews@hpa.org.uk
Tischer
Annedore
A
Siedler
Annette
A
Pebody
Richard G
RG
Barbara
Christopher
C
Cotter
Suzanne
S
Duks
Arnis
A
Gacheva
Nina
N
Bohumir
Kriz
K
Johansen
Kari
K
Mossong
Joel
J
Ory
Fernando de
Fd
Prosenc
Katarina
K
Sláciková
Margareta
M
Theeten
Heidi
H
Zarvou
Marios
M
Pistol
Adriana
A
Bartha
Kalman
K
Cohen
Dani
D
Backhouse
Jo
J
Griskevicius
Algirdas
A
D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D001771:Blood Banks; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D008457:Measles / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000276:immunology / Q000627:therapeutic use*; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D014613:Vaccines, Attenuated
D008458:Measles Vaccine; D014613:Vaccines, Attenuated