title: Towards elimination: measles susceptibility in Australia and 17 European countries.
abstract: 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.
authors: Centre for Infections, Health Protection Agency, London, England. nick.andrews@hpa.org.uk
authors: Nick
authors: N
authors: Andrews
authors: Annedore
authors: A
authors: Tischer
authors: Annette
authors: A
authors: Siedler
authors: Richard G
authors: RG
authors: Pebody
authors: Christopher
authors: C
authors: Barbara
authors: Suzanne
authors: S
authors: Cotter
authors: Arnis
authors: A
authors: Duks
authors: Nina
authors: N
authors: Gacheva
authors: Kriz
authors: K
authors: Bohumir
authors: Kari
authors: K
authors: Johansen
authors: Joel
authors: J
authors: Mossong
authors: Fernando de
authors: Fd
authors: Ory
authors: Katarina
authors: K
authors: Prosenc
authors: Margareta
authors: M
authors: Sláciková
authors: Heidi
authors: H
authors: Theeten
authors: Marios
authors: M
authors: Zarvou
authors: Adriana
authors: A
authors: Pistol
authors: Kalman
authors: K
authors: Bartha
authors: Dani
authors: D
authors: Cohen
authors: Jo
authors: J
authors: Backhouse
authors: Algirdas
authors: A
authors: Griskevicius
mesh_terms: 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
chemical_list: D008458:Measles Vaccine; D014613:Vaccines, Attenuated