Measles eliminated in Finland since 1996 – will it last?

Abstract

As far back as the 1960s and 1970s, some countries in the world managed – at least temporarily – to interrupt transmission of measles by vaccination (1). In 1989, the 42nd World Health Assembly set a target for the global control of measles through a 90% reduction in incidence by 1995 (2). Measles elimination has been defined as the situation in a large geographical area in which there is no sustained transmission following the occurrence of an imported case (3). This is only possible if very high levels of population immunity are achieved and maintained. The World Health Organization (WHO) then targeted three regions for elimination. In 1994, the target elimination year for the Americas was set as 2000. This was successfully achieved by Jamaica and some other Caribbean countries (1,4). In 1997, the Eastern Mediterranean Region target year was 2010. Finally, in 1998, the WHO European Region measles elimination target was set at 2007. Finland is the first country in Europe to have documented measles elimination, and did so more than a decade in advance. There have been no indigenous cases reported since 1996, despite laboratory testing of all suspect cases since 1987 (when laboratory confirmation became a requirement for notification (5,6)).