Abstract
Measles is a highly contagious, vaccine preventable disease. Measles results in a systemic illness which causes profound immunosuppression often leading to severe complications. In 2010, the World Health Assembly declared that measles can and should be eradicated. Measles has been eliminated in the Region of the Americas, and the remaining five regions of the World Health Organization (WHO) have adopted measles elimination goals. Significant progress has been made through increased global coverage of first and second doses of measles-containing vaccine, leading to a decrease in global incidence of measles, and through improved case based surveillance supported by the WHO Global Measles and Rubella Laboratory Network. Improved vaccine delivery methods will likely play an important role in achieving measles elimination goals as these delivery methods circumvent many of the logistic issues associated with subcutaneous injection. This review highlights the status of global measles epidemiology, novel measles vaccination strategies, and describes the pathway toward measles elimination.
Highlights
Measles virus (MeV) is the etiologic agent of measles, a highly contagious and vaccine-preventable illness
This review focuses on the global measles burden and the contribution of current and novel vaccination strategies to reaching the World
In the pre-vaccine era, outbreaks occurred in late winter and early spring in temperate climates, whereas in tropical climates outbreaks mainly occurred in the dry season with continual low-level measles transmission year-round [32]
Summary
Measles virus (MeV) is the etiologic agent of measles, a highly contagious and vaccine-preventable illness. Despite the existence of multiple genotypes, MeV strains are serologically monotypic, and polyclonal antibody raised against the vaccine strains will neutralize infectivity of all other genotypes [10]. This property is attributed, in part, to limitations in generation of non-deleterious mutations within the H protein. Key residues conferring binding capacity to SLAM, the receptor for wild-type (WT) viruses, are highly conserved, and unable to tolerate changes that result in loss of neutralizing ability [10,11,12]. Monoclonal antibody escape mutants are still efficiently neutralized by serum from vaccinees, and serum from vaccinees neutralizes representative strains from currently circulating genotypes of WT MeV [10,12,13,14,15]
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