Measles Elimination in the Western Pacific Region

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About 30,000 children die each year from measles
in the Region, nearly all of them in five countries: Cambodia, China , the Lao
People's Democratic Republic, Papua New Guinea and the Philippines.
-- Improve surveillance to detect all suspected cases of measles.

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Can the Western Pacific Region* eliminate measles within the next seven
years?
(Logo: http://www. A group of experts forming the Task Force on measles elimination
identified 2012 as a realistic target date for the Region to achieve
elimination.

-- Before immunization began in 1963, about 99% of children would get
measles in childhood.
-- Addressing that challenge, and providing regular immunization services
for the disadvantaged population can provide the foundation for
delivering other life -saving interventions and building regular health
services. The fact that 20 African countries have achieved
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Countries covered include: Algeria, Angola , Benin, Botswana, Burkino Faso,
Cameroon, Chad, Cote D'Ivoire, Democratic Republic of Congo, Egypt , Ethiopia,
Gambia, Ghana, Kenya, Lesotho, Libya, Madagascar, Malawi, Mauritius, Morocco,
Mozambique , Namibia, Nigeria, Senegal, South Africa, Sudan, Tanzania, Tunisia,
Uganda, Zambia and Zimbabwe.

Contains @links to country/Embassies_and_Consulates/Abroad/ categories.

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The challenge is for the rest of the world to catch up. Reaching and protecting these children
is not just a disease control issue; it is also about fairness and justice.

Complications of measles
-- The risk of developing complications varies, being much higher in
developing countries, especially in under-nourished cases.
-- Measles remains relatively common in several countries:
-- Cambodia -- Lao People's Democratic Republic
-- China -- Papua New Guinea
-- Japan -- Philippines

Burden of measles in the Western Pacific Region
-- Measles cases and deaths are under-reported, especially in the areas
with the highest burden.
-- A 2003 estimate was of about 30 000 deaths and one million cases per
year in the Region; whereas only about 100,000 cases were reported
(deaths were not reported).int

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"

* The 37 countries and areas comprising the WHO Western Pacific Region
are: American Samoa, Australia, Brunei Darussalam, Cambodia, China, Cook
Islands , Fiji, French Polynesia, Guam, Hong Kong (China), Japan,
Kiribati, the Lao People's Democratic Republic, Macao (China), Malaysia,
the Marshall Islands, the Federated States of Micronesia , Mongolia,
Nauru, New Caledonia, New Zealand, Niue, the Commonwealth of the
Northern Mariana Islands, Palau, Papua New Guinea, the Philippines, the
Pitcairn Islands, the Republic of Korea, Samoa, Singapore, Solomon
Islands, Tokelau, Tonga, Tuvalu, Vanuatu, Viet Nam, and Wallis and
Futuna.
-- Vaccine efficacy is reduced if the vaccine is damaged by heat or
light.
-- Cambodia was the last country in the Region to add measles vaccine to
its programme -- in 1986.
In early 2004, the last two countries on the continent, Guinea-Bissau and
Eritrea, launched mobile services. This compares to only 3% penetration of fixed -line
telephony.

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com/cgi-bin/prnh/20040820/RESEARCH )
Africa's cellular market is the fastest -growing in the world, gaining more
than 50% in 2002, almost 40% in 2003 and more than 40% in the first three
quarters of 2004 alone.

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Mobilizing sufficient political and financial support to achieve
the elimination goal will be a key consideration.
-- On average, one case infects 15-20 other cases in a population with no
immunity.
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It is primarily due
to the small number and high cost of fixed-line connections, which seldom
extend beyond the major urban centres.

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-- The initial symptoms are fever, cough, conjunctivitis, and runny nose. Those
cases that do not die are often left with permanent brain damage.
-- May cause encephalitis in less than 1 per million doses - not certain. Therefore, data on measles that is only
based on reported cases is unreliable.
-- Elimination means that measles virus is no longer circulating and that
following any importation any further spread is very limited.

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Measles vaccine safety
-- Causes a mild measles-like illness (rash and fever) in about 5%
- - More serious reactions are rare and do not usually cause long-term
problems. However, developments are still hampered by regulatory environments.

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-- Current status of measles control in the Western Pacific Region.

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-- Mortality rates can be as high as 2-15% in developing countries.
-- A second dose of vaccine is recommended for all children to protect
those who were not protected by the first.
-- Two doses will protect about 99%.
(Logo: http://www.

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com/cgi -bin/prnh/20040610/CNTH001LOGO )
That is the key question to be debated by immunization experts at a WHO
meeting in Beijing from 8 to 10 June.who. As early as 2001, Africa became the first
continent as a whole where mobile phones outnumbered fixed telephone lines,
which individually is the case in most African countries now.

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BEIJING and MANILA, Philippines, June 6 /Xinhua-PRNewswire/ -- Measles:
normal childhood illness or killer disease? Actually, it is both but it could
soon be neither . The Technical Advisory Group will
consider whether 2012 is a feasible date for the Region to achieve measles
elimination.
-- After recovery there is life-long immunity.
-- Spread is from person-to-person by direct contact or through airborne
spread.
-- Provide laboratory support so that laboratory testing is available to
confirm diagnosis.

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-- Symptoms usually start 10-12 days after infection.
-- About 1 in every 5-10 cases develops ear infections (otitis media),
diarrhoea, or pneumonia.
-- Live virus vaccine: attenuated (weakened ) form of the natural ('wild')
measles virus.
-- Infection with the vaccine virus generates life-long immunity without
causing the illness or complications of natural measles .
-- Every country in the world uses measles vaccine in their immunization
programme .
-- This means that once elimination is achieved, it must be maintained by
keeping practically every person immune to measles.

Achieving measles elimination requires:
-- Political commitment
-- Financial commitment
-- Technical capacity

Measles elimination, child survival, and health systems
-- Most measles deaths in the Region occur in disadvantaged populations
where regular health services are not available for various reasons,
such as cultural and geographical barriers. Despite this,
owning a mobile phone remains a luxury afforded by less than 8% of Africa's
840 million people.
Mobile licences frequently require that operators rely on a fixed network
operator for interconnection, and relatively few countries allow their mobile
operators to operate their own international gateways.

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-- Measles control continues to improve with more countries and areas
achieving very low levels of measles circulation; some have already
achieved elimination.

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''We want to eliminate measles as soon as possible,'' said Dr Shigeru Omi,
WHO Regional Director for the Western Pacific, ''but we have to realize that
progress across the Region varies and some countries are further advanced than
others .

Measles vaccine efficacy
-- A single dose of vaccine, given in ideal conditions , protects about
85% of children if given at the age of 9 months; about 90% at the age
of 12 months.

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But geographical, cultural, and other barriers leave many communities
underserved .

Background Information on Measles

What is measles?
-- Measles is caused by a virus (Paromyxovirus family).

Spread of measles
-- Measles only affects humans.

Measles elimination strategy
-- Ensure that 95% of children get two doses of measles vaccine.
-- As well as the indirect benefits, measles elimination will be of
greatest benefit to disadvantaged populations as they are the ones
that have the greatest disease burden.

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"
Because measles is one of the most infectious viruses, practically every
child needs to be immunized with two doses of measles vaccine to stop its
spread.
Routine immunization services are a fundamental public health requirement.

For more information , please contact:

Dr Yang Baoping,
Regional Adviser in the Expanded Programme on Immunization
Tel: +63-2-528-9747
Email: yangb@wpro.

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-- The characteristic rash (raised red blotches) usually appears 14 days
after infection; it spreads from the head to the trunk and then the
limbs over 3 to 4 days.

Measles vaccine
-- Available since 1963.
-- Measles has already been eliminated from a significant number of
countries . Measles elimination is an
issue of justice and fairness. DUBLIN, Ireland, African Mobile Communications Market to their offering.

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"The children who die from measles are generally the most
disadvantaged children in the Region.
-- About 1 per 1000 cases gets brain inflammation (encephalitis).

Measles elimination
-- Elimination does not mean zero cases -- because importations and some
spread from these are inevitable.

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Measles has already been eliminated in the WHO Region of the
Americas.newscom.
"It is unacceptable that children are dying from measles, a disease that
can be easily prevented by an effective, safe and inexpensive vaccine," said
Dr Omi. Measles elimination makes it essential for health services to
reach, and keep reaching , every community. In so doing, other health
interventions can also be delivered to the community , including other life-
saving vaccines.
-- It is one of the most infectious viruses.

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''
Despite a 95% reduction in measles deaths in the Region since the pre-
vaccine era, measles remains a leading cau se of death among young children. This means that health services need to reach every community,
especially the most disadvantaged that are at highest risk of disease and its
consequences . "Sustained political commitment and
sufficient funding are crucial to achieve measles elimination ," said Dr Omi.

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"We think that a target date of 2012 will help to mobilize these.
-- The high coverage requirement for measles elimination, and the need to
achieve that high coverage routinely for every birth cohort is
challenging.newscom.

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It also leaves at least as many with life-long disabilities like blindness,
deafness and brain damage.
But measles elimination has to compete for attention and funding with many
other development issues in the Region.com/reports/c14197

Laura Wood
Senior Manager
Research and Markets
press@researchandmarkets.

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