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Caribbean on measles watch

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The United Nations says its health agency has called for “stepped-up” surveillance to prevent the spread of measles in the Americas, including the Caribbean.

The U.N. said on Wednesday that the recent outbreaks of measles – one of the leading causes of deaths among young children – in the United States and Brazil suggest that immunization rates in some areas have dropped below levels needed to prevent the spread of imported into the Americas.

The U.N. World Health Organization (WHO) and the Pan American Health Organization (PAHO), based in Washington, D.C., have reported that there were 147 confirmed measles cases in four countries of the Americas this year, as of Feb. 8.

“Of that total, 121 cases were in the United States, linked primarily to an outbreak that began at Disneyland in California last December,” said the PAHO/WHO statement, adding that a single case in Mexico was also tied to that outbreak. Of the remaining cases, 21 were in Brazil and four were in Canada.

“Thanks to high levels of immunization, the Americas have been on track for more than a decade to be formally declared free of measles,” said Dr. Cuauhtemoc Ruiz, head of PAHO/WHO’s immunization program. “Maintaining high levels of vaccine coverage is key to preventing and halting outbreaks and to protect our populations from the constant threat of imported cases.”

Measles had been considered eliminated from the Americas since 2002, due to the absence of endemic transmission of the disease as the result of the region’s success in achieving high levels of immunization, the U.N. said.

Now, measles elimination “is facing major challenges, with several ongoing importations of measles in some countries,” said PAHO/WHO in an epidemiological alert distributed Tuesday to member-countries across the region.

The alert urges countries to strengthen measles surveillance activities and to “take appropriate measures to protect residents in the Americas against measles and rubella.”

“Countries in the Americas have reported cases imported from other regions every year during the past decade, but until recently, they did not lead to significant outbreaks,” Ruiz said. “The current outbreaks point to gaps in immunization that could allow measles and other vaccine-preventable diseases to take hold again and begin spreading in our hemisphere.”

Measles vaccine has been used for more than 50 years and has proven to be safe and effective, the U.N. said.

Globally, it said measles vaccine prevented an estimated 15.6 million deaths between 2000 and 2013.

PAHO/WHO recommends that children receive two doses of measles-containing vaccine before their fifth birthday and that levels of coverage with two doses be maintained at 95 percent or more to prevent the spread of imported cases.

Currently, an estimated 92 percent of one-year-olds in the Americas receive a first dose of measles vaccine, PAHO/WHO said.

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