What the world can learn from China's success at curbing measles

As the world grappled with major measles outbreaks across the globe this year, China took significant steps toward reducing the number of measles cases and deaths associated with them, the CDC reports.

Measles incidence declined from 31 per million in 2015 to 2.8 per million in 2018 and only one measles-associated death was reported from 2018 through June 2019. The reduction in measles cases is staggering, particularly considering that 182 countries reported 364,808 measles cases to the World Health Organization in the first half of 2019.

China developed a comprehensive measles elimination plan that substantially reduced measles incidence from 2006 to 2012. While the country experienced a resurgence from 2013 to 2015, it once again curbed the spread of the disease through 2019.

China has used laboratory-supported surveillance to guide its measles elimination activities and strengthen routine immunizations. It identified gaps in immunity among its population of 1.4 billion people and addressed the gaps with follow-up vaccinations. China has had a national requirement since 2005 that kindergartens and primary schools check vaccination status for children on entry, and children who have missed vaccine doses are referred to clinics to get them. However, vaccination is not mandatory for entry to kindergartens or other schools.

In addition, China used research to find out the weak points in its measles elimination strategies and developed policies to strengthen those strategies. For example, in 2015 the Chinese Ministry of Health recommended hospital professionals receive the measles vaccine. The country also consulted with international partners, including the CDC, WHO and the World Bank, to guide its strategies. In 2017, the China CDC and WHO hosted an international consultation to improve vaccine coverage assessment methods.

Mathematical modeling predicts that measles will eventually be eliminated in China if it continues to use current strategies.

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