Measles eradication: Is it in our future?

Measles eradication would avert the current annual 1 million deaths and sav e the $1.5 billion in treatment and prevention costs due to measles in perp etuity. The authors evaluate the biological feasibility of eradicating meas les according to 4 criteria: (1) the role of humans in maintaining transmis sion, (2) the availability of accurate diagnostic tests, (3) the existence of effective vaccines, and (4) the need to demonstrate elimination of measl es from a large geographic area. Recent successes in interrupting measles transmission in the United States, most other countries in the Western Hemisphere, and selected countries in other regions provide evidence for the feasibility of global eradication. P otential impediments to eradication include (1) lack of political will in s ome industrialized countries, (2) transmission among adults, (3) increasing urbanization and population density, (4) the HIV epidemic, (5) waning immu nity and the possibility of transmission from subclinical cases, and (6) ri sk of unsafe injections. Despite these challenges, a compelling ease can be made in favor of measles eradication, and the authors believe that it is in our future. The questio n is when.