MEASLES EPIDEMICS IN TURKEY AND DEVELOPING COUNTRIES: REVIEW OF THE LITERATURE

Vaccination with an attenuated live virus vaccine has proven to induce protective immunity in seronegative individuals, and even low titers of neutralizing antibodies seem to be protective. In developing countries with a high level of infection, infants below the age of 12 months are at high risk for MV infection. In this age group passively transferred maternal immunoglobulins (Ig) pose a problem because declining maternal antibodies interfere with vaccine-induced seroconversion but do not protect against infection with wild-type MV (2-5).

The World Health Organization (WHO) has advocated that outbreak immunization only be undertaken in areas with either high routine immunization coverage and the capacity to respond immediately to epidemics, or where there is overwhelming political pressure to intervene (6-8).

In Turkey, the children are vaccinated againts measles at nine months of age routinely. The goal numbered twenty-five of The National Health Politics Document published by The Ministry of Health in March 1993 was nationwide eradication of measles untill 2005 (9), measles epidemics are still seen in our country causing hundreds of children deaths.

In this study, it was aimed to evaluate the measles morbidity and mortality rates of Turkey during 1970-2001 and extent of global measles outbreaks.

Material and Methods
This epidemiological study included data about measles morbidity and mortality rates of Turkey during 1970-2001, distrubition of cases according to age and months in 2001 and reports of measles outbreaks that occurred between 1993 and 2002 in English published medline (PubMed).

Epidemiological data about measles rates of Turkey were obteined from web page of Turkish Ministry of Health available at www.saglik.gov.tr (10). We searched the pubmed for reports of measles outbreaks that occurred between 1993 and 2002 in English published literature (for measles AND outbreaks AND epidemics). We also searched WHO and Centers for Disease Control and Prevention (CDC) web pages and related journals (EPI Newsletter, Emerg Infect Dis, MMWR, Wkly Epidemiol Rec).

In this article, the term 'outbreak' is used to ensure consistency when referring to any increase in the occurrence of measles cases in a community above the number expected.