The elimination of measles and rubella from the European Region is one of the main objectives of the World Health Organization (WHO), as established by The “Global Measles and Rubella Strategic Plan” and the European Vaccine Action Plan 2015–2020. The elimination is defined by the WHO as “the absence of endemic transmission in a defined geographical area, for more than 12 months in the presence of an adequate surveillance system”.
Measles and rubella viruses have right requirements to be eliminated and eradicated. They are genetically stable microorganisms and exclusively human to human transmitted; no animal or environmental reservoirs exist; contagiousness period is very short; permanent immunity is conferred by infection and an effective, safe and cheap vaccine is available.
In Italy, the elimination of measles, rubella and congenital rubella are the objectives of the National Plan for the elimination of measles and congenital rubella 2010-2015 (PNEMoRc). PNEMoRc was first sanctioned in 2003 after the measles epidemic that caused over 40,000 cases, hundreds of hospitalizations, dozens of complicated cases and 8 deaths in the biennium 2002-2003. The PNEMoRc has been updated in 2011 to avoid the occurrence of new measles epidemics, and to implement the recommendations of the WHO.
One of the main objectives of the PNEMoRc is the achievement of a vaccination coverage of at least 95% for the 1st dose (coverage at 24 months) and 95% for the 2nd dose. In Italy, as in many other Europeans countries, the vaccination schedule provides for the active and free offer of MPR vaccination, by administering two doses: the first at 15 months, the second at preschool age.
Europe is very close to reach the elimination of measles and rubella while in Italy these two diseases are still endemic.
In 2011, the Regional Verification Commission (RVC) was founded to evaluate the documentation submitted by the Member States (MS) in order to verify the elimination of measles and rubella at the regional level.
In the last RCV meeting held in June 2019 (8th meeting of the European Regional Verification Commission for Measles and Rubella Elimination) the RVC concluded that, at the end of 2018, 37 out of 53 Member States provided evidence of having interrupted the endemic transmission of measles. Of these, 35 MS have interrupted the circulation of the measles virus for more than 36 months. Endemic transmission of rubella has been interrupted in 42 MS for at least 12 months, and 3 for at least 24 months.
Thirty-three MS have provided evidence for the elimination of both measles and rubella diseases, and 9 were considered endemic for both measles and rubella.