Answer:
Before the introduction of the vaccine, measles was a "must" disease in childhood, so that by 20 years of age more than 90% of the world's population had already had it. Of global endemic behavior, it caused epidemics of great proportions every two or three years, mainly at the end of winter, in spring in regions of temperate climate, and throughout the year in regions of tropical climate.
According to WHO figures, in the 1980s, measles caused about 2.6 million deaths in the world, and after intense vaccination campaigns, in 2013 there were 145,700 measles deaths worldwide, which translates 400 deaths per day and 16 per hour, with evident improvement in lethality figures, but persisting as a public health problem even in many countries22. The worldwide distribution of cases reported to WHO by different countries between 2008 and 2014
Measles vaccination has provided great public health benefits, reducing global mortality from this cause by 75% between 2000 and 2013. In 2013, approximately 84% of the world's child population received, through health services usual, a dose of measles vaccine close to one year of life. In 2000, that percentage was 73%. It is estimated that between 2000 and 2013, the measles vaccine prevented 15.6 million deaths, making it one of the best investments in public health.
In America, recent outbreaks of measles in the United States of America (USA) and Brazil, from cases imported from other regions of the world, suggest that immunization rates in some areas have fallen below the levels needed to prevent The spread of the disease. Measles is considered eliminated from the Americas since 2002 due to the absence of endemic transmission of the disease23. An international verification committee is compiling evidence to declare the measles-free region, which would make the Americas the first region in the world to eliminate the disease, in line with similar successes such as the elimination of smallpox in the 1970s and polio in the 90 ', achievements that have been the result of regional efforts to achieve high vaccination coverage, through regular immunization programs and mass vaccination campaigns.
However, the region has not been without problems, regional outbreaks originate from imported cases. The genotyping of cases identified in outbreaks in Latin America between 2010 and 2014 is presented in Table. This genetic characterization of circulating viruses is a critical component of measles laboratory surveillance and molecular epidemiological studies. The combination of molecular analysis and the investigation of a standard case, provides sensitive information to describe the routes of transmission of the virus and to document the interruption of endemic transmission of measles. The absence of endemic genotype (s) is one of the criteria to verify the elimination of measles in a country or region.
