I wish to make 2 points about the future of measles vaccine in developing areas of the world: the one is epidemiological and the other specifically concerns vaccine programs.
There is nothing homogeneous about the epidemiology of measles in developing countries. The mortality rates, insofar as they are accurate, show up to 10-fold variations without obvious reason. Each country, therefore, presents its own special problem. Within countries also there are apparently very great variations in measles mortality.
The factors which move measles from a relatively nonkilling to a killing disease are many. We know of some: the lack of medical care, for example in the Fiji outbreaks of the 1870's; famine; refugee camps; war, and so on; and, in the tropics particularly, undernutrition or malnutrition have been shown to be factors of importance.
It would seem, therefore, that in the developing countries we need to know a great deal more
COCKBURN WC. Measles Vaccine Future in Developing Areas of the World: Part I. Am J Dis Child. 1962;103(3):522–523. doi:10.1001/archpedi.1962.02080020534079
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