Morbidity and Mortality Weekly Report
Weekly / Vol. 71 / No. 50 December 16, 2022
INSIDE
1576 Drug Overdose Deaths Among Persons Aged
10–19 Years — United States, July 2019–
December 2021
1583 COVID-19 and Other Underlying Causes of Cancer
Deaths — United States, January 2018 – July 2022
1589 Prevalence of SARS-CoV-2 and Influenza
Coinfection and Clinical Characteristics Among
Children and Adolescents Aged <18 Years Who
Were Hospitalized or Died with Influenza — United
States, 2021–22 Influenza Season
1597 Notes from the Field: Burkholderia pseudomallei
Detected in a Raccoon Carcass Linked to a
Multistate Aromatherapy-Associated Melioidosis
Outbreak — Texas, 2022
1600 QuickStats
Continuing Education examination available at
https://www.cdc.gov/mmwr/mmwr_continuingEducation.html
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Progress Toward Measles and Rubella Elimination — India, 2005–2021
Ratnesh Murugan, MBBS
1
; Kristin VanderEnde, PhD
2
; Veena Dhawan, MBBS
3
; Pradeep Haldar, MBBS
4
; Sourabh Chatterjee, MCS
1
;
Deepa Sharma, PhD
1
; Kevisetuo Anthony Dzeyie, MPH
1
; Subramanya Balakuntlam Pattabhiramaiah, MBBS
1
; Sudhir Khanal, PhD
5
; Lucky Sangal,
PhD
5
; Sunil Bahl, MD
5
; Sukarma S.S. Tanwar, MMeD
2
; Michelle Morales, MD
6
; Ahmed M. Kassem, MD
6
In 2019, India, along with other countries in the World
Health Organization (WHO) South-East Asia Region,*
adopted the goal of measles and rubella elimination by 2023,
†
a revision of the previous goal of measles elimination and
control of rubella and congenital rubella syndrome (CRS) by
2020
§
(1–3). During 2017–2021, India adopted a national
strategic plan for measles and rubella elimination (4), intro-
duced rubella-containing vaccine (RCV) into the routine
immunization program, launched a nationwide measles-
rubella supplementary immunization activity (SIA) catch-up
campaign, transitioned from outbreak-based surveillance to
case-based acute fever and rash surveillance, and more than
doubled the number of laboratories in the measles-rubella
network, from 13 to 27. Strategies included 1) achieving and
maintaining high population immunity with at least 95%
vaccination coverage by providing 2 doses of measles- and
rubella-containing vaccines; 2) ensuring a sensitive and timely
case-based measles, rubella and CRS surveillance system;
3) maintaining an accredited measles and rubella laboratory
network; 4) ensuring adequate outbreak preparedness and rapid
response to measles and rubella outbreaks; and 5) strengthen-
ing support and linkages to achieve these strategies, including
planning and progress monitoring, advocacy, social mobiliza-
tion and communication, identification and utilization of
synergistic linkages of integrated program efforts, research,
and development. This report describes India’s progress toward
* WHO South-East Asia Region includes 11 countries: Bangladesh, Bhutan,
Burma, India, Indonesia, Maldives, Nepal, North Korea, Sri Lanka, Thailand,
and Timor-Leste.
†
Measles elimination is defined as the absence of endemic measles cases for
≥12 months in the presence of adequate surveillance. Rubella elimination is
defined as the absence of endemic rubella cases for ≥12 months in the presence
of adequate surveillance.
§
Rubella and congenital rubella syndrome control is defined as a 95% reduction
in disease incidence from the 2013 level.
the elimination of measles and rubella during 2005–2021,
with a focus on the years 2017–2021.
¶
During 2005–2021,
coverage with the first dose of a measles-containing vaccine
(MCV) administered through routine immunization increased
31%, from 68% to 89%. During 2011–2021, coverage with
a second MCV dose (MCV2) increased by 204%, from 27%
to 82%. During 2017–2021, coverage with a first dose of
RCV (RCV1) increased almost 14-fold, from 6% to 89%.
More than 324 million children received a measles- and
rubella-containing vaccine (MRCV) during measles-rubella
SIAs completed in 34 (94%) of 36 states and union territories
¶
Although India conducts sentinel site surveillance for CRS, national CRS
incidence is not regularly reported. Modeled incidence of CRS in India has
been published elsewhere and is beyond the scope of this report.
