Two-dose measles immunization as a strategy to eliminate measles in the Middle East and Israel.

640 Measles is still a significant cause of morbidity and mortality in children in the Middle East. This region has many hard-to-reach populations, causing difficulties in the provision of adequate immunization coverage. There has been concern that measles vaccine may produce transient immunosuppression in malnourished children and thereby increase their risk for the development of infectious diseases in the immediate post-immunization period. Since the Middle East has a relatively high rate of children suffering from chronic malnutrition, it is important to assess the immune response of these children to measles immunization in order to provide assurance that the measles vaccine, while effective in preventing measles, does not increase the risk for other infectious diseases. Israel is officially part of the European Region of the World Health Organization but belongs geographically to the Middle East. Other countries in the Middle East are included in the Eastern Mediterranean Region of the WHO. This paper reviews the progress made in Israel and the Eastern Mediterranean Region of the WHO towards achieving the WHO goal of the elimination of measles by the year 2010. In addition, this review summarizes data on humoral and cellular immune responses to measles vaccine that is relevant for programs targeted at the prevention of measles in populations suffering from malnutrition.