Migration and measles

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Abstract
Sirs—The study by Yaméogo et al.1 highlights the importance of understanding population movement when determining the optimal timing and geographical extent of a measles supplementary immunization activity (SIA). A wide age-range SIA usually reaches children who could not be reached by systematic immunization services, rapidly reducing the proportion of measles susceptible individuals in the population, resulting in a significant reduction in measles incidence and lengthening of the time interval between major measles outbreaks.2 Yaméogo et al.'s study shows that the time to a major outbreak following an SIA is not only determined by the vaccination coverage achieved, population density, and birth rate3,4 but also population movement. Our experience with measles control in Cameroon is consistent with this finding that, in our opinion, has important policy implications.

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