Although vaccination coverage for major infectious diseases in Haiti was below that of other countries in the region, recent WHO estimates had shown some improvement in recent years. Most recent data are summarized in the following chart:

Also check out GIDEON’s free ebook: Infectious Diseases of Haiti

A recent outbreak in Dulovo belies the fact that measles rates in Bulgaria and surrounding countries have decreased considerably in recent decades. See graph:

We may assume that decreasing rates are the result of excellent vaccine coverage, which currently exceeds 90% for all countries in the region. See graph:
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A case imported from India into the United States is the latest in a growing list of cross-border measles episodes. The following is a chronology of notable outbreaks reported during the past decade.

1998 – An outbreak (69 cases, 2 hospitalized, 0 fatal) in Tuvalu was ascribed to introduced cases among workers from Nauru.
1998 – An outbreak (33 cases) was linked to an infected visitor arriving to Alaska, United States from Japan.
1999 – An outbreak (75 confirmed cases) in Australia was traced to an index case from Indonesia.
2000 – Outbreaks (78 cases, total) in Canada were linked to travel in Mexico (6 cases), Bolivia (19 cases) and Belgium (25 cases).
2000 – An outbreak (992 cases, or 57% of all cases for the Americas region) in Haiti was thought to originated with imported cases from the Dominican Republic.
2000 to 2001 – An outbreak (1,062 cases, 0 fatal) was reported in Tanzania among refugees from Burundi.
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The recent upsurge of measles in Burkina Faso cannot be explained in terms of vaccine policy alone. Disease rates in that country declined during the 1980′s and 1990′s, at a time that estimated vaccine coverage was only 40% to 70%; while the current outbreak began despite a coverage rate of 94%.

A recent outbreak in Western Visayas belies the fact that measles rates in the Philippines have declined dramatically since the 1990′s, in parallel with increased vaccination usage.

From 1983 to 1997, the Philippines had reported one of the highest measles rates in this region.

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A recent outbreak in Cameroon reminds us that measles rates in West Africa have changed little during the past two decades.

The following graph illustrates the fact that vaccine use has clearly been associated with declining morbidity; however, vaccination rates remain below 75%.

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Steve Berger quoted in ProMED:

Although vaccine coverage in Qatar has lagged slightly behind those of neighboring countries, a slight increase in disease incidence during 2007 belies the fact that measles cases have been dramatically reduced through expanded immunization since 1990. This graph illustrates regional vaccine coverage estimates, and this graph displays trends in measles incidence for Qatar in comparison with concurrent vaccine coverage.

Following the latest outbreak of measles in Switzerland, Steve graphs vaccine coverage in the neighboring countries in this ProMED post:

This latest outbreak in Lucerne reminds us that the goal of 95 percent measles coverage continues to elude this region of Europe. See graph.

In another discussion on measles on the ProMED mailing list – this time in Taiwan – a great reference to the information available in GIDEON, which complements the information available from Taiwan’s CDC:

… according to the Global Infectious Disease & Epidemiology Network – GIDEON, the numbers of clinical cases of measles reported annually in Taiwan were: 1386 in 1988; 44 in 1990; 303 in 1992; 71 in 1993; 101 in 1994; 40 in 1995; 49 in 1996; 63 in 1997; 49 in 1998; 23 in 1999; 48 in 2000; 59 in 2003; 36 in 2004; 39 in 2005; 24 in 2006 — available at http://www.gideononline.com) Taiwan has undertaken the goal of measles elimination by 2010. Data available at the website review a vaccination coverage of the cohort born in 2002 of 95 percent with MMR 1st dose. No information was available on 2nd dose coverages.

A note about Russia and measles also references GIDEON.

Steve is quoted once again in ProMED:

The latest outbreak of Measles – Democratic Republic of the Congo (Katanga) highlights the fact that measles rates in this area have changed little during the past 2 decades.
The relevant data extracted from the GIDEON database can be viewed in graphic form via the following link.
There is little doubt that such outbreaks are related to continued suboptimal and erratic vaccination coverage.