The Evaluation of the San-Ma-Yi-Fong:Progress with the Programs to Eradicate Measles, Rubella, Congenital Rubella Syndrome,and to Eliminate Neonatal Tetanus

Kenneth J. Bart1, Feng-Ying C. Lin2, Ding-Ping Liu3, Hsu-Sung Kuo4

2010 Vol.26 NO.5

Correspondence Author: Kenneth J Bart


The program to eradicate poliomyelitis, measles, rubella, congenital rubella syndrome (CRS), and to eliminate neonatal tetanus (NNT), San-Ma-Yi-Fong, from Taiwan was begun in 1991. In the ensuing 19 years the immunization program has matured and has been fully integrated into the countries health care delivery system. Interim goals were established and met.
Recent program strategies have been directed to maintain and sustain polio eradication; to strengthen measles, rubella and CRS eradication efforts through further increases in MMR vaccine coverage and case containment; to complement clinical efforts to eliminate NNT maintain the high coverage rates of DTP/DTaP vaccines; ensure the age appropriate vaccination of each successive cohort of children; to take every opportunity to vaccinate vulnerable females in the reproductive age group; and to undertake special vaccination activities where lower coverage was recognized or cases have occurred.
The purpose of this evaluation was to review the progress of the San-Ma-Yi-Fong; to assess what needs to be done to complete the eradication/elimination efforts, to begin preparation of the documentation for the WHO certification of the eradication of measles, rubella, CRS, and the elimination of neonatal tetanus and the Annual Report on sustaining the eradication of poliomyelitis for WHO.
By active and passive surveillance, through May 2008, no indigenous polio or congenital rubella syndrome had been reported for 3 years; no indigenous measles cases have been reported for 2 years; 6 cases of rubella were reported in 2007 and 3 during the first 5 months of 2008. No virologically confirmed wild polio cases have been reported in Taiwan since 1983. Poliomyelitis was declared eradicated in Taiwan in 2000 by the WHO and vigilance is sustained. No imported polio cases have occurred. Imported cases of measles, rubella and congenital rubella syndrome have been recognized and potential spread prevented or contained. No indigenous cases of neonatal tetanus have been reported between 2004 and 2008.
Additional strengthening and confirmatory actions should be undertaken to ensure the completion of the eradication/ elimination of the San-Ma-Yi-Fong diseases.