There is no single indicator of elimination. Careful analysis of the: source, size and duration of outbreaks; genotyping, temporality and geography of “unknown source” cases; seasonality and age-distribution of cases; and effective reproduction rate provide a good indication of progress or achievement of interruption of endemic transmission and the integrity of population immunity. High quality coverage data are essential, at sub-national, district and even community levels, to guide decision-making. Clearly the quality of epidemiological data is dependent on the quality of surveillance and specifically the early investigation and confirmation of suspected

measles cases [40]. While the epidemiology may be elegant it is critical that the understandings extracted are applied for “action”. This is particularly Doxorubicin chemical structure pertinent as measles is often not only a “canary

in the coalmine” for measles immunity gaps but more broadly reflects on Apoptosis Compound Library nmr deficits in child health programme access or health service delivery. The elimination of measles brings additional benefits through strengthening health systems and better delivery of other vaccines including rubella. Measles will tell us quickly if we are off track, direct our efforts towards elimination and confirm our arrival if we allow its epidemiology to be our teacher. “
“Tuberculosis (TB) caused by infection with Mycobacterium tuberculosis (M. tb) or Mycobacterium bovis (M. bovis) remains one of the most old important infectious diseases of man and animals, respectively; inflicting a huge cost in both health, welfare and financial terms [1]. At present the only vaccine against TB is M. bovis bacille Calmette–Guérin (BCG), which demonstrates variable efficacy in humans and cattle [2] and [3]. In particular, BCG appears effective in childhood, but not in adolescents and adults [4]. Despite this performance, BCG remains the most widely used human vaccine, and due to its partial

efficacy and proven safety record, is unlikely to be withdrawn and remains the benchmark to improve upon. It is clear that optimal protection against TB requires CD4 T cells, as well as the effector cytokines IFN-γ and TNF-α (reviewed in [5]). However, as other studies demonstrate; CD4 T cell derived IFN-γ is not an exclusive component of vaccine-mediated immunity [6] and identification of other critical components of protection remains elusive. To compound our incomplete knowledge, the study of BCG induced immune memory has also proven difficult. The chronic nature of TB infection, lack of sterilising immunity, and transient protective window, all contribute to complicate the characterisation of vaccine-specific T cell memory. Memory T cells exist in a number of subsets.