Measles Surveillance
Introduction
- Cornerstone of National Measles-Rubella (MR) Elimination Programme under National Centre for Vector Borne Diseases Control (NCVBDC) and Integrated Disease Surveillance Programme (IDSP)
- Shifted to case-based Acute Fever and Rash (AFR) surveillance since 2021 (from outbreak-based system)
- Real-time reporting through Integrated Health Information Portal (IHIP)
- Aligned with WHO SEARO guidelines and Global Measles Elimination Strategy
- India targeting measles and rubella elimination by 2026 (incidence <1 case per million population)
- Mandatory notification from public and private sectors; integrated with U-WIN, ABDM, MR Campaign 2025-26 and RBSK
Objectives
- Early detection of every suspected AFR case to interrupt transmission chains
- Laboratory confirmation of all suspected cases
- Rapid outbreak investigation and response (Outbreak Response Immunization β ORI)
- Monitor trends, classify cases (indigenous/imported) and generate evidence for WHO certification
- Maintain surveillance sensitivity: β₯2 non-measles AFR cases per 100,000 population per year
Case Definitions (IDSP P-form 2024)
Suspected Case
- Any person with fever AND maculopapular (non-vesicular) rash OR
- Any person in whom a clinician or health worker suspects measles infection
Probable Case
- Suspected case with epidemiological link to a laboratory-confirmed measles case
Laboratory-Confirmed Case
- IgM positive in serum (collected within 28 days of rash onset) OR
- Measles virus detection by RT-PCR (throat swab/urine within 5 days of rash)
Epidemiologically Confirmed Case
- Suspected case with epidemiological link to a laboratory-confirmed case (no lab sample)
Discarded Case
- Suspected case with negative laboratory result and no epidemiological link
Surveillance Methods
Passive Surveillance
- Routine reporting from all health facilities (public/private) via IHIP
Active Surveillance
- House-to-house search in outbreak zones by ASHA/ANM
- School and Anganwadi screening (linked with RBSK)
Sentinel Surveillance
- Designated MR laboratories and district hospitals
Laboratory Network
- 27 accredited MR laboratories (expanded from 13 in 2017)
- Sample collection: Serum for IgM ELISA; throat swab/urine for RT-PCR
- Turnaround time: Results within 7β14 days
Investigation & Response Timeline
- Day 1: Immediate IHIP notification of every suspected case (within 24 hours)
- Day 3: Case investigation form completed; blood sample despatched to MR lab
- Day 7: Preliminary lab results; outbreak investigation if cluster detected
- Outbreak Response Immunization (ORI): MR vaccine to all children 6 monthsβ14 years in affected area within 72 hours of confirmation
- Contact tracing and vitamin A supplementation
Key Performance Indicators
- Non-measles AFR rate: β₯2 per 1,00,000 population
- Timely notification: β₯80%
- Adequate sample collection & transport: β₯80%
- Completeness of reporting: β₯90%
Integration with Child Health Programmes
- RBSK: Screening for fever/rash in school children
- RKSK: Adolescent awareness
- UIP/U-WIN: MR vaccine tracking via ABHA
- FBNC/SAANS: Management of complications in neonates/infants
- ABDM: Digital case records and follow-up
Current Status (2026)
- National Zero Measles-Rubella Elimination Campaign 2025-26 completed
- Current MR-1 & MR-2 coverage >92%
- Significant decline in measles outbreaks; India on track for WHO verification of elimination by end-2026
- Continued focus on high-risk areas (urban slums, migrant populations, international borders)