Measles is an acute viral disease caused by a paramyxovirus of the genus Morbillivirus. It is spread from one person to another by infected droplets from the mouth, nose and throat of an infected person. Its signs and symptoms include fever, cough, running nose, red and watery eyes and a generalised maculopapular erythetous rash (Kouadio et al. 2010). Measles is more severe in malnourished children and its complications include diarrhoea, middle ear infections, pneumonia, dehydration, stomatitis and encephalitis (CDC nd). The signs and symptoms of measles generally begin 10-12 days after contact with an infected person. Since the disease is contagious one week before and one week after the rash begins, it is during this period that measles is mostly transmitted. In the mid-1980s it was estimated that 2.1 million children in the world under the age of five years were dying annually from measles (Jeena and Coovada 2001). In 1998, there were an estimated 30 million cases of measles worldwide and about 900,000 deaths (WHO). This precipitous drop in measles-related fatality cases has largely been due to the Expanded Program on Immunisation, which has managed to vaccinate large numbers of children against measles. Although the virus causing measles was first isolated in 1954 by John Enders, the first measles vaccine was only licensed in the US in 1963 (CDC nd) and for developing countries such as Malawi the vaccine was made available much later.
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