Summary
The COVID-19 pandemic severely impacted measles-rubella vaccination initiatives creating lingering immunity gaps that continue to drive large and disruptive outbreaks in many countries. The GMRLN Guidance for Laboratories during Measles Outbreak (GLMO) is designed to outline the critical capacities required to enable a rapid and effective laboratory response to measles outbreaks. The guidance describes the planning needed to prepare for the current global increase of measles cases and outbreaks and the possibility of rubella outbreaks. This document is designed to be used in conjunction with the WHO Measles Outbreaks Strategic Response Plan: 2021–2023 or the upcoming Measles Outbreak Strategy 2026-2030 integrating both laboratory and epidemiologic surveillance. The GLMO can be used as an aid for global, regional, national, and local teams for developing country-specific outbreak response plans for laboratories. The GLMO will be included in the next revision of the WHO Laboratory Manual for Measles and Rubella.
The Measles Outbreak Strategic Response Plan outlines the following key planning objectives in preparing for measles outbreaks:
1. Coordination – Enhance national, regional, and global coordination mechanisms for measles outbreak preparedness and response.
2. Prevention – Expand vaccination efforts in vulnerable communities through resource mobilization for risk-based national plans in countries that are not eligible for Gavi support.
3. Preparedness – Enhance national capacity for outbreak preparedness in priority countries (e.g. planning, detection, readiness for investigation and response), including robust surveillance.
4. Response and recovery – Improve the timeliness and effectiveness of investigation and response to measles outbreaks, including detection, root cause analysis (RCA) to identify programmatic gaps to prevent future outbreaks, after action reviews and recovery
The type and magnitude of the response to measles outbreaks should be based on the characteristics of the outbreak and the feasibility of mounting an appropriate response. The more rapid the response, the more likely it is to mitigate the impact of the outbreak. The Measles Outbreak Strategic Response Plan covers key elements of response including coordination, case management, infection prevention and control, surveillance and laboratory, logistics, vaccination, risk communication, social mobilization and community engagement and disease control in special settings.