What next in measles control for Karnataka, India?

Introduction Worldwide, measles kills 400 people every day, more than 90% of them being under five years of age. Three out of four measles deaths happen in India, the only country that has not yet introduced a second dose of measles vaccine. Prevention of deaths due to measles is key to achieve fourth millennium development goal of reducing under-five mortality by two thirds by 2015. India’s progress in measles control is a major determining factor in global control of measles. There is limited literature available on measles epidemiology in India. No measles surveillance was done before 2006. The measles surveillance programme, based on an existing flaccid paralysis surveillance system, was launched in four southern states of India in 2006, including Karnataka. In this paper I attempt to describe the epidemiology of measles in Karnataka and to identify ways to improve measles control in the state.