Why tuberculosis is a difficult disease to target for control or elimination?

(33%) between 5 and 10 years and 8 (11%) more than 10 years. Amongst the clinical features, fever was seen in 100%, rash in 86%, coryza in 71% and conjunctivitis in 67%. Koplik spots, pathognomic of measles were seen only in 29%. Leucopenia (total WBC count<4000 cells/mm3) was seen in 46% and leucocytosis (total WBC count>10,000) in 13%. Measles specific IgM antibodies by ELISA was done only in 42(60%) and positive in 16(23%) and there was clustering of cases between the months of January-June. It is unfortunate that 77% children had received measles immunization earlier thus stressing the need for revaccination and only 56 (80%) children received oral vitamin A supplementation. The proportion of children attacked by measles even after immunisation went on increasing with the increasing age, suggesting the waning of immunity with increasing age, which is similar to earlier study reported by Sharma, et al(3). With regards to measles related complications, one child had mild upper GI bleed and one had photophobia. All cases were brought under measles surveillance system and managed conservatively. There was no mortality. To conclude, measles is re-emerging with lot of children affected despite their previous immunization status though our findings represent only the tip of the iceberg. Larger studies in future are needed to stress the importance of including second dose of measles in Universal Immunisation Program.