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Stephen C. Schoenbaum, MD
Harvard Community Health Plan Boston

JAMA. 1985;254(11):1451.

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In Reply.—

I would like to point out that I did not suggest the reinstitution of a foreign quarantine service. I believe I simply raised the possibility as one of the considerations in trying to decrease importations of measles, and I rejected it out of hand as unlikely to be cost-beneficial. Mr George's suggestion that perhaps the best approach would be global eradication of measles merits further scrutiny. It is not obvious to me that this would necessarily be cost-effective for underdeveloped countries. Given very limited resources, which of the many things that could be done to improve the health and welfare of the population of those countries ought to be done first? How many of the 2.6 million children estimated to have died of measles worldwide in 1984 would have died in childhood of other causes had measles been eradicated? On the other hand, might it not be cost-beneficial . . . [Full Text PDF of this Article]

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