Introduction Worldwide, measles still kills 400 people every day, more than 90% of them being under-fives. Three out of four deaths happen in India, The objectives of my work are to describe the epidemiology of measles in Karnataka and to identify ways to improve measles control in the state.

Methodology I collated and tabulated weekly surveillance reports and outbreak investigation line lists for 4 years. I synthesised the spatio-temporal distribution of measles cases and outbreaks in the state. Through logistic regression multivariate analysis, specified the contextual demographic and socio-cultural determinants of measles outbreaks and vaccination coverage in the state of Karnataka.

Findings Measles surveillance data from 2006 to 2009 reveal that measles is indeed endemic in Karnataka, with frequent outbreaks. The notification rate of measles is 10.94 cases per 100 000 population per year. Seasonality of notified measles cases characteristically increases between November and April and decreases from May to October. There were 163 confirmed outbreaks in the state in the 4 years under study. Measles outbreaks were happening consistently in the northern part of the state and sporadically in the southern part: The duration of these outbreaks from the date of appearance of rash in a first case to last case was ranged from 7 days to 120 days with median of 39 days.

Discussion Significant reduction in measles incidence and outbreaks can be attained only by adding a second dose to the routine vaccination scheme in the whole state and by conducting catch-up campaigns in northern Karnataka.