Table 1. Documenting elimination in Ontario: components of PAHO’s Plan of Action that were within the scope of this study.

Component	Indicators and suggested analyses
Epidemiology of measles, rubella and congenital rubella syndrome (CRS)	Verify the interruption of endemic measles, rubella, and CRS cases for a period of at least 3 years from the last known endemic case, through an examination of Morbidity rates Temporal and spatial characteristics Seasonality Demographic characteristics Outbreaks
Measles and rubella vaccinated population cohorts	Population cohort aged less than 40 years with ideally at least 95% coverage.
Quality of measles, rubella and CRS surveillance	Reporting rate Annual rate of suspected measles and rubella cases >= 2 per 100,000 population Annual rate of suspected CRS cases >= 1 per 10,000 live births Adequate investigation % suspected measles and rubella cases with the following 11 data points completed: name and/or identifier, place of residence, sex, age or date of birth, date of reporting, date of investigation, date of rash onset, date of specimen collection, presence of fever, date of prior MR vaccination, and travel history % suspected CRS cases with the following eight data points completed: name and/or identifier, place of residence, sex, date of birth, date of reporting, date of investigation, date of specimen collection, and vaccination history of mother; also clinical examinations for deafness, blindness, and congenital cardiopathy >=80% Viral detection % measles and rubella outbreaks with genotype information available from at least one viral specimen % confirmed congenital rubella syndrome cases with adequate specimen analyzed for virus detection/isolation >= 80%