Measles Cases in U.S. at a Twenty Year Record High
May 29, 2014

It’s all over the news.  Measles cases across the U.S. are appearing in record numbers.     

In a special briefing held by the CDC this afternoon, it was announced that the U.S. is experiencing a 20 year record high number of measles cases.  From January 1st through May 23rd there have already been 288 cases of measles reported. 

That’s the highest we’ve seen in the period between January and May since 1994.  By the end of 1994, the U.S. had reached 764 measles cases.  Let’s hope this is not where we are headed. 

Of course, this is not the kind of record you want to break.  But here it is.

 

There have been 288 cases, covering 18 different states, all part of 15 different outbreaks, the largest of which have occurred in Ohio, New York City and California.  

 

The face of this outbreak is varied. 

• Cases have occurred in people 2 weeks of age to 65 years of age, but approximately half of the cases (52%) were in people over 20 years of age. 
• 90% of people who were infected with measles were either not vaccinated or their vaccination status is unknown.
• Only 10% of the reported cases were in persons who were vaccinated.
• Among the 195 patients who had measles and were unvaccinated, 165 declined vaccination because of religious, philosophical, or personal objections, 11 were missed opportunities for vaccination, and 10 were too young to receive vaccination.
• There have been no deaths from the measles cases so far but 43 cases have required hospitalization, most often for pneumonia. 

Identifying the risks.

While everyone should be concerned about the outbreaks and take precautionary measures (due to the fact that measles is highly contagious and no vaccine is 100% effective), there are some people who are especially at risk.  These include anyone who is unvaccinated, as well as travelers and children who may be under-vaccinated or not up to date on their MMR vaccination.

In the year 2000, the U.S. declared the indigenous spread of measles eliminated, but today things appear to be changing.  Measles is very contagious and as we’ve seen can get out of control very quickly. Since 2000, all cases of measles in the U.S. have been imported and therefore it’s no surprise that 97% of the cases in the U.S. this year have been imported.  People travel to areas where measles is present and return to expose people here who are not adequately vaccinated.  The CDC reports that in the current measles outbreaks importations has come from at least 18 countries, with about half coming from the Philippines which currently has over 32,000 cases of measles.

 

In Ohio, where there have been 138 cases of measles this year as of May 23rd, the outbreak is believed to have originated among Amish community members who recently traveled overseas to do service work.   Since vaccination rates among the Amish were low it didn’t take long before the disease began to spread.  Realizing the risks of this contagious disease, the Amish community in Ohio is now working with the health department and many are taking steps to get vaccinated. 

Julie Miller, health commissioner in Knox County, where there have been 100 measles cases, was quoted in the USA Today as saying,

“The Amish population in Knox County has been very cooperative in getting vaccinated or self-reporting (if they have symptoms) or staying home if they do get the measles.” 

Even so, Melanie Amato, public information officer for the state Department of Health in Ohio was quoted in the USA Today as saying that there’s no sign that the momentum of the outbreak has yet been broken. 

“We don’t think it will be over any time soon.  We’re looking for this to continue into the summer.” 

It’s important that people realize that measles is contagious as long as four days before the symptoms appear.  Unfortunately parents and even physicians who haven’t seen measles in years may be unaware of the early warning signs or may simply not expect to be seeing a case of measles – which is why special news briefings, like the one issued from the CDC today, can be helpful to the public.   

Timely vaccination is the best way to prevent measles.  

Be sure you and your family members know your vaccination status and are up to date, especially before traveling abroad or to areas where there is a known outbreak. 

• Despite the fact that the MMR vaccine is not scheduled for children until 12-15 months of age, the CDC suggests that it is acceptable for younger children who are traveling internationally to receive an MMR vaccine as early as 6 months of age.   If babies receive a precautionary shot before 12 months of age, it is suggested that they still receive a dose at 12-15 months of age and then another at 4-6 years of age as indicated on the recommended schedule.
• Adults should have at least 1 dose of MMR vaccine but can receive 2 doses for full protection.  This is especially important for college students as well as adults who work as healthcare workers, provide childcare, or who are traveling internationally.
• The U.S. introduced the MMR vaccine in 1963 but it wasn’t until 1989 that the U.S. started the recommendation for the 2 doses (instead of just one dose).  Therefore all adults born between 1963 and 1989 may have only received one dose of MMR vaccine and can choose to get a second dose for added protection. 
• Adults born before 1957, likely had measles, and some people born after 1957 got measles, but if an adult is unsure as to whether they should be immunized they should go ahead and talk to their doctor.  
• People who are pregnant or immunocompromised should not get MMR vaccine (since it is considered a “live vaccine”). 

 

For the transcript of the CDC’s special news briefing go here. 

For the CDC’s new Morbidity and Mortality Weekly Report on the measles situation in the U.S. today visit here. 

For more information about measles and the MMR vaccine visit the CDC website here.       

 

 

 

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