Measles is spreading across the United States despite the fact that the deadly virus was declared eliminated from the United States 19 years ago.
The Centers for Disease Control reported Monday that from Jan. 1 to April 11, a total of 555 individual cases of measles have been confirmed in 20 states: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Texas and Washington.
Only 15 weeks into 2019, this is already the second greatest outbreak of imported measles since the highly contagious disease was eliminated from the United States in 2000, according to the CDC.
The greatest? 2018. The reasons? Visitors from abroad and declining vaccination rates.
The first elimination of indigenous measles transmission occurred when Dr. Robert Amler, dean of New York Medical College’s School of Health Sciences, was at the CDC as a young doctor on measles surveillance, which included many blood tests over many years. By the 1980s, the vaccine proved so successful that measles infections dropped to less than 1 case per 100,000 in the U.S.
“We had shown that there was not transmission between people within the U.S.,” Amler told Patch. “When imported cases of measles would come in … typically they could infect a couple of people around them but these sporadic instances would not generate an outbreak, because we had a highly vaccinated population.”
The CDC said the U.S. experienced 17 outbreaks in 2018. Three outbreaks in Rockland County, New York City and New Jersey, respectively, contributed to most of the cases. Cases in those states occurred primarily among unvaccinated people in Orthodox Jewish communities. Those outbreaks were associated with travelers who brought measles back from Israel, where a large outbreak is occurring. In all, 82 people are known to have brought measles to the U.S. from other countries in 2018.
This year, measles outbreaks related to unvaccinated international travelers, some foreigners and some citizens returning from trips, are ongoing in:
“The wild measles virus is very good at finding susceptible people in a community,” Amler said. “The virus is very efficient, very effective. The virus finds people sometimes faster than we can.”
Since the measles vaccine was licensed in the early 1960s, most of today’s adults had had very little experience with the disease, he said. “I think it is understandable that many people begin to ask — how important is it? and then they think — what could go wrong?”
The flaw in the logic, he said, is that parents find themselves espousing a point of view that really means they feel comfortable with putting their children at greater risk than the people around them. They are also putting other people at risk.
“It’s very sad. No matter what you believe in, parents care about their children,” he said, describing investigating a polio outbreak in an Amish community. “You should use the medicines we know work.”
The rate at which people with measles suffer from complications, which include deafness and encephalitis, is much worse than any from the vaccine, he said. “The vaccine virus has been tempered and weakened. The wild virus is just that.”
The measures public health officials are taking across the country are essential, he said, doing everything possible to prevent people susceptible to measles from coming in contact with people who are infected.
“If we want to stop the outbreak in its tracks we have to stop those linkages,” he said.
Step one is trying to get as many people as possible to check the immunization status for every member of the family and get everybody vaccinated. Step two is contact tracing, where health officials interview everyone with measles to try to find out where they’ve been and who they’ve been with. The third is deciding which areas need to be quarantined or protected.
The good news, he said, is that the measles vaccine works quicker in the body than the wild virus. If you’re unvaccinated and learn you’ve been exposed to measles, if you get the vaccine in the next day or two, there’s an excellent chance you’ll be protected from that exposure.
“It’s very straightforward,” he said. “The takeaway for every Patch reader is check the vaccination records of everyone in your household. If you are not sure, it never hurts to get an extra dose of vaccine.”
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