Measles Cases Approach Greatest Annual Number Since US Elimination

Since January 1, 2019, 626 cases of measles have been documented in the United States, according to the US Centers for Disease Control and Prevention (CDC). The nation has now recorded the second-greatest number of cases reported since measles was declared eliminated in the US in 2000.

With 71 new cases reported during the week ending April 19, health officials are anticipating that 2019 will see the greatest number of cases since 2000, forecasting that case counts will surge past the record of 667 cases documented during all of 2014.

According to the most recent data, measles outbreaks, which are defined as 3 or more cases, are ongoing in Rockland County, New York; New York City, New York; Butte County, California; Washington state; New Jersey; and Michigan. Although only 5 states are currently experiencing outbreaks, 22 states have reported confirmed cases of measles in 2019.

The current outbreaks have all been linked to travelers who brought the contagious disease into the United States following travel to nations including Israel, Ukraine, and the Philippines, where measles outbreaks are ongoing. As measles spreads through pockets of unvaccinated individuals and outbreaks grow, public health officials have been struggling to curb transmission in individuals who are not vaccinated.

In an effort to reinforce the safety and efficacy of the measles, mumps, and rubella (MMR) vaccine, Peter Marks, MD, PhD, director of US Food and Drug Administration’s (FDA) Center for Biologics Evaluation and Research, issued a statement on April 22, 2019.

“We cannot state strongly enough—the overwhelming scientific evidence shows that vaccines are among the most effective and safest interventions to both prevent individual illness and protect public health,” Marks said in the statement, pointing out that the vaccine not only protects the individuals who receive it but also the children with compromised immune systems due to illnesses such as cancer who cannot receive the vaccine.

Marks also pointed out that the vaccine also prevents complications caused by diseases including measles. Complications can result in pneumonia, brain swelling, and death, and 1-2 children out of every 1000 that contract the disease die from complications. One in 4 individuals who contract measles require hospitalization.

“But just to be clear, the FDA has determined that the MMR vaccine is both safe and effective in preventing these diseases,” Marks writes. “We join our colleagues at [Health and Human Services], CDC, National Institutes of Health, and state and local health departments across the country in the continued effort to encourage vaccinations against these preventable diseases.”

The statement also acknowledges the potential side effects that may accompany the MMR vaccine, but points out that these side effects, including rash and fever, are generally mild and short-lived. Marks recommends that parents with concerns about potential side effects should speak with their child’s health care provider about the benefits and risks of vaccines, as well as the potential consequences of not vaccinating against diseases.

In a recent segment of Contagion®’s Insights program on the measles, Glenn Fennelly, MD, MPH, professor and chair of pediatrics at Rutgers New Jersey Medical School and a pediatric infectious disease specialist, and Christina (Tina) Tan, MD, MPH, a state epidemiologist and an assistant commissioner with the New Jersey Department of Health, tackled the subject of overcoming vaccine hesitancy. The experts endorsed the CDC and the American Academy of Pediatrics for websites that provide evidence-based strategies related to how to have conversations with parents about the importance of vaccination.

In this segment, Tan addressed how the so-called “vaccination era” could be providing individuals with a false sense of security that vaccine-preventable diseases are no longer a threat to their community and the nation.

“I think that unfortunately, we’re always the victims of our own success. As a practicing physician and as a public health practitioner, we are really proud of the impact that vaccination has made in terms of curbing vaccine-preventable diseases,” Tan said. “And not seeing some of the diseases rampant as they were prior to the prevaccination era, as we call it—where you were seeing hundreds of thousands of cases of measles or other vaccine-preventable diseases—sometimes gives people a false sense of security.”

Contagion® will continue to monitor the outbreaks and cases in the United States provide updates as they become available. Case counts for the current outbreaks are available on the Contagion® Outbreak Monitor.