US Measles Outbreaks Surpass 1000 Cases for 2019

The number of measles cases nationwide has surpassed 1000 for 2019, according to a press release issued by the US Department of Health and Human Services (HHS).

Measles was declared eliminated in 2000 after a successful vaccine program, however, in 2008, several outbreaks occurred in pockets of unvaccinated individuals.

More than half of the measles cases in the United States have been reported in New York City, which has documented 566 cases to date. Another 255 cases have been confirmed in Rockland County, New York. Apart from New York, 25 other states have confirmed cases of measles so far in 2019.

In an exclusive interview, Contagion® spoke with Matthew Zahn, MD, an Infectious Diseases Society of America (IDSA) spokesperson, regarding the state of the outbreaks. Zahn said that what makes 2019 unusual is that there are several large outbreaks nationwide, not just 1.

“What I think is really unique this year is that we’re seeing so many large outbreaks at the same time. We’ve certainly have seen large outbreaks like these in recent years, but very often it’s 1 major outbreak per year. For example, in 2015 it was the Disneyland driven outbreak... we will see these outbreaks, but the number of different communities that are seeing large outbreaks this year I think is distinct from years past,” Zahn told Contagion®.

According to public health officials, the outbreaks are being fueled by misinformation surrounding the safety of vaccines.

“The Department of Health and Human Services has been deeply engaged in promoting the safety and effectiveness of vaccines, amid concerning signs that there are pockets of undervaccination around the country. The 1000th case of a preventable disease like measles is a troubling reminder of how important that work is to the public health of the nation,” Alex Azar, secretary of HHS, said in his statement.

According to officials, most of the cases in New York City have involved members of the Orthodox Jewish community. On April 9, the health commissioner ordered anyone who lives, works, or resides in 4 separate Brooklyn zip codes to be vaccine with the MMR vaccine if they have not been already. Noncompliance could result in a $1000 fine.

In a previous interview with Contagion®, Aaron E. Glatt, MD, chairman of the Department of Medicine and a hospital epidemiologist at South Nassau Communities Hospital, who is also an Orthodox rabbi in 2 New York congregations, said that it’s important not to conflate any certain religious or ethnic identity with anti-vaccine attitudes.

“As a physician and orthodox Rabbi, I have tried to be extremely vocal in disseminating appropriate medical and religious information to stop and prevent such outbreaks,” Glatt, who is also an IDSA spokesperson, states. “It is critically important to know the real science behind the phenomenal efficacy, benefit, and safety of the vaccine. MMR is truly one of the greatest lifesavers in medical history.”

Although under-vaccination is fueling this outbreak, tending to outbreaks of vaccine-preventable diseases can have implications and consequences for public health efforts.

Zahn, who currently serves as the medical director of the Division of Epidemiology and Assessment for the Orange County Health Care Agency and oversaw the 2015 Disney outbreak, says that having to respond to a preventable disease like measles takes public health staff away from their day-to-day responsibilities.

“The response to a measles, to even an individual measles case, is very labor intensive. It will frequently involve needing to reach hundreds of persons who’ve been exposed and assess their status and potentially offer them prophylaxis,” he said. “That’s for an individual case. When you have multiple cases or an outbreak, that becomes a great deal of work from public health and absolutely a local health department will end up taking staff away from their regular jobs to help assist with these events. So, it certainly creates a ripple effect in the public health work force even when you have a single case.”

For the most recent case counts in ongoing measles outbreaks, check out the Contagion® Outbreak Monitor.