CDC Cites Largest U.S. Resurgence of Measles Since 2001

At least four outbreaks of measles are underway around the United States, the largest resurgence in years of the once-common childhood disease, federal health officials reported yesterday.

At least 64 cases were reported in nine states between Jan. 1 and April 25, and four outbreaks are ongoing in Arizona, New York, Michigan and Wisconsin, the federal Centers for Disease Control and Prevention said. That is the largest number of cases reported for that time period since 2001.

"I am concerned. This is different from what we have been seeing in the last few years," said Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases.

The outbreaks appear to have been triggered by cases imported into the United States from other countries, particularly Switzerland and Israel, which are fighting very large outbreaks, Schuchat said. The disease apparently was able to take hold in this country because of pockets of children who were not immunized, either because they were too young or because their parents objected for religious or other reasons.

Officials, who have been growing increasingly worried about parents shunning vaccines for their children because of safety concerns, said the measles outbreaks illustrate the danger.

"We are concerned . . . about the population of people who are choosing not to be vaccinated and whether we may be on the verge of facing large-scale outbreaks in the United States," said Jane Seward, deputy director of the Division of Viral Diseases at the CDC.

Sixty-three of the cases occurred in people who were unvaccinated or whose vaccination status was unknown, including 21 people who were not vaccinated because of religious or personal beliefs.

Measles, which is caused by a virus that spreads like the cold or flu, usually causes symptoms such as a rash, high fever, cough, runny nose, and red, watery eyes. In rare cases, patients experience more serious complications, including pneumonia, encephalitis and even seizures and death.

No one has died so far this year, but at least 14 patients have been hospitalized.

The disease was once extremely common, infecting as many as 4 million people and killing as many as 500 each year. But the development of a highly effective vaccine in 1963 caused cases to plummet, and in 2000 health officials declared ongoing transmission of the disease eliminated except for cases imported from other countries.

Of the U.S. cases reported so far this year, 10 were in people infected in other countries, and 44 others have been directly linked to the imported cases.

"We do expect many more cases this year than in 2001, based on what's going on today," Schuchat said. "We have multiple near-simultaneous outbreaks with different importation sources. And we have gone on to the third, fourth or possible fifth generation of transmission in some of these circumstances. So I think that there is reason for concern that we haven't seen the end of this."