Measles cases in the United States have now exceeded the highest number on record in a single year since the disease was eliminated in 2000.
In a statement late Wednesday, Health and Human Services Secretary Alex Azar said the United States is seeing “a resurgence of measles, a disease that had once been effectively eliminated from our country. ... Measles is not a harmless childhood illness, but a highly contagious, potentially life-threatening disease.”
He called the measles vaccines “among the most extensively studied medical products we have,” with their safety “firmly established over many years in some of the largest vaccine studies ever undertaken.” He said the CDC is ready to support public health departments in monitoring and responding to these outbreaks.
The high number of cases this year is primarily the result of a few large outbreaks, the CDC said Wednesday. The outbreaks in New York City and New York State are among the largest and longest lasting since 2000. “The longer these outbreaks continue, the greater the chance measles will again get a sustained foothold in the United States,” the CDC said.
The outbreaks are linked to travelers who brought measles back from countries such as Israel, Ukraine and the Philippines, where large measles outbreaks are occurring.
This year, as in the past, officials say the majority of people in the U.S. who have fallen ill were unvaccinated. In some communities, anti-immunization activists have spread false claims about the measles, mumps and rubella vaccine, causing concern among parents about inoculating their children. When many people in a community have not been vaccinated, the disease can spread quickly.
The CDC said misinformation about the safety of the vaccine is “a significant factor contributing to the outbreaks in New York."” The agency said some organizations, which it did not name, are “deliberately targeting these communities with inaccurate and misleading information about vaccines.”
CDC urged parents to speak to their family health-care providers, and local leaders to provide “accurate, scientific-based information to counter misinformation.”
Measles is one of the most contagious diseases in the world and can cause serious complications, including pneumonia and encephalitis, an inflammation of the brain that can have long-term consequences, especially among young children, adults with weakened immune systems and the elderly. Before the widespread use of vaccines began in 1963, it infected millions every year in the United States, killing several hundred.
The states that have reported cases to CDC this year are: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Texas, Tennessee and Washington.
CDC’s last update was 626 cases from 22 states on April 22. The CDC defines an outbreak as three or more cases. In addition to New York City, there are measles outbreaks in California; Rockland County, N.Y.; New Jersey; and Michigan, where almost all 43 cases are linked to one man who traveled to the Detroit area from Brooklyn, unaware that he had measles.
The largest outbreak is in New York City, centered in a predominantly Orthodox Jewish community in Brooklyn. There have been 334 cases there this year, including 31 in just the past week. Two are pregnant women, including one who was diagnosed in mid-April, Health Commissioner Oxiris Barbot said Wednesday. City officials issued summonses to 12 individuals for failing to be vaccinated against measles, a violation of the city’s emergency order mandating immunizations to control a surging outbreak.
Among the latest outbreaks is one in Los Angeles County, where the health department tweeted Wednesday that it has five confirmed cases. Los Angeles county health officials said four of the cases are linked to one another after international travel, and an additional single case of measles also occurred after international travel.
In Oregon, officials reported an additional four cases in Multnomah County, which includes Portland. But these cases are not related to the Pacific Northwest outbreak that was centered in nearby Clark County in Washington.
In Washington state, 74 people contracted the infection in that outbreak, including 63 who were unvaccinated. Health officials are expected to declare that outbreak over if no more cases are reported by later this week.
Measles spreads by direct contact with infectious droplets or through the air when an infected person breathes, coughs or sneezes. The virus can remain infectious in the air for up to two hours after an infected person leaves an area. Infected people can spread measles to others from four days before through four days after the appearance of a rash. Symptoms begin with a high fever, cough, runny nose and red eyes, followed by a rash that usually begins at the head and spreads to the rest of the body.
The CDC recommends children get two doses of the MMR (measles, mumps and rubella) vaccine, starting with the first dose at 12 to 15 months of age and the second dose at 4 to 6 years of age. Adults born before 1957 are unlikely to need more MMR shots since most caught measles and have natural immunity.
But if someone doesn’t have written documentation of an MMR shot, they should talk with their doctor. People born between 1957 and 1989 generally had only one MMR dose. One dose is about 93 percent effective at preventing measles, but anyone in that age group can still get a second dose, health officials say. Two doses are about 97 percent effective. Even if someone has had two doses (or can’t remember), doctors say it is okay to get a third dose.