This article is more than 5 years old. Information may no longer be current.
CDC: Measles in the US at 20-year high
The CDC has reported the largest number of measles cases in the United States since 1994, with 288 cases documented from Jan. 1 to May 23, and the case count continues to rise.
“The number of measles cases has reached a 20-year high,” Anne Schuchat, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases, said during a media briefing. “This is not a record that we wanted to break.”
Anne Schuchat
Most cases (97%) were imported from at least 18 countries by unvaccinated travelers. Many of the current outbreaks are associated with travel to the Philippines, where there has been a measles outbreak, with more than 32,000 cases occurring since October 2013, Schuchat said.
“This is a reminder that measles is still common in certain parts of the world, and it is also one of the most contagious diseases in the world,” Schuchat said. “Vaccination is the best way to prevent measles. The measles vaccine is very effective, but only if it’s used.”
Most of the cases (90%) in the United States were among people who were not vaccinated or whose vaccination status was unknown. Among these people, 85% cited religious, philosophical or personal reasons for not being vaccinated.
Eighteen states have reported cases, with patients ranging in age from 2 weeks to 65 years. Most of the cases (52%) were among people aged 20 years and older. An ongoing outbreak among unvaccinated individuals in Amish communities in Ohio has reported 138 cases. An outbreak in California accounted for 60 cases, and an outbreak in New York City accounted for 26 cases. Forty-three cases have resulted in hospitalization.
Schuchat said health care providers must be alert to the possibility of measles and ensure that their patients are up to date with vaccinations, especially before international travel.
For more information:
Gastañaduy P. MMWR. 2014;63(early release).
Perspective
Back to Top
The CDC has given this issue great prominence, bringing it to the attention of not only health care providers, but to the general public. Many young adults today have little, if any, idea how serious a disease measles is because it has essentially been eliminated from the United States for the past 2 generations. When I tell our medical students that before we had the measles vaccine, 400 to 500 children died each year because of measles and its complications, they are disbelieving. Measles is not trivial. It is a serious infection with complications: Otitis media is bad enough, but measles can also result in pneumonia and encephalitis, which are what cause the mortality associated with the disease.
Measles persists around much of the world. Fortunately, in this hemisphere, we have eliminated endemic transmission through the use of the vaccine. The reason that we have a record number of measles cases this year is because there is a substantial number of young parents who are withholding their children from vaccination. Thus, we have a pool of susceptible children, some of whom travel abroad, acquire measles and bring it home where it spreads to children of likeminded parents. Almost 15% of the individuals in the United States who acquired measles in the United States had to be hospitalized, which is a testimony of how serious this infection is.
Another difficulty is that there is frequently a delay in diagnosing measles. Young physicians may have read about this disease, but they haven’t seen it because it has been virtually eliminated. This delay can result in more serious complications. Some of the individuals who acquire the infection are older and the complications are more frequent in older people. The most important intervention is for parents to vaccinate their children. The vaccine is safe and it is extremely effective. It has eliminated the disease from an entire hemisphere, saving the lives of 400 to 500 children in the United States each year. The misinformation, the hesitancy and the concern about the vaccine is a paradox. We’ve been so successful in eliminating the disease that young parents don’t know anything about it and they question the need for vaccination.