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Measles outbreaks result of unvaccinated population
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Eight measles outbreaks of varying sizes have been reported to the CDC this year, according to a CDC report released this week.
From Jan. 1 to Aug. 24, 159 cases of measles were reported to the CDC, of which 146 (92%) were in unvaccinated patients or those who had unknown vaccination status; 42 (26%) cases were imported.
Anne Schuchat
“This is a far cry from a crisis, but with measles, things can change quickly,” Anne Schuchat, MD, MPH, director of the CDC’s National Center for Immunization and Respiratory Diseases, said during a media telebriefing this week. “We need to stay ahead of this virus and need to maintain high coverage rates.”
Nearly two-thirds of the cases were reported from three outbreaks that occurred after introduction of measles into communities with pockets of philosophical or religious exemptions.
“The increase in measles cases in the United States in 2013 serves as a reminder that imported measles cases can result in large outbreaks, particularly if introduced into areas with pockets of unvaccinated persons,” Gregory Wallace, MD, and colleagues from the CDC wrote in the Morbidity and Mortality Weekly Report.
Most measles cases reported to the CDC from 16 states from January to August were among those who were unvaccinated (82%) or had unknown vaccination status (9%). A total of 42 two importations were reported, with 21 (50%) from the WHO European Region.
“Europe isn’t typically a place you think about updating your vaccinations when you travel, but measles cases are reported everywhere,” Schuchat said. “There are 160,000 cases of measles reported globally.”
Eight separate outbreaks accounted for 77% of the cases, including the largest outbreak reported in the United States since 1996. A total of 58 measles cases occurred in a religious community in Brooklyn, N.Y., between March and June. None of these patients had documentation of vaccination at the time of exposure, including 12 (21%) who were younger than 12 months. Of those who were eligible for vaccination, 31 (67%) had objected or had parental objection to vaccination because of religious or philosophical beliefs.
The second largest outbreak, which occurred in North Carolina, involved 23 people (including a California resident) who were not vaccinated because of philosophical exemptions.
In an ongoing outbreak in Texas, 21 confirmed cases have been reported as of Aug. 24 among members of a church community. Nineteen (95%) cases were in patients older than 12 months, and 17 (85%) of the patients were unvaccinated. The index patient was an adult with unknown measles vaccination history who traveled to Indonesia, according to the CDC.
Importations of measles into the United States continue to occur and pose a threat to our country, especially for those who are unvaccinated, Schuchat said.
“As these outbreaks are showing us, clusters of people with like-minded beliefs leading them to forgo vaccines can be susceptible to outbreaks when measles virus is imported from elsewhere,” she said. “We need very high rates of immunization to protect the most vulnerable: children who are too young to be vaccinated and those who can’t be vaccinated due to certain health conditions.” – byCassandra A. Richards
For more information:
- CDC. MMWR. 2013;62:752-753.
- CDC. MMWR. 2013;62:753.
- Texas Department of State Health Services. http://www.dshs.state.tx.us/news/releases/20130816.aspx. Last updated Aug. 16, 2013. Accessed Sept. 12, 2013.
Disclosure: The researchers report no relevant financial disclosures.