Nonprofit, nonpartisan journalism. Supported by readers.


UCare generously supports MinnPost’s Second Opinion coverage; learn why.

Measles cases this year total 626 — close to recent record high, CDC says

This year, measles cases have been identified in 22 states. Minnesota, fortunately, is not among them.

A sign warning people of measles in the ultra-Orthodox Jewish community of Williamsburg. On April 9, New York City Mayor Bill de Blasio declared a public health emergency in parts of Brooklyn in response to a measles outbreak.
REUTERS/Shannon Stapleton

Confirmed cases of the measles jumped by 71 cases last week, officials at the Centers for Disease Control and Prevention (CDC) announced on Monday.

That brings this year’s total number of cases to 626, a number that’s rapidly approaching the 667 cases reported in all of 2014 — the worst year for measles since 2000, when health experts declared the disease eradicated from the United States.

This year, measles cases have been identified in 22 states. Minnesota, fortunately, is not among them. Six outbreaks of the disease (defined as three or more cases) are currently ongoing in New York State (Rockland County), New York City, Washington state, New Jersey, California (Butte County) and Michigan.

“These outbreaks are linked to travelers who brought measles back from other countries such as Israel, Ukraine, and the Philippines, where large measles outbreaks are occurring,” the CDC announcement notes.

Highly contagious

Almost all — 68 — of last week’s new measles cases were diagnosed in either New York City or in Rockland County, which is just north of New York City.  Those outbreaks have been centered in ultra-Orthodox Jewish communities, where some parents have refused to vaccinate their children.

Measles, a highly contagious viral disease, spreads rapidly among unvaccinated people. When someone ill with measles sneezes or coughs, the virus can stay alive (and infectious) in the air or on surfaces for as long as two hours.

measles cases
*Cases as of Dec. 29, 2018. Case count is preliminary and subject to change.**Cases as of April 19, 2019. Case count is preliminary and subject to change. Data are updated every Monday.
Studies have shown that up to 90 percent of people without immunity to the disease will become infected after being exposed.

“We cannot state strongly enough — the overwhelming scientific evidence shows that vaccines are among the most effective and safest interventions to both prevent individual illness and protect public health,” said Dr. Peter Marks, director of the Food and Drug Agency’s Center for Biologics Evaluation and Research, in a statement released on Monday.

“Vaccinating against measles, mumps and rubella not only protects us and our children, it protects people who can’t be vaccinated, including children with compromised immune systems due to illness and its treatment, such as cancer,” he added.

Not a trivial disease

In a commentary published last week in the New England Journal of Medicine (NEJM), three doctors, including Dr. Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases (NIAID), write with dismay about how and why the momentous achievement of eliminating measles in the United States was so short-lived.

“The resurgence in measles cases is all the more frustrating since the disease is entirely preventable through vaccination,” they point out. “Measles has all the component of an eradicable disease: There is a safe and highly effective vaccine, it has a readily diagnosable clinical syndrome, and it has no animal reservoir to maintain circulation. But because of the highly contagious nature of the virus, near-perfect vaccination coverage (herd immunity of 93 to 95 percent) is needed to effectively protect against a measles resurgence.”

Herd immunity is being threatened, however, by vaccine hesitancy — the reluctance or downright refusal of people to allow themselves or their children to be vaccinated despite the availability of safe vaccines.

Article continues after advertisement

“The growing antivaccination movement, based heavily on philosophical objections to vaccinations, poses a threat to public health,” the doctors write.

Indeed, the World Health Organization (WHO) has declared vaccine hesitancy one of the top 10 global health threats of 2019.

The greatest risk of measles-related complications, which can include pneumonia, encephalitis and death, are to children and to people with medical conditions that suppress their immune systems — and who therefore can’t be safely vaccinated. Those people include individuals who have HIV or cancer, who have had organ transplants, and who are taking certain medications for arthritis or other rheumatic diseases.

But, as the doctors warn in their NEJM commentary, “if we continue to lose ground on measles prevention through vaccination, we face the reemergence of measles into new populations, which will pose new and varied challenges.”

“Measles is by no means a trivial disease,” they stress. “[B]efore widespread vaccination, the virus caused 2 million to 3 million deaths globally per year. Even today, it remains a leading cause of vaccine-preventable illness and death worldwide, claiming more than 100,000 lives each year.”

Preventable tragedies

Vaccination has prevented an estimated 21 million deaths worldwide since 2000. But that remarkable achievement is being threatened. In just one year — 2016-2017 — the number of measles cases reported globally jumped 31 percent, the doctors point out.

“Each complication or death related to measles is a preventable tragedy that could have been avoided through vaccination,” they stress. “The recent upsurge in U.S. measles cases, including the worrisome number seen thus far in 2019, represents an alarming step backward.”

“If this trend is not reversed, measles may rebound in full force in both the United States and other countries and regions where it had been eliminated,” the doctors conclude. “Promoting measles vaccination is a societal responsibility, with the ultimate goal of global elimination and eradication — relegating measles to the history books.”

Article continues after advertisement

FMI: You’ll find the NEJM commentary on the journal’s website. For more information about measles and the measles vaccine, go to the websites for the CDC or the Minnesota Department of Health.