A Los Angeles County Department of Public Health poster lists the symptoms of measles. (Damian Dovarganes/AP)
By Lena H. Sun
At least 704 people in the United States have been sickened this year by measles, the highly contagious and potentially life-threatening disease, according to a new report released Monday morning, April 29 by the Centers for Disease Control and Prevention. It’s the greatest number of cases in a single year in 25 years and represents a huge setback for public health after measles was declared eliminated in the United States in 2000. More than 500 of the people infected were not vaccinated. Sixty-six people have been hospitalized, including 24 individuals who had pneumonia. More than one-third of the cases are children younger than five.
The biggest and longest-lasting outbreaks are in New York’s Rockland County and Brooklyn, centered in ultra-Orthodox Jewish communities.
Despite the evidence, the anti-vaccination movement is gaining strength.
There have been 13 outbreaks reported in 2019, accounting for 663 cases, or 94 percent of all cases. The CDC defines an outbreak as three or more cases. Half of those outbreaks were associated with close-knit religious or cultural communities that were under vaccinated, accounting for 88 percent of all cases.
In response to the record number of cases this year, New York City has imposed a mandatory vaccination order, and Rockland County has mandated that anyone with measles must avoid public spaces or face a $2,000-a-day fine. And in California, hundreds of college students were quarantined last week after one student with measles attended classes on three days while contagious at the University of California at Los Angeles, and another contagious person spent hours at the library of California State University, Los Angeles.
The rare and extreme measures reflect the seriousness of this year’s outbreaks. In a statement Monday, Health and Human Services Secretary Alex Azar said: “We have come a long way in fighting infectious diseases in America, but we risk backsliding and seeing our families, neighbors, and communities needlessly suffer from preventable diseases.”
“We are very concerned about the recent troubling rise in cases of measles,” Azar said in a briefing with reporters. Measles is not a harmless illness but one with deadly consequences that most people have not seen because it was eliminated in 2000. “Vaccine-preventable diseases belong in the history books, not in our emergency rooms. The suffering we are seeing today is completely avoidable. Vaccines are safe because they are among the most studied medical products we have,” Azar said.
To mark National Infant Immunization Week, he urged everyone to make sure they and their loved ones are up-to-date with the CDC’s recommended vaccine schedule, which provides guidelines for people of all ages and with specific health conditions.
There are no treatments and no cures for measles, said CDC Director Robert Redfield. “There is no way to predict how bad a case of measles will be,” he said. Most of those sickened in this year’s outbreaks have been unvaccinated, and most are in children under 18, he said. “Measles can be serious in any age group, but particularly in children younger than five and older adults, they are more likely to suffer complications.”
No deaths have been reported in outbreaks this year.
Measles can be deadly, especially for babies and young children. Some people may have severe complications such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain), which can lead to hospitalization and death. Measles may cause pregnant woman to give birth prematurely or have a low-birth-weight baby.
As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children. About 1 child out of every 1,000 who get measles will develop encephalitis, which can lead to convulsions and can leave the child deaf or with intellectual disabilities. On average, for every 1,000 children who get measles, one or two will die of it.
The United States was able to eliminate person-to-person transmission of measles in 2000. The recommended two doses of the measles, mumps and rubella vaccine is 97 percent effective in a given person in preventing measles. But because the virus is so contagious, communities need to have near-perfect levels of between 93 to 95 percent of the population vaccinated to protect against the disease.
Gaps in vaccination coverage in the United States and around the world in recent years have resulted in lower immunization rates, and many countries in Europe, Asia, the Middle East and Africa are experiencing large measles outbreaks.
As a result, when unvaccinated travelers get measles abroad and return to the United States, especially to close-knit communities with low vaccination rates, these communities are “at risk of sustained measles outbreaks,” the CDC report said.
The virus lives in the nose and throat of an infected person. It can spread by direct contact with infectious droplets or through the air when an infected person breathes, coughs or sneezes. The measles virus can remain infectious in the air for up to two hours after an infected person leaves an area. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses or mouths, they can become infected. Measles is so contagious that if one person has it, up to 90 percent of the people close to that person or who walk through the same area and are not immune also may become infected.