In 2000, measles was declared to be eliminated (defined as the interruption of year-round endemic transmission) in the USA. There were occasional, small numbers of secondary outbreaks since then resulting from individuals who were not vaccinated and who had visited areas that still had endemic measles outbreaks.
Measles incidence fell from around 600,000 cases per year in 1960 to an average of around 60 per year in the 2000’s in the USA as a result of a widespread vaccination with the MMR vaccine. This is an incredible success in public health, since around 5% of those children who catch measles require hospitalization, and 1 in 1000 die.
Unfortunately, this year, measles has come back. Luckily, not as bad as in 1960, but still, after we thought we had stopped endemic outbreaks in the USA to see it return is troublesome.
A new report from the US Centers for Disease Control and Protection (CDC) states that there have been 288 measles cases in the USA from 1 January through 23 May 2014, slightly less than 5 months. This is the highest number of cases since measles was declared eliminated in the USA, and more than the 220 in all of 2013 (what was previously considered the worst year). Fifteen outbreaks accounted for almost 79% of these measles cases. Most of the cases were in Ohio, California and New York City.
What is particularly frightening is that most of the 288 measles cases reported this year were in persons who were unvaccinated (69%), or who had an unknown vaccination status (20%). Only 30 cases (slightly less than 10%) were in persons who were fully vaccinated. Of the 195 who had measles and were unvaccinated, 165 (85%) declined vaccination because of religious, philosophical, or personal objections. This totally debunks the outrageous lies by antivaccine propagandist Sayer Ji and others who claim that only vaccinated individuals spread the disease.
As the CDC has reported previously, MMR vaccine uptake in the USA is still high enough for herd immunity (>90%). But that’s an average across the whole country, and there are many pockets of unvaccinated children, mainly because vaccine refusal tends to cluster among certain groups. And it takes only one person who has visited and returned from a country with endemic measles (such as the Philippines, which has a significant number of visitors to and from the USA) to begin an outbreak in these unvaccinated clusters.
There’s really no excuse to not vaccinate children with the MMR vaccine. We’ve already shown that the vaccine does not cause autism. Let’s protect children from this disease, and eliminate it (again) from the USA.
- Gastañaduy PA, Redd SB, Fiebelkorn AP, Rota JS, Bellini WJ, Seward JF, Wallace GS. Measles — United States, January 1–May 23, 2014. Morbidity and Mortality Weekly Report (MMWR). 2014 May 29;63:1-4.
- Katz SL, Hinman AR. Summary and conclusions: measles elimination meeting, 16-17 March 2000. J Infect Dis. 2004 May 1;189 Suppl 1:S43-7. Review. PubMed PMID: 15106088.