Not expectantly, the measles outbreaks of 2014 continue to grow larger.
We now have at least 89 cases in the United States, including:
- at least 25 cases of measles in New York City, including 13 adults and 12 children, with 6 requiring hospitalization.
- at least 21 cases in Orange County, California, with 7 requiring hospitalization.
As in most other outbreaks of vaccine-preventable diseases, unlike the anti-vaccine propaganda going around stating that 90% of the people in these outbreaks were vaccinated, many were too young to get their first dose of the MMR vaccine, had just not been vaccinated yet, or had parents who had refused to get their child vaccinated. In the New York City outbreak, only one of the children was vaccinated, but had just received one dose of MMR, so was actually just partially vaccinated and not fully protected against measles.
To help control the New York City outbreak, a health alert is advising that children in certain high risk zip codes in Northern Manhattan, the Bronx, and the Lower East Side (10034, 10040, 10033, 10032, 10451, 10453, 10002) get their first dose of MMR at 12 months. Doctors in the area should be calling all of their unvaccinated children to them get up-to-date and protected against measles.
Older children between the ages of 12 months and 4 years can get their second dose of MMR as long as it has been 28 days since the first dose. These children should not wait until they are 4 years old, as is routinely recommended. This recommendation is just for kids who show up for "routine health care services" though. The health alert is not advising that all of these children be called in to get vaccinated.
So what's next? While it is impossible to predict, we should note that most measles cases in the US are imported from other countries, where the reports of international measles outbreaks include:
- at least 3,734 confirmed cases in the Philippines and an additional 9,568 reported cases in early January 2014 through February 24 and at least 23 deaths - CDC Watch Level 1 Travel Health Notice
- at least 40 cases in southern Alberta alone, 10 in Saskatchewan, and at least 320 cases in an outbreak that began in a Christian school in British Columbia, Canada but has now spread to the general community (and to Washington State - 4 cases)
- at least 180 cases already in Japan in 2014 (232 cases in all of 2013), including at least one case of measles encephalitis and almost all unvaccinated or partially vaccinated
- large outbreaks in at least six countries in the European Union, even though, according to the European Centre for Disease Prevention and Control "the measles transmission season has not yet started"
Has measles season started in the US? High vaccination levels had seemed to interrupt the old 2-3 year cycles of high "measles years" and measles seasons. If we are getting back to those cycles, then you have to think that we are nowhere near the end of the outbreaks this year. In 2011, when we hit a record high of 220 cases, it is important to note that most of those cases came after April and May. And it shouldn't be surprising that we saw much the same patterns in the other two big years for measles, in 2008 (140 cases) and 2013 (189 cases).
Get Educated. Get Vaccinated. Stop the Outbreaks.