In the United States, rates of measles, a vaccine-preventable disease, are usually fairly low, with just 61 cases in 2010. Since 1997, measles cases have ranged from a low of 37 in 2004 to a high of 220 in 2011.
Before the routine use of the measles vaccine (1963) and the MMR vaccine (1971), though, measles cases -- and complications from those cases -- were high. There used to be about 500,000 cases of measles and 500 measles deaths each year in the United States.
Measles Outbreaks 2014
After a recent record high in 2011, measles cases were down to just 54 in 2012, but were up again to at least 189 cases in 2013.
Keep in mind that measles cases are starting to rise in other countries too, especially in the Philippines, Turkey, Vietnam, Italy, Germany, and the Netherlands.
So far, there have already been at least 112 confirmed cases of measles in the U.S. in 2014.
Some recent measles outbreaks and exposures include:
- Another case of measles in New York City. (2014)
- At least 56 confirmed cases in California, a jump from the 49 cases they were reporting a few weeks ago. (2014)
- A resident of Kitsap County, Washington who likely developed measles after being exposed in the San Juan County outbreak. This brings the total number of cases in Washington to at least 12. (2014)
- An unvaccinated person in Maricopa County, Arizona who had recently returned from Europe and who likely exposed people at the Phoenix Sky Harbor Airport and other areas in Phoenix and Scottsdale. (2014)
- A tourist from California who exposed people in West Seattle and the Sea-Tac Airport in Washington. (2014)
- A resident of Redding, California who may have exposed people at a local Olive Garden restaurant. It is their first case in 17 years. (2014)
- A student at UC Berkeley who exposed Bay Area residents while taking BART from Oakland to Berkeley and attending classes. (2014)
- A confirmed case in a hospitalized patient in Springfield, Massachusetts. (2014)
- Four more cases of measles in New York City, bringing the total case count in this outbreak to at least 25 people, including 12 children and 13 adults. (2014)
- An adult who may have exposed others in San Juan Island, Washington. (2014)
- An unvaccinated infant who exposed others at the Portland International Airport. (2014)
- At least 4 cases of measles in Whatcom County, Washington, which initially started in a resident who contracted measles while traveling in British Columbia's eastern Fraser Valley, where there are at least 228 cases. (2014)
- A resident of California who may have exposed others to measles at Sea-Tac airport. (2014)
- At least 49 cases of measles in California so far this year (as compared to just 4 cases at this same time last year), including cases in Alameda (1), Contra Costa (4), Los Angeles (10), Orange (21), Riverside (5), San Mateo (3), San Diego (4) and Santa Clara (1) counties. (2014)
- At least 21 cases of measles in Orange County, California so far this year, including 7 people who required hospitalization, in what the Orange County Health Department is calling the worst outbreak in 20 years. (2014)
- Two more cases of measles in NYC, bringing the total case count to 21 - 10 kids and 11 adults, with most of the children either intentionally not vaccinated or too young to be vaccinated. (2014)
- At least 32 cases of measles in California so far this year (as compared to just 3 cases at this same time last year), including cases in Alameda (1), Contra Costa (4), Los Angeles (10), Orange (6), Riverside (5), San Mateo (1), San Diego (4) and Santa Clara (1) counties. (2014)
- Three more cases of measles in NYC, bringing the total case count to 19. (2014)
- Two unrelated cases with unknown sources in Farifield County, Connecticut, including an unvaccinated adult and a 7-month old infant, who was too young to be vaccinated. (2014)
- Another large measles outbreak in New York City, affecting at least 7 adults and 9 children in Manhattan and the Bronx. (2014)
- A fifth case of measles in Orange County, California, who exposed others in St. Joseph's ER on March 2nd and 3rd. (2014)
- Two more cases of measles in San Diego, California which are linked to an outbreak in February, when a person exposed others at two different Naval medical facilities after contracting measles in the Philippines. (2014)
- A second case of measles in Macomb, Illinois. (2014)
- Two more cases of measles in Massachusetts, this time in Middlesex County. (2014)
- An unvaccinated man in Rhode Island, who may have exposed people to measles at two area hospitals and a CVS in North Attleboro, Massachusetts. (2014)
- Two unvaccinated family members of the University of California student who had contracted measles following a trip to the Philippines. (2014)
- A case of measles in San Mateo County, California - a person who had recently traveled internationally. (2014)
- A case of measles in Orange County, New York. (2014)
- A small child in McDonough County, Illinois. (2014)
- Another suspected case of measles in Hawaii, an unvaccinated toddler (delayed immunization) that was exposed (in a doctor's office) to the unvaccinated infant with measles that had traveled to the Philippines a few weeks ago. (2014)
- Two cases in the suburbs west of Boston. (2014)
- Two more cases of measles among the unvaccinated, quarantined students at Crowne Hill Elementary School in Temecula, California. (2014)
- A person in San Diego, California who contracted measles in the Philippines and who exposed people at Branch Health Clinic Miramar on Feb. 14 and Feb. 18 and at Naval Medical Center San Diego on Feb. 17. (2014)
- At least one person in Allegheny County, Pennsylvania who developed measles after exposure to someone in New York. The University of Pittsburgh graduate student exposed people to measles on a city bus and could have exposed up to 100 cancer patients to measles at UPMC's Hillman Cancer Center. (2014)
- At least four people in Orange County, California who have developed measles, with at least two of them becoming infected while traveling in Asia. (2014)
- An unvaccinated 11-month-old infant in Oahu, Hawaii who had just returned from the Philippines, where there has been a very large outbreak of measles in the last few years.
- A student at a Temecula, California elementary school, which has led to the quarantine of at least 10 other unvaccinated students.
- An unvaccinated student at the University of California, Berkeley who studied abroad in Asia and exposed others while attending classes and riding Bay Area Rapid Transit (BART) between Tuesday, February 4 through Friday, February 7.
- A confirmed case in Dallas, Texas which is not linked to two other area cases, did not travel internationally, and who did require hospitalization. (2014)
- A confirmed case in Grant County, Washington. (2014)
- A student at the University of Rochester in Monroe County, New York. (2014)
- Two related cases in North Texas, including an unvaccinated 12-month-old in Collin County, Texas who contracted measles on a trip out of the country. (2014)
- A graduate student at MIT in Cambridge, Massachusetts who likely contracted measles on a trip to South America. (2014)
- A resident of Rockland County, New York who may have exposed people at the Palisades Center Mall. (2014)
- An unvaccinated young child who may have exposed people to measles at Albany Medical Center in New York. (2014)
- An adult in Wisconsin who may have exposed hundreds of people to measles at UW Hospital. (2014)
- An unvaccinated student at Rensselaer Polytechnic Institute in Troy, New York. The student had signed a waiver to allow them to attend the college without the otherwise required vaccine. (2014)
- A child in Silverton, Oregon who reportedly developed measles after contact with an adult and other family members in a household outbreak of measles that is now affecting at least five family members. (2014)
- Someone in California - the first case of 2014.
- A partially vaccinated elementary school child in Clark County, Washington who developed a mild or "modified case" of measles after getting exposed to the child in Portland. (2013)
- An infant who was supposedly too young to be vaccinated in King County, Washington who was likely exposed to measles on an overseas trip and exposed people around Seattle, including the Sea-Tac Airport. (2013)
- A child in Washington County, Oregon who developed measles on an overseas trip and exposed hundreds of people in the Portland area. (2013)
- An additional person in King County, Washington, an incompletely vaccinated sibling to the unvaccinated child who got measles while traveling in Europe. (2013)
- An least two cases in Boston, Massachusetts, including multiple exposures at area hospitals, which has led that state to issue a measles alert. (2013)
- An unvaccinated person in Monroe County, Illinois who exposed others to measles at the Indianapolis International Airport. (2013)
- An unvaccinated child in King County, Washington who exposed people to measles at the US Tennis Association Pacific Northwest Juniors Sectional Tennis Tournament in Washington County and area stores, hotels, and restaurants. (2013)
- Sixteen confirmed cases of measles in Tarrant County, Texas, which includes Fort Worth, in what began with an adult who traveled overseas. Another case is under investigation, with one of the cases being an infant who is only 4 months old. The majority of the cases were not vaccinated against measles.(2013)
- A teenager in Kern County, California who contracted measles while vacationing in Europe. (2013)
- A confirmed case of measles in the Orlando, Florida area. A British tourist who visited numerous tourist attractions in the Orlando area. (2013)
- One confirmed case in Ventura County, California and an additional four probable cases that are linked to a tourist from Europe, where there have been a high number of cases in recent years. (2013)
- A person in San Diego who was exposed to measles on an international flight from Europe and may have exposed others at Fallbrook Hospital. (2013)
- Two cases in western Washington, including a child, who may have exposed others in Mercer Island, Seattle, and Kirkland. (2013)
- A traveler who passed through Sea-Tac Airport in Seattle, Washington on July 4 while contagious. (2013)
- A person in Bellingham, Washington who may have exposed people to measles at a local Costco and the Bellis Fair Mall. (2013)
- The New York City measles outbreak which grew to 58 confirmed cases and prompted new vaccination rules for area children to help stop the outbreak. This is the largest outbreak in the United States since the endemic spread of measles was eliminated! (2013)
- A person in Watchung, New Jersey who may have exposed others at BJ's Wholesale Club on June 3. (2013)
- A traveler at Dulles International Airport in Virginia who may have exposed people to measles at the baggage claim area of the airport. (2013)
- A man in Colorado who had traveled from India and likely exposed others at a clinic and the Sky Ridge Medical Center between May 25 and 27, one of which subsequently developed measles. (2013)
- A 14-month-old child in Dallas, Texas who was unvaccinated and had recently traveled out of the United States. (2013)
- At least one case of measles in Spring Valley, New York who may have exposed others at the Hatzlacha Grocery Store on May 22, when a mother brought her infected child to the store. The case is thought to be linked to the measles outbreak in Brooklyn. (2013)
- A possible case of measles at the Grand Coulee Dam School District in Coulee Dam, Washington. (2013)
- From the initial 5 cases, there are at least 34 cases of measles in New York City now, including 27 in the Borough Park area of Brooklyn and 7 in Williamsburg. All of the cases are in people who were unvaccinated and according to a measles alert from the New York City Department of Health and Mental Hygiene, complications have included "pneumonia, a miscarriage, and two hospitalizations." (2013)
- An ongoing measles outbreak in North Carolina, with an additional case being discovered after a person who attended two youth baseball games in Orange County developed symptoms of measles and exposed many people to measles on May 3 or 4, bringing their case count to 21, with an additional 44 people requiring quarantine. (2013).
- An infant in Battle Creek, Michigan, who traveled out of the country without being vaccinated against measles and likely exposed others to measles at an area pediatric office and an emergency room. (2013).
- At least 1 case in Beverly, Massachusetts. A person who was at Beverly High School during the ACT test and who exposed 344 people to measles, including 95 Beverly High students and 167 students from other schools. (2013).
- At least 19 cases in Stokes County and Orange County, North Carolina that has been traced to an unvaccinated individual who traveled to India and spread it to other people. (2013).
- At least 5 cases in Borough Park area of Brooklyn, New York. All of the cases were in unvaccinated individuals, who ranged in age from 10 months to 23 years. Due to the large number of exposures in the area, additional cases are expected. The initial case was a traveler from London, where there is a large outbreak of measles (2013).
- An unvaccinated one-year-old in Harris County, Texas with a recent history of international travel and who may have infected several other people. (2013).
- At least eight cases, including five children, in Stokes County and Orange County, North Carolina that has been traced to an unvaccinated individual who traveled to India and spread it to other, mostly unvaccinated people. (2013).
- Three cases in Somerset, New Jersey that are thought to be linked to a patient at Somerset Medical Center. (2013).
- A student at the Indiana University Bloomington campus. (2013).
- At least two cases in Gentry, Arkansas in unvaccinated siblings. A third case is suspected. (2012).
- Seventeen cases of measles in Indiana, including sixteen cases of measles in two counties just north of Indianapolis, Indiana (2012).
- An vaccinated 6-year-old (it is unknown if she was fully or partially vaccinated though) in Clayton, Delaware (2012).
- An unvaccinated child in Riverside County, California (2012).
- Six cases in Finley County, Kansas, which started in two family members who had traveled out of the country and then spread to four of their contacts (2012).
In addition to many developing countries where measles is still endemic, international measles outbreaks have been reported in:
- Canada - at least 320 cases that began in a Christian school in British Columbia, but has now spread to the general community
- Pakistan - over 25,000 cases, with 146 deaths in children
- Turkey - 7,132 cases (up from 700 last year) - CDC Watch Level 1 Travel Health Notice
- Netherlands - at least 2,499 cases in the Dutch "Bible belt" with at least one case of measles encephalitis and one death, a 17-year-old girl. Almost all of the measles cases in this outbreak are unvaccinated and the majority are children. An outbreak in Canada is linked to this outbreak in the Netherlands.
- Italy - at least 2,216 cases with an outbreak in the Milan area (350 cases)
- Germany - at least 1,772 cases (10 times more than 2012)
- Australia - already 180 cases in 2014, (151 cases in 2013), including large clusters of cases in Victoria and Queensland.
- Japan - 274 cases already in 2014 (232 cases in all of 2013), including at least one case of measles encephalitis and almost all unvaccinated or partially vaccinated.
- United Kingdom - 1,413 cases (2013)
- Philippines - at least 3,734 confirmed cases 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 Notice179 confirmed cases (up 616 percent)
As in previous years, almost all cases were not vaccinated or were only partially vaccinated. In Europe, among 10,271 cases, there have been 8 cases of acute measles encephalitis 3 deaths.
The rise in measles cases around the world has changed the recommendations for measles vaccination in the U.S. While children routinely get their first MMR vaccine at 12 months and a booster dose at 4 years, if they are traveling overseas, infants should get their first dose as young as six months of age. Children who are at least 12 months old should get two doses of MMR, separated by at least 28 days.
Measles Outbreaks - What You Need To Know
Other things to know about measles and measles outbreaks include:
- From 2 to 5% of people do not respond to their first dose of measles vaccine, which is why a booster dose is recommended. But more than 99% of people develop immunity to measles after two doses of a measles vaccine, like MMR.
- A booster dose of MMR was not first recommended in 1989, so many adults born before 1985 may not have had two doses of MMR.
- Measles is fatal in about 0.2% of cases.
- Very few of the measles cases in these outbreaks are in people who are completely vaccinated. For example, in the outbreaks in Europe in 2011, when 30,000 people got measles, causing 8 deaths, 27 cases of measles encephalitis, and 1,482 cases of pneumonia, most cases were in unvaccinated (82%) or incompletely vaccinated (13%) people.
- The measles virus is spread by respiratory droplets and can stay in an area for up to two hours after a person with measles symptoms has left.
- People with measles are contagious from four days before they develop the measles rash to four days after it goes away.
- Call your pediatrician if you think your child has measles (don't just show up at their office or in the ER), especially if he develops a high fever and/or rash during a local measles outbreak or after a trip out of the country.
- It is expensive to contain a measles outbreak.
Most importantly, parents should understand that a measles vaccine (MMR) is the best way to protect your child from measles, and is especially important if there is a measles outbreak in your area or if you are traveling to an area with high rates of measles.
CDC. Notifiable Diseases and Mortality Tables. MMWR. February 28, 2014 / 63(08);ND-100-ND-113.
European Centre for Disease Prevention and Control. Measles and rubella monitoring January-December 2013. 28 Feb 2014
CDC. Outbreak of Measles --- San Diego, California, January--February 2008. MMWR. February 29, 2008 / 57(08);203-206
CDC. Update: Measles --- United States, January--July 2008. MMWR. August 22, 2008 / 57(33);893-896
Manual for the Surveillance of Vaccine-Preventable Diseases (4th Edition, 2008)
The Pink Book: Epidemiology and Prevention of Vaccine Preventable Diseases. Updated 11th Edition, (May 2009)
World Health Organization. Measles Fact Sheet. December 2009. Accessed February 2011.