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 2013
After a recent record high in 2011, measles cases are down to just 54 in 2012, but are up again to 75 (91 provisionally) so far in 2013. That likely reflects lower numbers in Europe, after intense efforts to improve vaccination levels in those countries. Keep in mind that measles cases are starting to rise again, especially in the UK, where there have already been over 800 cases of measles in Swansea, Wales since November. There were 2,000 cases of measles in the UK in 2012, the highest since 1994.
Some recent measles outbreaks and exposures include:
- 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)
- The New York City measles outbreak which has now grown to 48 confirmed cases, with additional suspected cases being investigated. This has prompted new vaccinated rules for area children to help stop the outbreak. This is the largest measles outbreak in the United States since 2000! (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, 2013 international measles outbreaks have been reported in:
- Pakistan - over 25,000 cases, with 146 deaths in children
- Ukraine - 11,734 cases
- France - 679 cases
- Italy - 592 cases
- Spain - 334 cases
- Romania - 4,087 cases
- United Kingdom - 2,314 cases
- Australia - at least 89 cases
- Quebec, Canada - 742 cases
Of the 8,499 cases of measles in the European Union in the past 12 months, 82% were unvaccinated, 13% were not fully vaccinated, and only 4% had received two doses of the MMR vaccine. There were also 6 cases of measles encephalitis, a serious complication of measles.
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.
- 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.
- 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.
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.
Sources:
CDC. Notifiable Diseases and Mortality Tables. MMWR. January 7, 2011 / 59(52);1704-1717.
European Centre for Disease Prevention and Control. Measles and rubella monitoring, April 2013. Surveillance reports - 24 Apr 2013.
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.
