In the United States, rates of measles, a vaccine-preventable disease, had been fairly low since the endemic spread of measles was eliminated in 2000.
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 2015
Unfortunately measles cases have been on the rise recently. After hitting a record low number of cases in 2004 (just 37 cases), we seem to continue to hit new record highs for measles every few years now.
So far, there have already been over 644 confirmed cases of measles in the U.S. in 2014 - the most since 1994. And 2015 is getting off to a very strong start already - at least 154 cases in 17 states.
Most concerning, more and more, cases don't seem to have an source that is easy to find, which could mean that the endemic spread of measles has returned in the United States. So instead of having to travel out of the country or be exposed to someone who got measles with a link to international travel, you could get measles just by going to a ball game, a movie theater, or to Disneyland. That makes it more important than ever to learn how to avoid measles.
It is also important to stay up to day on the recent measles outbreaks and exposures include:
- A new case in Illinois, the 15th - and so far not linked to the other two outbreaks in the state. (2015)
- New cases in Los Angeles, Riverside County, and Santa Clara, bringing the case count in California up to 126 cases for 2015.
- A student at Princeton University in New Jersey. (2015)
- We continue to see more measles cases in California - a total of 123 confirmed cases now, including two separate outbreak strains - D8 (endemic in India) and B3 (an outbreak strain in the Philippines) and a continued shift towards younger ages - 27% of cases are now under the age of 5 years. (2015)
- More measles in Clallam County, Washington - a 14-year-old sibling of a previous case and who was already in quarantine when he developed symptoms (showing the importance of quarantines, since he hopefully didn't expose any other people). Another adult was also diagnosed with measles, an acquaintance of the first case in the area. The increase in cases has led at least one daycare to refuse unvaccinated children. (2015)
- Another infant, the 12th, from the KinderCare Learning Center in Illinois, bringing to 13, the total count in this outbreak. (2015)
- Another case of measles in the Washington D.C. area, a case without a known source. (2015)
- Two more infants at the KinderCare Learning Center in Palatine, Illinois (a suburb of Chicago), bringing the total in the outbreak to 12 - all unvaccinated. (2015)
- An unvaccinated student at Olympic Christian School in Port Angelas, Washington, which has led to the quarantine of up to 16% of students at the school until the end of February. (2015)
- Two new cases in Ventura County, California. (2015)
- A case in Contra Costa County, California who may have exposed riders on the Bay Area Rapid Transit (BART) riders commuting between East Bay and San Francisco. (2015)
- A case in a student at Elgin Community College in Kane County, Illinois. (2015)
- Three more cases in north suburban Cook County, Illinois (near Chicago), including another unvaccinated infant in a KinderCare daycare (6 infants and 1 adult). All together, 8 of 9 cases of measles in Illinois this year were unvaccinated, including all of the cases at the daycare. (2015)
- A hospitalized infant in Atlanta, Georgia. (2015)
- Multiple reports of possible cases of measles in Lancaster, Pennsylvania; Shelby County, North Carolina; and Montgomery County, Pennsylvania (not measles).
- An unvaccinated 1 year old in Jersey City, New Jersey. (2015)
- New case counts in California, where at outbreak that started at Disneyland is now up to 103 cases, including 36 without a known source of exposure.
- Five infants at a Chicago area daycare. (2015)
- A hospitalized man in Port Angelas, Washington, with an unknown source of measles infection. (2015)
- A traveler in King County, Washington that may have exposed others in Seattle. The unvaccinated visitor is from Brazil, where there was a large outbreak of measles last year (almost 400 cases). (2015)
- At least one more case in Clark County, Nevada and four more possible cases in Southern and Northern Nevada, which led to the quarantine of at least 11 students at the Spanish Springs Elementary School. (2015)
- A case in Franklin County, Pennsylvania that is not linked to the Disneyland outbreak. (2015)
- Four cases of measles in travelers, including two international travelers, who visited Florida. (2015)
- More measles in California, including a infant in Santa Monica that led to the closing of a daycare and the quarantine of over a dozen infants. (2015)
- Another quarantine in Riverside County, California - at least 40 unvaccinated students at Vista Murrieta High School won't be able to return to school because a school employee developed measles recently. (2015)
- A case in Washington D.C. (2015)
- At least 91 cases in California, including at least 58 that are linked to the Disneyland outbreak. (2015)
- A student at Bard College in Dutchess County, New York, who exposed many people while traveling on an Amtrak train to Penn Station in New York City. (2015)
- An unvaccinated woman in New Castle County, Delaware who had recently traveled out of the country. (2015)
- A case on the University of Minnesota Twin Cities campus in a student that had recently returned from out of the country. Although others were exposed, it is considered to be a "highly immunized" population, so hopefully the outbreak won't spread. (2015)
- A case in Fresno County, California, which may have exposed people on the labor and delivery ward of a hospital. (2015)
- Two more cases in Arizona that are tied to the Disneyland outbreak, including a woman in Phoenix who may have exposed others up to 195 children at the Phoenix Children's East Valley Center, including a 3-year-old getting chemotherapy for leukemia. (2015)
- An adult in Cook County, Illinois which in not linked to Disneyland. (2015)
- A student at Valley High School in Las Vegas which led to the quarantine of 36 unvaccinated students until early February. (2015)
- A baseball coach at Santa Monica High School in California. (2015)
- Four cases among an unvaccinated family in Kearny, Arizona that is directly linked to the Disneyland outbreak. (2015)
- A child in Sioux Falls, South Dakota that is unrelated to 13 recent cases in the area and which has no link to travel out of the area. (2015)
- A new case in Oakland County, Michigan that is likely linked to the Disneyland measles outbreak, meaning that the outbreak has now spread to include 7 states and 2 countries. (2015)
- There are now 68 measles cases in California, including 48 with a known link to the Disneyland outbreak and 20 additional cases with no known direct link. Plus 9 other cases outside of California that are linked to the Disneyland outbreak in Arizona (1), Utah (3), Colorado (1), Washington (2), Mexico (1), and now Oregon (1). (2015)
- A case in Maricopa County, Arizona has been linked to the Disneyland outbreak. (2015)
- There are now 59 measles cases in California, including 42 with a known link to the Disneyland outbreak and 17 additional cases with no known direct link. (2015)
- A person in Nebraska who could have exposed others in Omaha and Blair, including at the Omaha Children's Museum. (2015)
- Two more cases in Riverside County, California that are linked to the Disneyland outbreak. (2015)
- A case in Lane County, Oregon that has been linked to the Disneyland measles outbreak. (2015)
- A resident of Tarrant County in North Texas who developed measles after a trip to India. (2015)
- Another unvaccinated person in Utah with links to the Disneyland outbreak has tested positive for measles, bringing the total in that state to 3 cases. (2015)
- There are four new cases of measles in California, bringing the new total of the outbreak that started with visitors at Disneyland up to 51, including cases in Orange County (16), San Diego County (10), Los Angeles County (8), Alameda County (4), Ventura County (3), Riverside County (2), and San Bernardino County (2), California; Utah (2), Washington (2), Colorado (1), and Mexico (1). That we are seeing so many new cases with no apparent link to Disneyland, could mean that measles is spreading in the community, will be harder to contain, and could mean that this will turn into another big outbreak.
- In addition to the 36 measles cases that have been associated with the Disneyland outbreak, California already has 5 additional measles cases this year with no link to Disney, including cases in Alameda, Orange, and Ventura Counties. (2015)
- The Disneyland measles outbreak case count is now up to 42, and includes 36 cases in California, 2 cases in Utah, 2 cases in Washington, one case in Colorado, and a case in Mexico (a 22-month-old unvaccinated girl). (2015)
- Seven more measles cases in California, an unvaccinated family in San Diego that had temporarily shut down a clinic (call ahead before visiting a doctor or ER if you think that you have measles so that they can be prepared and can avoid exposing other patients and staff), bringing the case count from this outbreak to 39. (2015)
- Six more measles cases have been confirmed as being linked to the Disneyland outbreak, which now includes 28 cases in California, 2 cases in Utah, and one case in both Washington and Colorado. (2015)
- An unvaccinated teen at Huntington Beach High School in Orange County, California, but which is not thought to be linked to the large outbreak from Disneyland. (2015)
- The Disneyland measles outbreak case count is now up to 26, with more cases being confirmed in Southern California. (2015)
- An unvaccinated teenager from Grays Harbor County, Washington who had visited Disneyland. There are now at least 20 cases of measles in the Disneyland outbreak. (2015)
- The Disneyland measles outbreak total is up to 19 now, including 16 cases in California, 2 in Utah, and 1 in Colorado. Most of the cases are unvaccinated. (2015)
- Five more people in California have contracted measles after a trip to Disneyland, bringing the total in the Disneyland outbreak to 15. (2015)
- Another case in South Dakota. There are now 13 cases, all unvaccinated, in this South Dakota outbreak that started with an unvaccinated adult traveling to India. (2015)
- A person in Colorado Springs, Colorado who likely contracted measles after visiting Disneyland, bringing the total in the Disneyland outbreak to 10. (2015)
- At least nine people who developed measles after visiting Disneyland in Southern California, including seven people from California (Alameda, Orange, Pasadena, Riverside, and San Diego counties) and two people from Utah. Only one was vaccinated. (2015)
- Three more intentionally unvaccinated people in Davison County, South Dakota, bringing the total in this outbreak to 12 and perhaps making these new cases the first measles cases of the new year. (2015)
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 second (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.
- In addition to many developing countries where measles is still endemic, international measles outbreaks have been reported in Europe, Japan, and the Philippines, etc., which makes it important to make sure you are fully vaccinated before traveling out of the US.
- 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.
- 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.
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.
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.