Measles on the Rise
Measles Cases on the Rise
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As the result of high immunization rates with the measles, mumps, and rubella (MMR) vaccine since 1996, measles was officially eliminated in the United States in 2000. However, the disease is less well controlled in the rest of the world. With travel in and out of the United States so easy and common, the number of measles cases reported in the U.S. has slowly started to increase.
According to a new report from the Centers for Disease Control and Prevention (CDC),[1] in 2011 the U.S. saw its highest number of confirmed measles cases in over a decade, with 222 cases and 17 outbreaks. In comparison, from 2001 to 2010, the median was 60 cases and 4 outbreaks annually. Of the 222 cases, 196 occurred in U.S. residents with a median age of 14. Among all of the cases, 90% were imported from other countries, including 26% of people returning to the U.S. from abroad and 10% from foreign visitors. The country that imported the most cases of measles was India (16), followed by France (13), and the Philippines (6). Among a country cluster, Europe was the source of the most cases (33). Seventy of the patients with measles (32%) were hospitalized for diarrhea, dehydration, or pneumonia; no cases of encephalitis or deaths were reported.
Almost 90% of patients were unvaccinated or had an unknown vaccination status, although 85% of them were eligible the MMR vaccine. Among the 66 patients unvaccinated between the ages of 16 months to 19 years, 76% of them had not received the vaccine because of a philosophic, religious, or personal objection.
The increase in measles importations and outbreaks during 2011 serves as a reminder that measles remains endemic in many parts of the world and unvaccinated U.S. residents continue to place themselves and others in their communities at risk for measles and its complications. A drop in MMR vaccination coverage in a community can increase the risk for large sustained measles outbreaks, as experienced recently in Canada and France,[2,3] or reestablishment of endemic transmission, as experienced in the United Kingdom.[4]
The CDC reminds you to
- Suspect measles in patients presenting with febrile rash illness and cough, coryza, or conjunctivitis and who’ve recently traveled internationally or who’ve had close contact with international travelers
- Use isolation measures immediately and report suspected cases to local health departments
- Remind patients who plan to travel internationally of the increased risk for measles and potential exposures during bus, train, air travel, and at large international events or gatherings (eg, Euro 2012 and the 2012 Summer Olympics) and of the importance of vaccination
- Ensure all eligible children and adults are appropriately vaccinated as follows:
- Children: one dose at 12 months; second dose at 4-6 years
- Adults without evidence of measles immunity: one dose
- Unvaccinated healthcare personnel, international travelers, students attending college outside of the United States: two doses
- Anyone older than 6 months who will be traveling outside of the U.S. and is eligible to receive the MMR vaccine should be vaccinated before travel
- Children older than 1 year should receive two doses of MMR separated by at least 28 days prior to travel
Jill Shuman, MS, ELS
Published May 1, 2012
References
- Centers for Disease Control and Prevention. Measles-United States, 2011. MMWR Morb Mortal Wkly Rep. 2012;61:253-257.
- European Centre for Disease Prevention and Control. Surveillance report: European monthly measles monitoring, 21 February 2012. Stockholm, Sweden: European Centre for Disease Prevention and Control; 2012. http://ecdc.europa.eu/en/publications/publications/sur_emmo_european-monthly-measles-monitoring-february-2012.pdf . Accessed April 6, 2012.
- Measles. Ministere de Santé et Services sociaux Quebec Website. http://www.msss.gouv.qc.ca/en/sujets/prob_sante/measles/measles.php. Published 2012. Accessed April 6, 2012.
- Measles once again endemic in the United Kingdom. Euro Surveill. 2008;13(27):pii: 18919.
Thanks for the good summary that parallels the MMR recent report ; I have not seen native measles since 1987 but I have seen 3 cases of vaccine rash in the last 3 months in some very young children and have an autistic 4 yr old nephew who was imprudently vaccinated when he had a viral uri at 12 months ; I have not had a single autism case in my entire peds practice of 28 yrs by giving the MMR seperately from the other vaccines and that is my final answer.