Thursday, January 22, 2015

California DPH Statement On Measles Outbreak


2014 Measles Status As of November – Credit CDC


# 9612


Fifteen years ago measles was declared eliminated in the United States – a product of  more than 35 years of successful vaccination policies.   But measles, like Whooping Cough (Pertussis), has made a comeback over the past decade, with rising rates both in the United States and around the world.


During the 1950s – before the introduction of the measles vaccine – the US saw roughly 4 million infections which hospitalized nearly 50,000, and contributed to the deaths of several hundred every year. 


Last May, in CDC Telebriefing: Worst US Measles Outbreak In 20 Years, we looked at the worst start for measles in 2 decades, and as the chart at the top of this blog shows, that trend continued throughout the year.  According to the CDC, many of the cases in the U.S. last year were  brought in from the Philippines (see the Measles in the Philippines Travelers' Health Notice).

The CDC warns:

  • The majority of the people who got measles are unvaccinated.
  • Measles is still common in many parts of the world including some countries in Europe, Asia, the Pacific, and Africa.
  • Travelers with measles continue to bring the disease into the U.S.
  • Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated.


Although 2015 has barely begun, already California is reporting a major measles outbreak linked to exposures at Disneyland earlier in the month.  Here is the latest update.



California Department of Public Health Confirms 59 Cases of Measles

Date: 1/21/2015

Number: 15-008

Contact: Anita Gore - (916) 440-7259


Dr. Ron Chapman, director of the California Department of Public Health (CDPH) and state health officer, announced today that local public health officials have confirmed a total of 59 cases of measles in California residents since the end of December 2014. 

“If you have symptoms, and believe you may have been exposed, please contact your health care provider. Unless you have an emergency, it is best to contact your health care provider by phone to prevent spread in doctor’s offices.” said Chapman. “The best way to prevent measles and its spread is to get vaccinated.”

Of the confirmed cases, 42 have been linked to an initial exposure in December at Disneyland or Disney California Adventure Park in Anaheim, California. The confirmed cases include five Disney employees. In addition, other cases have visited Disney parks while infectious in January. CDPH recommends that any patient with a measles compatible illness who has recently visited venues where international travelers congregate, such as theme parks, airports, etc., be considered to have a plausible exposure to measles.

Measles is a highly infectious, airborne disease that typically begins with fever, cough, runny nose and red eyes, and within a few days a red rash appears, usually first on the face and then spreading downward to the rest of the body. 

Vaccination is the most important strategy to prevent measles. Two doses of measles-containing vaccine (MMR vaccine) are more than 99 percent effective in preventing measles. Measles vaccines have been available in the United States since 1963, and two doses have been recommended since 1989. If you are unsure of your vaccination status, check with your doctor to have a test to check for measles immunity or to receive vaccination.

Local health departments and CDPH continue to investigate reported cases. Several “secondary” cases in persons exposed to the initial group have been reported.  Secondary cases are common with measles. As with the first group of cases, there is a risk of additional transmission in places where the secondary cases have been while infectious. Persons can be infectious for a few days prior to developing symptoms of measles and may feel well enough to be out and about potentially exposing others. 

In addition, public health officials are continuing to contact persons exposed to measles cases to determine their vaccination history and implement strategies to prevent spread. This is an ongoing situation, and CDPH expects to receive additional reports of cases.

Measles has been eliminated in the United States since 2000. However, large measles outbreaks have occurred in many countries, particularly in Western Europe, Pakistan, Vietnam and the Philippines in recent years. Travelers to areas where measles circulates can bring measles back to the U.S., resulting in limited domestic transmission of measles. California has many international attractions and visitors come from many parts of the world. It is important for health care providers and the public to be aware that measles transmission can occur in California, and they can prevent transmission by receiving the MMR vaccine. 

The California measles patients reside in 11 local health jurisdictions (Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, Santa Clara and Ventura Counties and the cities of Long Beach and Pasadena). Patients range in age from seven months to 70 years. Vaccination status is documented for 34 of the 59 cases. Of these 34, 28 were unvaccinated, one had received one dose and five had received two or more doses of MMR vaccine. 

Health care providers treating patients with fever and a rash should consider measles, and ask patients about travel to international destinations and domestic venues that are popular with international visitors. People who are unvaccinated should know that there is presently a risk for acquiring measles in California.

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