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In 2019, just prior to the COVID lockdown, the United States reported 1274 measles cases (see COCA Call: Most Measles Cases In 25 Years), raising concerns that this scourge - considered eliminated in the U.S. since 2000 - was making a comeback.
But in 2022, the number of measles here in the United States began to creep up again (n=121 across 6 jurisdictions). That number dropped in 2023 (n=58), but they were were reported by 20 jurisdictions: CA, CO, DC, FL, HA, ID, IL, KY, MD, MO, NJ, NYC, OH, OR, PA, TX, UT, VA, and WI.The following year, when the world went into lockdown for COVID, the rate of measles - along with influenza, RSV, and many other communicable diseases - dropped precipitously.
Just over 2 months into 2024, the number of cases reported (as of yesterday) to the CDC is fast approaching the number reported in all of 2023. This from the CDC's Measles Cases and Outbreaks web page.
Measles cases in 2024
As of March 7, 2024, a total of 45 measles cases were reported by 17 jurisdictions: Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York City, Ohio, Pennsylvania, Virginia, and Washington.
Three weeks ago, in ECDC Threat Assessment Brief: Measles on the Rise in the EU/EEA, we looked at reports of measles' resurgence in Europe, and over the past week we've seen several measles alerts issued, including in Michigan (n=3 cases), in Canada (n=7 active cases), and last night this alert from El Dorado county, California on the potential exposure of up to 300 people.
POSSIBLE MEASLES EXPOSURE IN EL DORADO COUNTYMeasles, which was once almost a youth’s `rite of passage’ in the United States, has been all but eliminated in the years after the introduction of the first measles vaccine in 1963.
(PLACERVILLE, CA) – On March 5th a child with a confirmed case of measles was seen in the Emergency Department at UCDAVIS after being evaluated at San Joaquin Urgent Care. According to estimations approximately 300 people, including a small number of residents from El Dorado County, may have been exposed during that time. Counties of residence for the individuals include El Dorado County.
This notification is to provide clear instructions so that appropriate protective measures can be taken for anyone at risk. If you were in the UC Davis ED on March 5th between 12pm and 5 pm, please contact The El Dorado County Public Health line at:
Placerville (530) 621-6320
South Lake Tahoe (530) 573-3154
"We will be receiving a list of those who were confirmed at the UC Davis Emergency Department at that time and will be contacting those individuals for further instructions," said Dr. Matthew Minson, El Dorado County's Public Health Officer. "Please do not go directly to the emergency Department as that could increase spread and put others at risk," he added.
Measles is a serious illness especially for the very young, pregnant individuals, and immunocompromised people. It can be prevented with vaccination. If you suspect you or someone you know has measles, early evaluation is critical.
The chart below (source: CDC) shows the remarkable effectiveness of the vaccination campaign.
While many parents today think of measles as a relatively benign childhood illness, it actually produced significant morbidity and mortality with respiratory, ocular, and neurological complications - sometimes resulting in death.
Yesterday the CDC released the following update on measles in the United States.
Measles in the United States — March 2024
March 8, 2024, 4:15 PM EDT
Updates on respiratory illness and vaccine-preventable diseases.
Thanks to a strong childhood vaccination program, measles was declared eliminated from the United States in 2000. Although overall childhood vaccination rates remain high in the U.S., measles still occurs frequently in other parts of the world. That’s especially true right now. The World Health Organization has noted a significant increase in measles cases worldwide, with a 30-fold increase in Europe. This includes popular international tourist destinations for Americans, like England.
Measles can easily come to the United States by way of unvaccinated travelers, and measles cases have been increasing around the country. This most commonly happens when people who live in the United States visit countries where there are measles outbreaks. Once someone gets measles and returns to America, measles can spread if people in their community aren’t up-to-date on their vaccinations.
Worse, measles can be very serious. Children younger than 5 years and adults older than 20 years are more likely to suffer from complications. Common measles complications include ear infections and diarrhea. More severe complications like pneumonia (lung infection) and encephalitis (infection and swelling of the brain) are possible and often require hospitalization and even intensive care. This is a real risk for people who are not vaccinated, especially for young children, adults, pregnant persons, and people who are immunocompromised. On average, nearly 1 in 5 unvaccinated people in the United States who get measles need to be hospitalized. For example, in a recent outbreak in Ohio, over 40% of infants and children infected with measles were hospitalized.
- Measles is so contagious that if one person has it, up to 90% of the people close to them can also become infected if they are not protected by vaccination (or, less commonly, prior infection).
- The measles virus can stay in the air for up to 2 hours after an infected person left an indoor space.
- Someone can get infected by simply being in a room where a person with measles walked through.
- In addition, people with measles can transmit to others when their symptoms are fever, cough, and runny nose, which look like common respiratory viruses.
When outbreaks do occur, local health departments lead the response. The playbook for ending measles outbreaks is decades old, and it works. People who are infected or who are exposed to measles but haven’t been vaccinated are recommended to stay home and away from settings where unvaccinated people may be exposed, like schools and daycares. By following these simple procedures, countless jurisdictions have successfully curbed local measles outbreaks and limited the illness and suffering that accompany them.
Key to maintaining the elimination of measles in the U.S. is vaccination. The measles-mumps-rubella vaccine (MMR) is part of the national immunization schedule for all children and adults. Vaccination with MMR is the best and safest way to prevent measles. When both doses of MMR vaccine are given (typically when the child is about 1 and 4 years old), MMR is 97% effective at preventing measles.
CDC recommends the safe and effective MMR vaccination as part of the routine immunization schedule for all children and adults, with special guidance for those travelling internationally. With spring break travel coming up and people going to and coming from countries that have seen sharp upticks in measles cases, the time to be sure you and your family members are up to date on their MMR is now.
