#18,340
The above graphic illustrates how - since my childhood - measles has gone from a right of passage to near-elimination in the United States 25 years ago; all thanks to the introduction of a measles vaccine in the early 1960s.
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.
Each year, the WHO estimates more than 100,000 deaths (mostly in children) are caused by measles virus around the globe. In 2019, just prior to the COVID pandemic, measles cases in the United States had risen to a 25-year high (n=1274), but plummeted due to social distancing and mask use in 2020 (see chart below).
That trend has reversed, and in the first two months of 2025 more than 125 cases have been reported, mostly linked to a large outbreak in Texas (see DHHS Feb 25th Update). Much of this increase can be traced to a drop in childhood vaccination against measles (see map below), driven by online vaccine skepticism.
Late yesterday the L.A. County Health Department issued the following alert, after a traveler from South Korea tested positive. People on this individual's flight, and at the airport - and other contacts - may have been exposed.
First the press release, after which I'll return with a postscript.
Measles, sadly, is making a comeback around the globe, and with our highly mobile society, more and more cases are destined to come to America. Our declining vaccination rates only exacerbates the problem.The Los Angeles County Department of Public Health has been notified of one case of measles in a non-Los Angeles County resident who traveled to Los Angeles International (LAX) airport while infectious.
This person arrived on Korean Air flight KAL11/KE11 at the Tom Bradley International Airport (TBIT) Terminal B on February 19th.
Individuals who were at Terminal B on February 19th from approximately 1 p.m. to 4 p.m. may be at risk of developing measles due to exposure to this traveler. In collaboration with the Centers for Disease Control, passengers assigned to specific seats that may have been exposed on Korean Airlines flight KAL11/KE11 on February 19th will be notified by local departments of health. These agencies work together to investigate communicable disease exposures on international flights to the United States.
Exposed individuals should confirm if they have been vaccinated against measles. If they have not had measles in the past and have not yet obtained the measles vaccine, they are at risk of contracting measles if they have been exposed. Unimmunized persons or those with unknown immunization status who were at this location during the date and times listed above are at risk of developing measles from 7 to 21 days after being exposed and should monitor for symptoms. Exposed individuals who have been free of symptoms for more than 21 days (March 11th) are no longer at risk.
“Measles is a serious respiratory disease that spreads easily through the air and on surfaces, particularly among people who are not already protected from it,” said Muntu Davis, MD, MPH, Los Angeles County Health Officer. “A person can spread the illness to others before they have symptoms, and it can take seven to 21 days for symptoms to show up after exposure. Measles can lead to severe disease in young children and vulnerable adults. The best way to protect yourself and your family from infection is with the highly effective measle vaccine.”
People who were in the locations above around the aforementioned times should:
· Review their immunization and medical records to determine if they are protected against measles. People who have not had measles infection or received the measles immunization previously may not be protected from the measles virus and should talk with a health care provider about receiving measles, mumps and rubella (MMR) immunization.
· Contact and notify their health care provider as soon as possible about a potential exposure if they are pregnant, an infant, have a weakened immune system and/or are unimmunized regardless of vaccination history.
· Monitor themselves for illness with fever and/or an unexplained rash from 7 days to 21 days after their exposure (the time period when symptoms may develop).
· If symptoms develop, stay at home, and avoid school, work and any large gatherings. Call a healthcare provider immediately. Do not enter a health care facility before calling them and making them aware of your measles exposure and symptoms. Public Health can assist health care providers in appropriately diagnosing and managing your care.
About Measles
Measles spreads easily through the air when an infected person breathes, talks, coughs, or sneezes. The virus can stay in the air and on surfaces for many hours, even after the infected person has left. The infected person can spread the disease up to four days before a measles rash appears and up to four days after the rash appears. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected.
Common symptoms for measles include:
· High fever (higher than 101° F)
· Cough
· Runny nose
· Red and watery eyes
· Rash 3-5 days after other signs of illness. The “measles rash” typically starts at the face and then spreads down to the rest of the body.
Measles can be prevented with a measles, mumps, and rubella vaccine (MMR or MMRV). The MMR vaccine protects against three diseases: measles, mumps and rubella. The MMRV vaccine protects against four diseases: measles, mumps, rubella, and varicella (chickenpox). They are administered in two doses and are highly effective: two doses are 97% effective against measles and one dose is 93% effective. The spread of measles can be prevented if 2-dose coverage of vaccine remains at 95% or above in the community. For more information on measles, visit: ph.lacounty.gov/measles.
Most health insurances cover the cost of the MMR and MMRV vaccine. Insured persons should check with their doctor or local pharmacy to see what vaccines are offered. Uninsured or underinsured children and adults can access free or low-cost vaccines at clinics enrolled in the Vaccines for Children (VFC) and Vaccines for Adults (VFA) program. For a list of clinics that offer free or low-cost immunizations for persons who are uninsured or underinsured, call 2-1-1 or visit: http://publichealth.lacounty.gov/ip/clinics.htm.
In the United States, as of February 21, a total of 93 measles cases have been reported this year, which is likely to increase given the ongoing measles outbreaks in Texas and New Mexico. Furthermore, 25% of these cases required hospitalization for management of measles complications or isolation. Most of these cases have been unimmunized. The last case of measles in a Los Angeles County resident was reported in February 2024.
Practically every day I see articles on the internet purporting to tell the `truth’ about vaccines, and in nearly every case it is about as far removed from the truth as you can get and still remain on this planet.
Their techniques are simple, but effective.
First, they use biased and inflammatory language, filled with incendiary adjectives like `deadly’, `useless’, `dangerous’, or `untested’ practically anytime the word `vaccine’ is used.
Second, they build a straw man, by claiming that vaccines are supposed to be 100% safe and effective (which no one in medicine claims), and then proceed to knock that down with some story about a purported bad reaction or side effect.
And third . . . and used with great effect online . . . they cherry pick a news article that somehow bolsters their claims, without acknowledging any evidence to the contrary.
Extremely effective tactics – particularly on the internet - that in recent years have encouraged a growing number of parents to file personal belief exemptions to avoid vaccinating their children.
Parents that have never seen what a measles, pertussis, or polio outbreak can do, because they were spared those perils by the vaccines introduced in the 1950s and 1960s.
