Measles – 2019 Outbreaks
Total Number Of Measles Cases In US Climbs To 25-Year High Of 971, CDC Reports
The Washington Post (5/30) reports there have been 971 cases of measles in the US so far this year, “the greatest number since 1994, when 963 cases were reported for the entire year,” according to the Centers for Disease Control and Prevention (CDC). The agency announced the new total on Thursday, rather than waiting for Monday when it typically updates the count, “because it had reached this new milestone.”
The New York Times (5/30) reports CDC Director Robert Redfield said, “Measles is preventable and the way to end this outbreak is to ensure that all children and adults who can get vaccinated, do get vaccinated.” Redfield added, “Again, I want to reassure parents that vaccines are safe, they do not cause autism. The greater danger is the disease that vaccination prevents.” The Times adds that the “measles was eliminated as an endemic disease in the United States in 2000,” but if the current outbreak continues then the US could lose that status, “meaning the disease would be considered endemic in the country for the first time in a generation.”
Updated 5/22/2019 
Pediatricians are monitoring multiple outbreaks of measles across several U.S. states.
Situation
- Current outbreak locations:
- Number of infections: 880 cases in 24 states (from 1/1/19 through 5/17/19)
- Pediatric population affected: All pediatric populations at risk. Patients 19 years or younger have accounted for 77% of the cases so far; 48% have been younger than 5 years old.
- The main outbreaks have been associated with travelers who brought measles back from Israel, Ukraine, and the Philippines.
- Cases have been reported in Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Pennsylvania, Oklahoma, Oregon, Texas, Tennessee, and Washington.
Background
- Infants and children aged less than 5 years, adults aged more than 20 years, pregnant women, and people with compromised immune systems, such as from cancer, chemotherapy, or HIV infection, are at high risk for severe illness and complications from measles.
- Measles can cause serious illness requiring hospitalization, even in previously healthy children.
- Consider measles in patients with fever and rash and ask about recent international travel, exposure to international travelers, or exposure to people with measles
- During an outbreak, MMR vaccine should be offered to all people exposed or in the outbreak setting who lack evidence of measles immunity. During a community-wide outbreak that affects infants, MMR vaccine has been shown to be effective in preventing symptoms after exposure and may be recommended for infants 6 through 11 months of age.
- Involvement of state and local health departments is often advisable for any diagnosis of measles, as there may be specific ways these departments wish to receive specimens and manage patients.
Actions as recommended by the American Academy of Pediatrics and the U.S. Public Health Service
- Clinical Manifestations (Red Book)
- Diagnostic Tests (Red Book)
- Treatment (Red Book)
- Control Measures (Red Book)
- Prevention
- Measles can be prevented with measles-containing vaccine, which is administered as the combination measles-mumps-rubella (MMR) vaccine.
Resources
- CDC Measles 2019 Outbreak Webpage
- CDC Measles Webpage
- MMR Vaccine VIS
- AAP News articles:
- CDC updates measles vaccination guidance for infants traveling to U.S. outbreak areas
- ID Spotlight: When should measles vaccine be given? What is interval between doses?
- ID Spotlight: What are the indications, precautions, contraindications for MMR vaccination?
- ID Spotlight: Measles associated with numerous complications, death
- HealthyChildren.org articles:
- What you should know:
- In any given year, measles cases can occur because of:
- An increase in the number of travelers who are exposed to measles abroad and bring the virus into the U.S.
- Further spread in U.S. communities with pockets of unvaccinated people.
- Measles starts with fever, runny nose, cough, red eyes, and sore throat. It’s followed by a rash that spreads over the body, head to toe.
- Measles is highly contagious and spreads in the air through coughing and sneezing.
- Make sure you, your children, and whole family are protected by being up to date with the measles, mumps, and rubella (MMR) vaccine.
- Everyone with plans to travel outside of the US should be vaccinated against measles before traveling abroad. Infants 6–11 months old need 1 dose of measles vaccine. Children 12 months and older need 2 doses separated by at least 28 days. More information: (CDC) (Red Book)
- In any given year, measles cases can occur because of:
- Healthcare professionals are trying to ensure all patients are up to date on MMR vaccine.
10 Things You Should Know about Measles:
