Measles Make a Comeback

Measles Befalls 288 in Biggest Outbreak Since ‘94

The number of measles cases in the U.S. has hit a new high since the highly contagious disease was officially declared eliminated 14 years ago, in the latest sign of a troubling resurgence.

The 288 cases reported in 18 states as of May 23 is the highest number of cases in the first five months of the year since 1994, the Centers for Disease Control and Prevention said Thursday. Nearly all of the cases were linked to foreign travel by unvaccinated people, and many had been in the Philippines, where a large outbreak has been under way since October. About 90% of all the patients either hadn't been vaccinated or didn't know if they had been vaccinated, and 15%, or 43 people, were hospitalized.

The largest cluster of cases is in Ohio, sparked by two unvaccinated members of an Amish community who contracted the disease on a humanitarian aid trip to the Philippines in March and then spread it to others at home, according to the CDC. Ohio's health department said the state had 164 cases as of Thursday.

"Since I've taken this position about 10 years ago, this scenario is the one that I've had the most nightmares about," said D.J. McFadden, health commissioner and medical director for Holmes County (Ohio) General Health District. Pockets of the Amish community refuse immunization, but many travel overseas to countries where measles still flourishes, he said.

Every affected county in Ohio has set up free vaccination clinics and more than 8,000 people have been immunized since Tuesday, according to the Ohio Department of Health.

In 2000, the U.S. officially eliminated measles, meaning it was no longer circulating from within the country's borders. But measles outbreaks still occur when susceptible residents bring the disease into the country from abroad.

To prevent outbreaks, officials are trying to make it harder for parents to exempt children from vaccination requirements for schools and day-care centers. Several states, including Washington and Oregon, have adopted tougher rules.

In California, site of the second-largest outbreak, a third of the 60 illnesses reported so far this year were in unvaccinated children, according to the California Department of Public Health. Up to 20% of students in some counties are exempted from vaccination requirements for school for reasons of personal belief, an exemption that is allowed, the health department said.

Bree Guevara, who lives in Fort Irwin, Calif., said she and her husband had decided not to vaccinate their 1-year-old daughter as they view the chance of her contracting a preventable disease as low. "I would rather her get measles or something and go through it and fight it and that will give her a lifelong immunity that a vaccine never can," she said.

Health officials say vaccines are safe and prevent serious illnesses. Measles, a respiratory condition spread by coughing and sneezing, is highly contagious: 90% of those who aren't vaccinated contract it from close contact with someone else who is infected. People who catch it experience a fever, cough and rash, and most fully recover. But the disease can lead to deafness and pneumonia and, in about one in 1,000 cases, death.

"This is not an insignificant illness. This is an illness that is well worth avoiding," said Matt Zahn, Orange County (Calif.) Health Care Agency's medical director for epidemiology.

By: Karishma Mehrotra, The Wall Street Journal
Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

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