Robert R. Redfield
There have been 704 cases of measles reported by 22 states so far in 2019 — the greatest number of measles cases in the United States since 1994, the CDC reported today.
As National Infant Immunization Week begins, the CDC held a news conference to discuss the latest case count — a record number since the disease was declared eliminated in the U.S. in 2000 — and the importance of on-time vaccination for protection and prevention against measles.
HHS Secretary Alex Azar noted that most of the cases have occurred among children aged younger than 18 years who have not been vaccinated.
“This year, we’re celebrating 25 years of National Infant Immunization Week,” he said. “When this observance was established in 1994, health departments and immunization programs were facing significant challenges. The nation was in the midst of a serious measles outbreak and communities across the United States were seeing serious decreases in immunization rates among children.”
Today, he continued, most parents protect their children with vaccines. However, Azar and CDC officials are concerned about the recent rise in cases.
CDC Director Robert R. Redfield, MD, noted that children aged younger than 5 years and older adults are at the highest risk for severe complications from measles. Data in a newly released MMWR revealed that of the cases reported this year, 9% have resulted in hospitalization and 3% have resulted in pneumonia. So far, there have been no deaths.
The key tool for preventing measles and protecting those at higher risk — children who are too young for vaccination and people with underlaying health conditions — is two doses of the MMR vaccine, with the first dose recommended to be given at age 12 to 15 months and the second between ages 4 and 6 years.
A high number of U.S. measles cases are the result of three large outbreaks. On Monday, officials declared an end to an outbreak in Washington state, which accounted for 72 cases. Ongoing outbreaks in New York City and New York state are two of the largest and longest lasting measles outbreaks in the U.S. in the 2000s, said Nancy Messonnier, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases, accounting for 592 total cases.
According to the MMWR report, 44 U.S. measles cases in 2019 have been directly imported from travelers who were unvaccinated or had unknown vaccination history before traveling, including the index case in the New York City outbreak, a child who was infected on a trip to Israel.
Redfield noted that unvaccinated infants aged 6 months to 11 months should get one dose of measles vaccine before travel, unvaccinated children 12 months and older should get two doses separated by at least 28 days and adolescents and adults who have not had measles and have not been vaccinated should get two doses separated by 28 days.
“Most of us have never seen the deadly consequences that vaccine-preventable diseases have on a child, family or community, and that’s the way we want to keep it,” Azar said. “Vaccine-preventable diseases belong in the history books, not in our emergency rooms.” – by Caitlyn Stulpin
Patel M, et al. MMWR Morb Mortal Wkly Rep. 2019;doi:10.15585/mmwr.mm6817e1.
Disclosures: Azar, Redfield and the authors report no relevant financial disclosures.