With 555 total cases, 2019 now has the second-highest number of measles cases in the United States in 25 years – and the year is not even half over.
"I'm obviously very concerned about the size and also acceleration of the current outbreak," said Dr. Nancy Messonier, director of the CDC's National Center for Immunization and Respiratory Diseases. "This is not going to stop on its own."
Measles is not just rising in the United States. The World Health Organization reported Monday there were more than 110,000 measles cases worldwide in the first three months of 2019 – an increase of nearly 300% from the same period last year.
The data is provisional, and the actual number of measles cases are likely higher, as WHO estimates that less than 1
Ukraine had the highest number of cases in the past 12 months, with more than 72,000 cases, followed by Madagascar and India with more than 69,000 and 60,000 cases respectively. WHO warned that there are delays in reporting and this data may be incomplete.
A 'fast-moving, life-threatening disease'
Additionally, 1 or 2 out of 1,000 children who get measles will die from it.
After the vaccine, cases plummeted, with 963 cases in 1994. In 2000, the disease was declared eliminated in the United States. Despite the ongoing outbreaks in communities across the United States, measles is still considered eliminated, which means it is not being continuously transmitted in this country. Measles would no longer be considered eliminated once it was continuously transmitted for longer than 12 months.
The CDC recommends two doses of the measles mumps and rubella, or MMR, vaccine for children. The first should be given at 12 to 15 months and the second when the child is 4 to 6 years old. The first dose gives 93% protection against measles and the second dose gives 97% protection.
The anti-vaxer movement
Experts point to one reason for this year's large outbreak: the power of the anti-vaccination movement.
"It's just terribly sad that children in the US are having to suffer measles. This should not happen, "said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and an adviser to the CDC on vaccines. "We'd previously eliminated this disease not just in the US but in the entire Western Hemisphere, and it appears that now we've profoundly and sadly turned back the clock."
The 20 states reporting measles this year are Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Texas and Washington.
Most of the cases have been in New York, site of an outbreak among ultra-Orthodox Jews who started in the fall.
Messonier says the New York outbreak has been particularly difficult to control.
"Most measles outbreaks in the US stop sooner than this, "she said.
Health officials in Rockland County, New York, tried to bar unvaccinated children from public places, but a judge prohibited the county from enforcing that rule.
Messonier said it's a matter of "correcting myths" about vaccination. Health authorities have worked with rabbis to explain that vaccination is safe, but that still has not turned the outbreak around.
"You have to just approach people where they are and answer their questions," Messonier said. "It's about the slow work of developing trust."