Federal officials say the country’s cases ‘will likely’ surpass the previous high seen since measles’ elimination in 2000.
MEASLES CASES AROUND the country are approaching their highest total since the disease was declared eliminated in the U.S. nearly two decades ago.
The resurgence of measles this year has hit multiple states and has spurred debate over how to stop the viral infection from spreading. Officials had confirmed 626 cases across the U.S. as of April 19, according to the Centers for Disease Control and Prevention, up from 555 cases reported the week before.
There were 667 cases in all of 2014 – the highest mark since measles’ declared elimination in the U.S. in 2000 – concentrated in large part among unvaccinated Amish communities in Ohio.
“In the coming weeks, 2019 confirmed case numbers will likely surpass 2014 levels,” the CDC says.
Cases of measles this year have been confirmed in 22 states, with ongoing outbreaks of three or more cases in Washington, Michigan, New Jersey, New York City, New York’s Rockland County and California’s Butte County. In Butte County, health workers are scrambling to manage both the measles outbreak and the fallout from November’s massive wildfire, the Los Angeles Times reported.
“The measles vaccine is highly effective, and because of its uptake in the past, cases prior to this outbreak were sporadic,” says Dr. Rachael Lee, an epidemiologist and assistant professor at the University of Alabama at Birmingham. “In fact, many clinicians have learned of measles signs and symptoms from textbooks alone and not clinical cases.”
Ongoing outbreaks have been linked to travelers who brought measles back from countries such as Israel, Ukraine and the Philippines, the CDC says. Last month, for example, one man who was unaware he had measles traveled from New York to Michigan, where he infected 39 people, The Washington Post reported.
The outbreaks have prompted action at both the state and local levels. Late last week, a judge in New York upheld an order mandating vaccinations for four ZIP codes in Brooklyn, which has seen hundreds of measles cases in recent months, mostly among the area’s Orthodox Jewish neighborhoods.
“The unvarnished truth is that these diagnoses represent the most significant spike in incidences of measles in the United States in many years and that the Williamsburg section of Brooklyn is at its epicenter,” Judge Lawrence Knipel wrote in his ruling.
The New York City Health Department also announced Thursday that parents of three children could be fined $1,000 for refusing to vaccinate their kids, and that it was issuing closure orders for four school sites where officials reportedly would not turn over student vaccination records.
State lawmakers have been split on efforts aimed at preventing such outbreaks. While some lawmakers have looked to tighten their states’ vaccine exemption laws, including legislators in Washington and Maine, others in states such as West Virginia and Mississippi have introduced bills that would expand vaccine exemptions.
Currently, 17 states allow parents to exempt their school-age children from vaccinations for personal, moral or other beliefs, according to the National Conference of State Legislatures.
“When the vaccine was introduced, the school entry requirement … helped to decrease measles cases,” Lee says. “I would think that we will see less cases and outbreaks of measles in states that eliminate nonmedical vaccine exemptions.”
Tightening vaccine exemptions may not be enough to completely reverse an area’s low vaccination rates, though. In California – which enacted a law barring nonmedical exemptions in 2016 after 147 people were sickened in a Disneyland-linked outbreak – the number of medical exemptions has soared. The uptick has been led by a “small but adamant population of families and physicians” who have taken advantage of loopholes in the law, California Healthline reported.
“It’s really scary stuff,” Dr. Brian Prystowsky, a pediatrician in Santa Rosa, told California Healthline. “We have pockets in our community that are just waiting for measles to rip through their schools.”