International Travel Boosts US Measles Rates
There have been 13 outbreaks totaling 129 cases of measles in the United States in the first 4 months of 2014, which is more than the amount in the first 4 months of any of the last 18 years, according to new data released by the CDC.1
Of the 129 cases, 58 were reported in California, the most in the state since 1995 and 49 more than the average of 9 cases a year. Patients ranged in age from 5 months to 60 years old.
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This outbreak is believed to be the result of a wide outbreak of measles with upwards of 20,000 cases occurring in the Philippines and increased travel between the 2 locations. Of the 58 California cases, 93% are believed to be importation-associated.
“Thirteen [of the cases were] importations, 13 cases epidemiologically linked to importations, 18 with virologic evidence suggesting recent importation, and 10 linked to cases with virologic evidence of recent importation.”
Of the 58, 25 were unvaccinated and 18 had no vaccination documentation. Nineteen of the 25 had “philosophical objections to vaccination.”
Another possible complication is lack of experience with the disease among physicians, due to the historic success of the measles vaccine.
“The increase in importations from this outbreak and subsequent transmission in certain settings in the United States highlights the importance of ensuring age-appropriate vaccination for persons traveling to areas where measles is endemic and maintaining high vaccination coverage at the national and local level,” they concluded.
The CDC is now recommending that all US residents born after 1956 receive the MMR vaccine or undergo testing for measles immunity. People who are traveling outside of the Americas should receive 2 doses of the MMR vaccine separated by at least 28 days. Traveling infants between 6 and 11 months old may be given a single dose of the vaccine.
Physicians should suspect measles in their patients that present with a ferbile rash illness including Koplik spots, cough and runny nose, and conjunctivitis. Symptoms normally begin between 1 and 2 weeks after infection. 2
Suspected cases should be immediately isolated and reported to local health departments. Physicians should take blood samples during the first encounter for serologic testing.
–Michael Potts
1. Zipprich J, Hacker JK, Murray EL, Xia D, et al. Notes from the field: measles — California, January 1–April 18, 2014. MMWR. 63(16);362-363. April 25, 2014.
2. Ask the experts: measles, mumps, and rubella. Immunization Action Coalition. http://www.immunize.org/askexperts/experts_mmr.asp. February, 2014.