NEW YORK – Measles, a highly contagious but preventable disease, is resurging in pockets of the United States, a warning of the dangers of the strengthening anti-vaccine movement.
The Centers for Disease Control and Prevention (CDC) has recorded more cases in 2024 than the 58 tallied in all of 2023, although the agency is not expected to release exact numbers until March 22. On March 18, the agency advised health care providers to ensure that unvaccinated patients, especially those travelling internationally, stay updated on their immunisations.
The number of cases is likely to keep rising because of a sharp spike in measles worldwide, along with spring travel to some regions with outbreaks, including Britain, said Dr Manisha Patel, chief medical officer at the CDC’s respiratory disease division.
Nearly all the cases in the United States so far are related to unvaccinated travellers. “We’re not going to see widespread measles cases going throughout the country,” Dr Patel said. “But we do expect additional cases and outbreaks to happen.”
Measles is among the most contagious of diseases; each infected person can spread the virus to as many as 18 others. The virus is airborne and can stay aloft up to two hours after an infected person has left the room, spreading rapidly through homes, schools and child care facilities.
In Chicago, one case of measles at a migrant shelter has grown to 13, prompting the CDC to send a team to help contain the outbreak. (Two additional cases in the city appear to be unrelated.)
In Florida, seven students at an elementary school contracted measles even as the state’s surgeon general, Dr Joseph Ladapo, left it to parents to decide whether unvaccinated children should attend school.
In southwest Washington, officials identified measles in six unvaccinated adult members of a family living in two counties. And in Arizona, an international traveller infected with measles dined at a restaurant and transmitted the virus to at least two others.
Measles was eliminated in the United States in 2000, and American children generally must be immunised to attend school. Yet sporadic cases lead to larger outbreaks every few years. But now a drop in vaccination rates, exacerbated by the coronavirus pandemic, has experts worried about a resurgence.
When vaccinations lag, “the first disease to appear is measles, because it’s highly infectious,” said Dr Saad Omer, dean of the O’Donnell School of Public Health at U.T. Southwestern in Dallas.
Nine of 10 unvaccinated people in close contact with a measles patient will become infected, according to the CDC.
Measles is far less deadly in countries with high immunisation rates and good medical care. Fewer than three of every 1,000 American children with measles will die as a result of severe complications like pneumonia or encephalitis, the swelling of the brain.
Still, about one in five people with measles may end up in a hospital.
Because widespread measles outbreaks have been rare, most Americans, including doctors, may not recognise the vibrant red rash that accompanies respiratory symptoms in a measles infection. They may have forgotten the impact of the disease on individuals and communities.
“Most of our local health department folks have never seen a measles outbreak,” said Dr Christine Hahn, state epidemiologist of Idaho, which contained a small cluster of cases last year.
“It’s going to be a big challenge to us to respond if and when we get our next outbreak,” she said.
