October 7, 2019

CDC on Thursday said it expects the United States to maintain its World Health Organization (WHO) designation as a country that has eliminated measles.

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Background

Measles largely is preventable with the measles, mumps, and rubella (MMR) vaccine. One dose of the vaccine is 93% effective at preventing measles, and two doses are 97% effective against the disease. But the disease is highly contagious and requires communities to maintain measles vaccination levels between 93% and 95% to prevent its spread.

WHO considers a country to have eliminated measles after a country has gone more than a year without continuous spread of the disease. The United States received the designation in 2000, when it largely eliminated person-to-person transmission of the measles.

However, Nancy Messonnier, director of CDC's National Center for Immunization and Respiratory Diseases, in August warned there was a "reasonable chance" WHO would rescind the United States' designation as a country that has eliminated measles if an outbreak in New York continued beyond Sept. 30 of this year. 

New York's measles outbreak ends

According to the latest CDC data, health officials have reported a total of 1,243 measles cases in the United States so far this year, with just two new cases between Sept. 12 and Sept. 26. The number of measles cases reported in the country so far this year is the highest reported in a single year since 1992, CDC said:

CDC officials said 131 of the patients who contracted the measles were hospitalized, and 65 of them experienced complications including encephalitis and pneumonia, but no patients died.

According to the latest CDC data, 31 states have reported measles cases as of Sep. 26. CDC researchers noted more than 75% of measles cases this year were linked to the outbreaks in New York:

However, New York Health Commissioner Howard Zucker in a statement issued Thursday announced that measles outbreaks in New York's Sullivan, Orange, and Rockland Counties had ended by Sept. 30. He said, "[T]here are no longer any active [measles] cases in New York … associated with the initial … outbreak from October 2018."

But Zucker added, "The threat … for vaccine-preventable diseases remains, and [New York's State] Department [of Health] is not letting down its guard." Zucker said state health officials are remaining "vigilant" and investigating new measles cases that are unrelated to the state's initial outbreaks.

For example, one of the newly reported cases involves a patient who returned to Rockland County from a trip overseas. Health officials consider the case to be "imported" and not connected to Rockland County's initial outbreak.

Reaction

CDC said, "The end of the New York state measles outbreak is a credit to the great work by local and state health departments, community and religious leaders, and other partners. However, this outbreak is a grave reminder that we need heightened vigilance around measles as well as other vaccine preventable diseases, and we continue to address the myths and misinformation driving these outbreaks."

Peter Hotez, professor of pediatrics and dean of the National School of Tropical Medicine at Baylor College of Medicine, said the United States "remain[s] highly vulnerable" to measles cases because there are "at least 100 geographic pockets in the [United States] where a high percentage of kids are not being vaccinated," and measles "cases [are] now regularly [being] imported from Europe, where measles is even more widespread."

Hotez added that he expects the United States to "hit peak measles transmission season" in the first and second quarter of next year. "[The] bottom line [is] nothing has really been done to combat the anti-vaccine movement in America, and we're just as vulnerable to measles epidemics as we were this time last year," he said (O'Reilly, Axios, 10/3; Owens, "Vitals," Axios, 10/4; Gumbrecht/Bonifield, CNN, 10/3; Cara, Gizmodo, 9/27).

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