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CDC: U.S. measles cases reach 20-year high

Monday June 2, 2014
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Measles cases in the U.S. have reached a 20-year high with 288 cases reported between Jan. 1 and May 23, according to the CDC. This is the largest number of measles cases reported in the U.S. in the first five months of a year since 1994, according to a news release.

“The current increase in measles cases is being driven by unvaccinated people, primarily U.S. residents, who got measles in other countries, brought the virus back to the United States and spread to others in communities where many people are not vaccinated,” Anne Schuchat, MD, assistant surgeon general and director of CDC’s National Center for Immunizations and Respiratory Diseases, said in a news release. “Many of the clusters in the U.S. began following travel to the Philippines where a large outbreak has been occurring since October 2013.”

The Philippines has reported more than 32,000 cases and 41 deaths from measles from Jan. 1 to April 20, according to Schuchat, who spoke during a May 29 telebriefing.

Ninety percent of all U.S. measles cases were in people who were not vaccinated or whose vaccination status was unknown, according to the CDC. Among the U.S. residents who were not vaccinated, 85% cited religious, philosophical or personal reasons, according to the release.

The measles cases have been reported in 18 states and New York City. Most cases were reported from Ohio (138), California (60) and New York City (26), according to CDC data. Fifteen outbreaks have accounted for 227 (79%) of the 288 cases. An outbreak is defined as three or more related cases.

The outbreak occurring in multiple Amish communities in Ohio has roots in travel to the Philippines.

“We know that many communities of faith are very active in service missions,” Schuchat said in the briefing. “So these were Americans traveling to the Philippines and bringing the virus back and into communities where lots of people were not immunized. I understand that the community has responded really well to the problem, is working very closely with the local and state health departments. ... Thousands and thousands of [vaccine] doses have been administered.”

Patients with reported measles cases this year have ranged in age from 2 weeks to 65 years; 18 (6%) were younger than 12 months, 48 (17%) were ages 1–4, 71 (25%) were ages 5–19, and 151 (52%) were ages 20 and older, the CDC reported. Forty-three (15%) were hospitalized, and complications have included pneumonia (five patients), hepatitis (one), pancytopenia (one) and thrombocytopenia (one). No cases of encephalitis and no deaths have been reported, according to the CDC.

About 20 million people get measles each year worldwide, and importations into the U.S. continue to pose a risk for measles cases and outbreaks among unvaccinated persons, according to the CDC. “The last outbreak that was larger than this one was in 1994, and it originated in Summit, Colo.,” Schuchat said in the telebriefing. That outbreak involved 233 reported cases.

In the release, the CDC suggests healthcare providers ensure their patients are up to date on vaccinations — especially before international travel.

“Many U.S. healthcare providers have never seen or treated a patient with measles because of the nation’s robust vaccination efforts and our rapid response to outbreaks,” Schuchat said in the release.

Patients who present with fever and rash along with cough, runny nose or pink eye should be evaluated for measles; especially, if the patient is unvaccinated and recently traveled internationally or was exposed to someone else who has measles or recently traveled. If healthcare providers suspect a patient has measles, they should isolate the patient immediately, report the case to their local health department and collect specimens for serology and viral testing.

In the U.S., routine MMR vaccination is recommended for all children, with the first dose given at 12–15 months, and a second dose at 4-6 years. Catch-up vaccination is recommended for children and adolescents who have not received two appropriately spaced doses. Unless they have other evidence of immunity, adults should receive at least one dose of MMR vaccine, and two appropriately spaced doses of MMR vaccine are recommended for healthcare personnel, college students and international travelers.

For information, visit: www.cdc.gov/measles/hcp/index.html


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