Before a measles vaccine was licensed in 1963, hundreds of those infected would die annually and tens of thousands of victims hospitalized. The CDC believed the disease was eradicated in the U.S. in 2000, but now, after 14 years, measle cases are on the rise.
Why the Increase in Measles Cases?
In 2013 there were roughly 175 cases of the measles in the U.S. More than 98% of those patients were not vaccinated for the disease. That is three times the normal number of cases according to the CDC.
The U.S. has seen nine outbreaks with the largest in New York, North Carolina, and Texas. While the majority of Americans continue to receive vaccinations, increased global travel combined with pockets of the population refusing vaccinations is resulting in the rising number of measles cases.
The CDC issued their Top Five health threats for 2014, in which the second concern was the globalization of travel. Almost all of the cases of the measles in the U.S. were linked to international travel, either foreign travelers entering the U.S., or U.S. citizens returning back from vacations. The measles remains a common disease in many parts of the world including Europe, Asia, and Africa.
While someone who is vaccinated cannot be infected by measles, they can carry the virus for a short time and risk infecting those around them who are not vaccinated. A number of communities around the U.S. refuse to allow their children to be vaccinated due to religious beliefs, and are thus more at risk for infection.
In addition, there is increasing debate by parents and public figures over the safety of vaccinating children. For example, actress Jenny McCarthy is very vocal in her belief that vaccines play a role in causing autism, despite medical reports to the contrary. A study conducted in 2011 found that 24% of parents place “some trust” in information provided by celebrities regarding vaccines.
Recommendations
According to the CDC, the best protection against the measles is the MMR or MMRV vaccine. This is usually given as part of a combination vaccine against measles, mumps, and rubella.
The CDC recommends children receive two doses: one at 12-15 months, and again at 4-6 years of age. If a child is going to be going out of the country, and thus more at risk to exposure of the measles, they may be able to get the vaccine as early as 6 months old.
The CDC states that like smallpox, measles can be eliminated but only if the vast majority of the population is vaccinated in order to prevent further outbreaks.
CDC Director Dr. Tom Frieden states, “The steady arrival of measles in the US is a constant reminder that deadly diseases are testing our health security every day.”
Have you seen an increased aversion to vaccinations from your patients? Does this increase in measles cases last year cause concern you, or do you feel most Americans will continue to get the vaccination and keep the spread of measles to a minimum? If you’re an M.D. or D.O. we’ll be discussing this more inside the Sermo community. Come join us.
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