With six states in seven separate outbreaks, in 2019 it is formed as one of the worst years for measles over a long period of time. USA. totaling 626 counts and incidents. That's about 250 more than what happened all of 2018 and makes it the second worst year for measles, since the US said they were eliminated in 2000. We are only 41 people away from breaking the record for most cases since 1995.
In the meantime, we are still accumulating new outbreaks, some of them in places where researchers predicted they are at risk due to low rates of vaccination. Portland, Houston and Kansas City all had small outbreaks and were designated as hazardous areas in 2018 PLoS Medicine study. The outbreak in Clark, Washington, just across the state border from Portland, Oregon, was the most extensive. Now, the Detroit area is also experiencing an important area in the area just the county that predicted the paper.
A large part of these cases were in tightly connected communities with low rates of vaccination. The outbreak in the state of Washington came from a Slavic community and the two current situations in New York – Rockland County and Brooklyn – are largely within the Orthodox Jewish groups living in the area. This is true for many of the recent serious months of measles. In 2014, more than half of all cases were from a single outbreak between Amish in Ohio. A small, concentrated group of Somalis-Americans in Minnesota was the focus of the main 2017 eruption, and Orthodox Jews were the focus of many of the 2018 affairs.
However, there is also the growing problem of vaccination exceptions. Many states allow parents to report religious or philosophical exceptions to prevent their children being vaccinated, and these loose laws have allowed some communities to form pockets with immunization rates low enough to allow their spread to an extremely contagious disease such as measles. To prevent the virus from falling among humans, 95% of the population must be immune. But many nations currently have nursery populations with rates of vaccination far below that.
Outbreaks such as these can expose people who can not be vaccinated either because they have problems in the immune system or are just too young, and these people are really worried about public health officials. It is the vulnerable among us that we are trying to protect.
Here are answers to some other questions you may have as a development of these outbreaks.
Where are these cases?
As of April 19, 22 states reported measles in the Centers for Disease Control in 2019: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Oregon, Texas, Tennessee, and Washington. Seven of these – Arizona, Colorado, Oregon, Texas, Michigan, Missouri, and Washington – allow for philosophical objections to vaccinations and have counties with dangerously low rates of vaccination.
There are not all those states with outbreaks – some have isolated cases, which are not unusual. Only parts of New York, Washington, New Jersey, California and Michigan have hotplates, which are defined as 3 or more cases in a cluster. But we have already seen a spark out another. Michigan public health officials confirmed that their outbreak began when a man fell into the measles in Brooklyn and then traveled to Detroit.
Most of the other continual situations are the result of international travel. Since the virus is no longer endemic in the United States, this is the primary way to initiate measles: someone who is not vaccinated travels and then brings the virus back to the states. And when you have pockets of low rates of vaccination, these separate events can spread quickly.
Many of the cases of measles imported into the United States annually, for example, come from the Philippines. There is currently a continuing outbreak in the Philippines, where more than 200 people (most of the children) have died since January from a total of 12,700 cases. This is a pretty big increase from last year and, according to the Al Jazeera, has been largely accused of falling immunization rates. According to health officials in the Philippines, some regions have coverage of only 30% and the total figure is already 60%.
How many people are sick so far?
Here are the most up-to-date information for each country (updated April 23):
California: Of the 21 total cases this year (the same figure as the total of 2018), 13 have been associated with outbreaks in various provinces, although the current situation is in the county of Butte County in northern California.
New York: There are 359 cases in Brooklyn and Queens from October 2018 and 199 in County Rockland at the same time – all of them are in the Orthodox Jewish community where vaccination rates are very low.
Oregon: There are now 10 cases in County Multnomah, four of which are linked to the main outbreak (patient Zero seems to have taken the virus while in Washington state). There are also four other cases that are not related to the outburst.
Texas: 15 cases so far, with the largest accumulation around the Houston area and a smattering around the rest of the state.
Washington: There are 74 cases, one in King County and the other in Clark County, the vast majority of which are in non-vaccinated children. Only a handful of these cases are in adults over the age of 18 years.
Michigan: 43 people have been sick so far, all but one of them can be traced directly to the outbreak of New York. State health officials confirmed that a man traveled from the city to southeast Michigan while he was contagious, but before he had symptoms.
New Jersey: There are 13 cases so far, of which 11 are related to the event. This is above the previous outburst that began from October 2018 to January 2019, where 33 people got sick
How did all this begin?
For the past twenty years, US measles has started in much the same way: someone brings measles from a foreign country and spreads to non-vaccinated Americans.
In general, however, this is because we have allowed the rates of vaccination to slip backwards. Although the national rate of vaccination is 91.9%, there are pockets where prices fall below it, especially in young children who are most vulnerable to the virus. These pockets allow the spread of measles and possibly jump to the wider population, exposing people who can not receive the MMR vaccine for medical reasons. Although lawmakers in the state of Washington voted as soon as a bill banning personal and philosophical exceptions, Arizona lawmakers do the opposite: they have introduced multiple accounts that would make it even easier to avoid vaccinations. According to CNN, at least 19 other states have tried to import similar accounts, although that does not necessarily mean they will pass.
Do I have to do anything?
If you or your children have not gotten you both doses of the MMR vaccine should be your first priority. Children under the age of 9 months can get their first shot and prevent a medical issue (your doctor needs to know if you have one or more of those that prevents you from being vaccinated), all healthy teenagers and adults can also take the shot. It is only an excellent exception for people who are pregnant.
Some minors have begun to search for vaccination without the permission of their parents. In most states, there is not much you can do until you are 18, as many laws prevent minors from making their own health decisions. But there are 15 states where you can take vaccines without parental consent: Alabama, Alaska, Arkansas, Delaware, Idaho, Illinois, Kansas, Louisiana, Maine, Massachusetts, Montana, Nevada, Oregon, Pennsylvania, South Carolina, Tennessee West Virginia. If you live in one of these states, you should be able to get a doctor to give you a vaccine, as long as they consider you quite mature to understand the procedure.
If you live in or near one of the areas affected by outbreaks, you can check the list of potential exposure sites on your state health website. Washington and Oregon, for example, have an extensive list that is constantly updated. If you find that you may be exposed to measles (or if you think you may have it), the CDC recommends that you immediately call your doctor to determine if you are immune to the virus. You think you are immune if you had two doses of MMR or if you were born before 1957, as the virus was so widespread until almost all the children were exposed. If you were born shortly after that and you are vaccinated in the 60s or 70s, you may need to take another shot. We have more information about this here.
If you may not be immune, CDC asks you to stay away from places where there may be immunosuppressed people or those who are too young to get vaccinated – such as schools or hospitals – until your doctor can do you good. You should also pay special attention to avoid contact with pregnant and newborn babies. Some parents with young babies who have not yet been vaccinated choose to stay as close as possible to the public to reduce the risk of exposure.
Bottom Line: Inoculate and encourage others to do the same.
This story is regularly updated as new instances and information arrive.