Outbreaks of the measles in Washington state and in New York state may be spreading.
This week, two more confirmed measles cases pushed the outbreak total to 118 in Rockland County, New York. In Clark County, Washington, near Portland, health officials announced five new possible cases on Tuesday, bringing the total count there to 23 confirmed and 7 suspected of having the illness.
The Centers for Disease Control and Protection (CDC) report that an outbreak is also ongoing in Brooklyn, New York, where 62 cases have been verified. The state of New Jersey only recently declared an end to a flare-up of measles there in which 33 incidents were identified.
The Unvaccinated Face the Highest Risk
“This outbreak is bigger than we’ve seen in the past here in the Northwest, and I wouldn’t be too surprised if it spread,” says Richard Leman, MD, a public health physician with the Oregon Health Authority. “The people who are clearly at risk of infection are those who have never been vaccinated against measles.”
So far, Clark County Public Health has found that 20 of those with the disease had not been immunized. In New York and New Jersey, the measles have mostly affected Orthodox Jewish communities that have been resistant to getting the vaccine, according to the CDC.
William Schaffner, MD, an infectious disease specialist and a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee, estimates that the measles immunization is about 98 percent effective in protecting people from the illness.
Because of widespread use of the vaccine, measles was declared eliminated from the United States in 2000. But the CDC confirmed that 349 people suffered from the measles in 26 states and Washington, DC, in 2018. This was the second greatest number of annual cases since 2000.
“The measles is now only being reintroduced because children are not being 100 percent vaccinated,” says Dr. Schaffner. The World Health Organization says that unvaccinated young children face the highest risk of measles and its complications, including death.
The CDC recommends that children get the measles, mumps, and rubella vaccination, starting with a first dose at 12 to 15 months, followed by a second dose at ages 4 to 6. The health agency says that most people born before 1957 don’t have to get the immunization because they were probably exposed to the virus and already immune.
“But it’s never too late to get vaccinated,” says Dr. Leman. “So if you don’t remember having the illness and you never got vaccinated, it wouldn’t hurt to get the vaccine.”
Health authorities in Seattle reported Wednesday, January 23, 2019, that a male in his fifties who had visited Clark County was hospitalized with measles.
An Extremely Contagious Virus
The CDC says that typically individuals get measles abroad in areas where immunization rates are low, and then spread the illness in pockets of unvaccinated people. On the East coast, travelers brought the infection back from Israel, which had experienced a large outbreak.
“If the measles virus is introduced from abroad into populations that have not had the vaccination, it will spread very widely since measles is probably the most contagious virus we know,” says Schaffner.
Because the disease is so easily transmitted, Clark County health officials have warned the public to be on the alert if they have been to public places where the infected have visited. These locations include a Costco, an IKEA, the Portland airport, and the basketball arena where the Portland Trail Blazers play.
“If someone has been in one of these places where a person with infectious measles was present and they developed symptoms with fever, cough, runny nose, or red itchy eyes, we want them to call a healthcare provider to let them know they’ve been exposed,” says Leman. “That way they can get medical evaluation and they won’t necessarily expose a lot of other people.”
Leman also warns people not to underestimate how serious the infection can be. The virus can lead to pneumonia (infection of the lungs) and encephalitis (swelling of the brain). As many as 1 out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.
“Some people say, ‘Why would you get vaccinated for something that is no worse than a cold?’" says Leman. “I can tell you, anybody who says that has never had measles.”
Schaffner adds, “It’s no joke. It’s not like a cold for three days. You can feel absolutely miserable for 10 days to two weeks.”