Through May, nearly 1,000 cases of measles have been confirmed in the United States, the highest number of cases since 1992 and since measles was reported eliminated in 2000, according to the CDC. From January 1 to May 31, 2019, the CDC notes, 981 individual cases of measles have been confirmed in 26 states.
States reporting cases to the CDC are Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, and Washington.
Public health officials advise that more measles cases can occur in a given year either because of an increase in the number of travelers who get measles abroad and bring it into the U.S., and/or further spread of measles in U.S. communities with pockets of unvaccinated people.
The CDC described the following situations by year:
• 2018: The U.S. experienced 17 outbreaks in 2018. Most of the cases were from three outbreaks in New York State, New York City, and New Jersey, respectively, with cases occurring primarily among unvaccinated people in Orthodox Jewish communities. The outbreaks were associated with travelers who brought measles back from Israel, where a large outbreak is occurring. The CDC adds that 82 people brought measles to the U.S. from other countries in 2018, the greatest number of imported cases since measles was eliminated from the U.S. in 2000.
• 2017: A 75-case outbreak was reported in Minnesota in a Somali-American community with poor vaccination coverage.
• 2015: The United States experienced a large (147 cases), multistate measles outbreak linked to an amusement park in California. The outbreak likely started from a traveler who became infected overseas with measles, then visited the amusement park while infectious. No source was identified, although CDC analysis indicates that the measles virus type in this outbreak (B3) was identical to the virus type that caused the large measles outbreak in the Philippines in 2014.
• 2014: The U.S. experienced 23 measles outbreaks in 2014, including one large outbreak of 383 cases, occurring primarily among unvaccinated Amish communities in Ohio. Many of the cases in the U.S. in 2014 were associated with cases brought in from the Philippines, which experienced a large measles outbreak.
• 2013: The U.S. experienced 11 outbreaks in 2013, three of which had more than 20 cases, including an outbreak with 58 cases.
• 2011: More than 30 countries in the WHO European Region reported an increase in measles that year, and France was experiencing a large outbreak. These led to a large number of importations (80), with most of the cases brought to the U.S. from France.
• 2008: The increase in cases in 2008 was the result of spread in communities with groups of unvaccinated people. The U.S. experienced several outbreaks in 2008, including three large outbreaks.
Pharmacists can do their part to help prevent the outbreak, public health officials emphasize. “Pharmacists are a crucial community source of information on vaccinations for potentially life-threatening diseases, like measles,” the CDC points out on its website.
Public health officials advise pharmacists to recommend routine childhood MMR vaccination, starting with the first dose at age 12 months through age 15 months, and the second dose at age 4 years through age 6 years or at least 28 days after the first dose.
Adults need at least one dose of MMR vaccine if they do not have evidence of immunity, the CDC adds.
Before any international travel, public health officials recommend the following:
• Infants age 6 months through age 11 months should have one dose of MMR vaccine. If they receive one dose of MMR before their first birthday, they should get two more doses of the vaccine at the regularly recommended intervals (one at age 12 months through age 15 months and another dose at least 28 days later).
• Children age 12 months or older should have two doses separated by at least 28 days.
• Adolescents and adults who do not have evidence of immunity should get two doses separated by at least 28 days.
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