U.S. health officials have issued a stark warning to clinicians across the country to remain vigilant for potential cases of measles, following a series of outbreaks, particularly among eligible children who have not received the vaccine.
In an email communication on Thursday, the Centers for Disease Control and Prevention (CDC) urged healthcare providers to be on high alert, citing nearly two dozen cases of the preventable virus reported since December. The alert emphasized the importance of clinicians being watchful for patients exhibiting symptoms of measles, such as rash and fever, and paying attention to those who have recently traveled internationally.
According to the CDC, seven cases of measles have been imported into the country, and two separate outbreaks with more than five cases each have been identified within the U.S. The majority of cases were found in young children and adolescents who were eligible for the measles, mumps, and rubella (MMR) vaccine but had not received it. This marks the first nationwide alert to clinicians about the recent surge in measles cases.
Public health experts are expressing concern over the rising incidence of measles among children, emphasizing the need for increased vaccination rates. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, noted that the U.S. is at a critical juncture, with a surge in cases among children who have not been vaccinated against this highly infectious and preventable disease. Federal data indicates a significant drop in vaccinations, coupled with record levels of vaccine exemptions among kindergartners.
Osterholm warns that without intervention, the country is likely to witness more outbreaks, resulting in severe illness, hospitalizations, and potentially deaths among children. Measles can lead to hospitalization in about a fifth of cases, with severe complications such as brain swelling occurring in one in 1,000 cases and a mortality rate of one to three in a thousand.
The surge in measles cases appears to be linked to a growing number of parents refusing to comply with vaccine recommendations, coupled with challenges in accessing healthcare for vaccination amid the ongoing pandemic. The recent cases underscore the risks associated with forgoing the safe and effective MMR vaccine.
Since December 1, outbreaks have been reported in various locations, including Philadelphia, a children’s hospital, a daycare facility, and a family with six cases in Washington state. Additionally, measles exposures have been documented at two international airports in the Washington, D.C. area and a separate case in the Atlanta area involving an unvaccinated person who traveled abroad. New Jersey has also reported a recent case.
Between December 1 and January 23, the U.S. recorded 23 cases of measles, compared to 56 cases in all of 2023 and 121 cases in 2022. This uptick in cases aligns with a global rise in measles cases and deaths, as highlighted in a report by the CDC and the World Health Organization (WHO) in November. In 2022, there were 9 million cases and 136,000 deaths worldwide, with Europe experiencing a significant increase in measles cases.
Vaccination rates have declined in the U.S., reaching an all-time high for vaccine exemptions in the 2022-23 school year, putting approximately a quarter-million kindergartners at risk of measles, according to a CDC report. Recent measles cases often originate from unvaccinated U.S. residents traveling internationally and transmitting the disease to others who lack immunity.
The CDC stressed that the increased number of measles importations reflects a rise in global measles cases, emphasizing the growing global threat posed by the disease. Measles is highly contagious for individuals who are not vaccinated or immune, spreading through respiratory droplets. The MMR vaccine, administered in two doses, is a highly effective preventive measure, providing near-complete immunity.
The current alert serves as a call to action for healthcare providers to remain vigilant, identify potential cases promptly, and advocate for increased vaccination efforts to curb the resurgence of measles in the U.S.