Health officials are turning up the alarm over rapidly increasing cases of measles spreading around the world, and experts are worried the United States is on the cusp of another massive outbreak like we experienced in 2019.
The number of measles cases worldwide nearly doubled from 2022 to 2023 — going from 171,153 cases to 321,582 cases, according to the latest data from the World Health Organization. So far this year, almost 100,000 cases have been reported globally.
Dr. Patrick O'Connor, the WHO's medical officer for measles and rubella, called the jump in measles cases over the year "very concerning," NPR reported. John Vertefeuille, director of the U.S. Centers for Disease Control and Prevention's Global Immunization Division, call the increase "staggering" but not totally unexpected given declining vaccination rates.
According to the CDC, the U.S. has reported a total of 128 confirmed or suspected cases of measles since April 26 across 20 jurisdictions: Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York City, New York State, Ohio, Pennsylvania, Vermont, Virginia, Washington and West Virginia. That's nearly three times the total amount of cases reported in all of 2023.
So far this year, there have been seven outbreaks (defined as three or more related cases), and 67% of cases (86 of 128) are outbreak-associated, according to the CDC. For comparison, four outbreaks were reported during 2023 and 48% of cases (28 of 58) were outbreak-associated.
A majority of those sickened (57 of 128) were ages five or younger and more than half of the cases (70 of 128) required hospitalization.
Although measles was declared eliminated in the U.S. in 2000 — meaning the disease is no longer constantly present in the country — that status is in jeopardy as cases continue spiking. Authorities are worried the U.S. is tracking toward an outbreak like in 2019, when 1,274 cases were confirmed in 31 states. It's the largest number of cases reported in the U.S. since 1992.
If a measles outbreak continues for a year or more, the U.S. could lose its measles elimination status. Reestablishing elimination status would take time and resources, but the CDC says there wouldn't be any economic, political or practical penalties, or adverse implications for the immunization program.
Measles is among the most infectious diseases. It spreads in the air when an infected person coughs or sneezes and can remain infectious in the air and on surfaces for up to two hours. Symptoms include fever, cough, runny nose and a distinctive rash. While measles can affect anyone, it's most common in children under 5.
Measles infects the respiratory tract and then spreads throughout the body. Symptoms include a high fever, cough, runny nose and a rash all over the body. Symptoms of measles generally begin approximately eight to 14 days after exposure but can range up to 21 days. Transmission is possible four days before the rash becomes visible and four days after the rash appears.
Infection can lead to permanent physical damage such as deafness. Most deaths are due to complications like encephalitis, severe dehydration, serious breathing problems and pneumonia.
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There is no specific treatment for measles. Caregiving focuses on relieving symptoms, making the person comfortable and preventing complications.
Health officials say being vaccinated is the best way to prevent getting sick with measles or spreading it to other people. However, vaccine coverage rates are "well under the 95% coverage with two doses that is necessary to protect communities from outbreaks," the WHO said. So far this year, 81% of the cases involve a person who is unvaccinated or whose vaccination status is unknown.
According to the CDC, almost all people in the U.S. with measles either traveled internationally or were around someone who traveled internationally. When travelers bring measles into the U.S., it can spread and cause outbreaks among people who are not vaccinated. The most common source for internationally imported cases is from countries in the Eastern Mediterranean and African WHO regions.
While vaccination is a person's best defense, the COVID-19 pandemic led to major setbacks in the fight against measles, according to the WHO.
"The suspension of immunization services and declines in immunization rates and surveillance across the globe left millions of children vulnerable to preventable diseases like measles," the agency said. "No country is exempt from measles, and areas with low immunization encourage the virus to circulate, increasing the likelihood of outbreaks and putting all unvaccinated children at risk."
In the U.S., every state requires children to have certain routine vaccines to go to public school to prevent outbreaks of once-common childhood diseases like measles. However, all states also provide exemptions for children who have a medical reason for avoiding the shots, and most also offer waivers for religious beliefs.
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