Measles Outbreaks; Lack of Vaccination

On February 1, 2019, the CDC announced that in 2019 three measles outbreaks (defined as three or more cases) have been reported in New York state, New York City, and Washington state. From January 1 to 31, 2019, 79 individual cases of measles were confirmed in ten states. The ten states that have reported cases to the CDC are California, Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Oregon, Texas, and Washington.


All three outbreaks were associated with travelers who brought measles back from Israel and Ukraine, where large measles outbreaks are occurring. The majority of people who got measles were unvaccinated. Measles is still common in many parts of the world including some countries in Europe, Asia, the Pacific, and Africa. Travelers with measles continue to bring the disease into the U.S. Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated.


In a given year, more measles cases can occur for a number of reasons. More measles cases can occur due to an increase in the number of travelers who get measles abroad and bring it into the U.S. More measles cases can occur due to further spread of measles in U.S. communities with pockets of unvaccinated people.


For example, the U.S. experienced 17 outbreaks in 2018, including three outbreaks in New York state, New York City, and New Jersey, respectively. Cases in those states occurred primarily among unvaccinated people in Orthodox Jewish communities. These outbreaks were associated with travelers who brought measles back from Israel, where a large outbreak is occurring. Eighty-two people brought measles to the U.S. from other countries in 2018. This is the greatest number of imported cases since measles was eliminated from the U.S. in 2000.


In 2017, a 75-case outbreak was reported in Minnesota in a Somali-American community with poor vaccination coverage.


The United States experienced a large (147 cases), multi-state measles outbreak linked to an amusement park in California in 2015. The outbreak likely started from a traveler who became infected overseas with measles, then visited the amusement park while infectious; however, no source was identified. Analysis by CDC scientists showed 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.


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.


The U.S. experienced 11 outbreaks in 2013, three of which had more than 20 cases, including an outbreak with 58 cases.


In 2011, more than 30 countries in the WHO European Region reported an increase in measles, and France was experiencing a large outbreak. These led to a large number of importations (80) that year. Most of the cases that were brought to the U.S. in 2011 came from France.


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.


See the CDC Announcement


Medical Risk Law: Vaccines: An Ounce of Prevention May Lead to a Pound of Injury