Measles

Texas or Ontario, Which Controls Measles Better

Karen McClorey Hackett — Tue, 15 Apr 2025 06:18:31 +0000

Reviewer:

When the northern hemisphere experienced unexpected measles outbreaks in 2025, two areas separated by 2,400 miles reported similar challenges but contrasting vaccination rates.

While Canada's Alberta, New Brunswick, Quebec, and Manitoba provinces have reported a limited number of measles cases this year, Ontario has become the overwhelming leader.

As of April 14, 2025, Ontario had reported 816 measles cases (678 confirmed, 138 probable) since mid-October 2024.

In Ontario's rural Southwestern Public Health district, which includes the City of St. Thomas, Elgin County, and Oxford County, 343 measles patients have been confirmed, representing about 40% of all Ontario cases.

Among infants, children, and adolescents in this district located near the city of London, 92.5% of cases were unimmunized, and 62% of adults were unvaccinated.

Ontario's ongoing measles outbreak appears to be a rural challenge as its largest city, Toronto, recently confirmed only its second measles case in 2025, which was linked to an international traveler.

In 2024, with over 6 million residents, Toronto reported only ten measles cases for the year.

The most concerning data point is that Ontario's immunization rates have averaged about 70% during the past few years. This indicates that the highly transferable measles virus is hard to control.

"Ontario's immunization rates are lower than our peer countries in Europe and are down since 2017," stated Dr. Dick Zoutman, an infectious disease specialist, in a press release on April 11, 2025.

"This is a Public Health failure that must be addressed with the utmost urgency."

While in the southern United States, the Texas Department of State Health Services (DSHS) has been reporting a similar measles outbreak, primarily in West Texas.

Based on the most recent data, DSHS has identified measles outbreaks in Cochran, Dallam, Dawson, Gaines, Garza, Lynn, Lamar, Lubbock, Terry, and Yoakum counties.

As of April 11, 2025, 541 cases had been confirmed in western Texas since late January, the most in the U.S.

Separately, Houston, one of Texas's megacities with about six million residents, has only reported four measles cases this year.

When comparing vaccination rates against Ontario, Texas has done a better job.

The Annual Report of Immunization Status of (Texas) Students 2023-2024 School Year indicates a statewide vaccination rate exceeding 94%.

However, DSHS says the vaccination status of about 530 people infected during the measles outbreak in West Texas remains unknown.

There is one action item both Ontario and Texas agree with: the best way to prevent getting sick from measles is to be immunized with two doses of the MMR vaccine, which are offered at most pharmacies.

Sub Title:

Measles vaccination rates indicate outbreak risk

References:

Southwestern Public Health Measles Outbreak Report 0 5 10 15 20 Episode Date N u m b er of C ases Nov 2024 Dec 2024 Jan 2025 Feb

Texas Department of State Health Services April 2025

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Public Health Ontario April 2025

Texas Measles Outbreak Source Remains Unknown

Karen McClorey Hackett — Mon, 31 Mar 2025 13:27:33 +0000

Reviewer:

Robert Carlson, MD

The United States has been experiencing its largest measles outbreak since 2019, and the World Health Organization (WHO) has recently stated that the outbreak's source is "unknown."

On March 27, 2025, the WHO published Disease Outbreak News (561), confirming that measles was declared eliminated in the United States in 2000. Since then, imported measles cases have been reported, as this highly contagious disease remains endemic in many parts of the world.

Starting in January 2025, when Harris County Health (Houston) reported travel-related measles cases, the U.S. CDC confirmed over 483 measles cases in 20 jurisdictions.

In Texas, the health department has confirmed 408 cases during this year's outbreak.

While the WHO says the 'source of this outbreak is unknown.'

'And currently, there is no evidence of decreased vaccine effectiveness or changes in the virus that would result in increased severity.'

However, the WHO and the CDC disclosed that Texas, New Mexico, and Kansas submitted identical DNA sequences in genotype D8.

Additionally, five distinct genotype B3 sequences were reported from Alaska, California, Florida, Kentucky, New York, Rhode Island, Texas, and Washington.

A study published in 2024 stated, 'Variability in measles (genotype) transmissibility may have important implications for measles control.'

The U.S. CDC says, 'Measles virus genotyping can help establish which foreign country may be the source of an imported U.S. case. However, genotyping alone is not sufficient since each genotype can circulate in multiple countries and even in different regions of the world.'

To alert travelers of this health risk in the U.S. and worldwide, the CDC has published Travel Health Advisories for over 50 countries reporting measles outbreaks this past year.

This includes Ontario, Canada, which reported about 557 measles cases in 2025.

'The public health risk for measles in the Region of the Americas is considered high due to the persistence of the circulation of the virus from imported cases, ' wrote the WHO.

Both the WHO and CDC recommend that most people receive two doses of the MMR vaccine to protect themselves from measles. Measles vaccines are readily available at most pharmacies in the U.S.

Sub Title:

Measles genotype D8 and B3 identified in Texas in 2025

References:

WHO DOB 561 2025

US CDC Travel Advisory 2025

Factors Associated With Measles Transmission in the United States During the Postelimination Era

Genetic Characterizations and Molecular Evolution of the Measles Virus Genotype B3’s Hemagglutinin (H) Gene in the Elimination E

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by Nel Botha

Measles Outbreaks Can Be Eliminated

Karen McClorey Hackett — Tue, 12 Nov 2024 17:37:18 +0000

Reviewer:

Robert Carlson, MD

For several years, the World Health Organization and the U.S. Centers for Disease Control and Prevention (CDC) have collaborated to eliminate measles cases. In 2020, these health agencies endorsed the Immunization Agenda 2030, a global vision and strategy to reach under-immunized and unimmunized children.

Unfortunately, measles outbreaks continue to be a global concern for international travelers in 2024, even in the United States.

As of November 12, 2024, the CDC maintains a global Watch-Level 1, Practice Usual Precautions, Travel Health Notice, identifying measles outbreaks in 56 countries.

The CDC says international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, including an early dose for infants 6–11 months, at least two weeks before visiting outbreak areas.

In the U.S., the CDC recently reported 277 measles cases in 32 jurisdictions, far exceeding 2023, when only 59 measles cases were reported by 20 jurisdictions.

In 2024, significant measles outbreaks were confirmed in Chicago (64 cases), Minneapolis (65), and Oregon (31). Furthermore, about 89% of the cases were unvaccinated or had an unknown status.

Since measles is highly contagious, the CDC says people with suspected measles should notify the healthcare facility before visiting so staff can implement precautions to prevent spread within the facility.

To ensure everyone is protected against this serious disease, speaking with a healthcare provider about MMR vaccination options remains the best advice.

Sub Title:

Travel vaccinations reduce measles outbreaks in 2024

Reference:

US CDC Measles Travel Advisory - 2024

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US CDC measles case map November 2024

Measles Vaccine Failure is Minuscule

Karen McClorey Hackett — Tue, 13 Aug 2024 15:57:35 +0000

The U.S. Centers for Disease Control and Prevention (CDC) recently published an early release (Volume 30, Number 9—September 2024) review of 14 studies in Emerging Infectious Diseases. These researchers wrote that despite the effectiveness of measles-containing vaccines, infection remains possible in immunized persons.

They confirmed measles in persons with secondary vaccination failure (SVF) may be less infectious than cases in unvaccinated persons.

All included studies reported a meager attack rate (0%–6.25%) and Reff (0.063 [95% CI 0.0–0.5]).

Published on August 9, 2024, these Australian researchers wrote, "Despite the effectiveness of measles-containing vaccines, infection remains possible in immunized persons," the authors said.

"This phenomenon has come to be known as vaccination failure."

"Our findings are in keeping with the results of Gastañaduy et al., who looked at the factors associated with measles transmission. Although they did not disaggregate Primary vaccination failure and SVF, they found a Reff of 0.17 for persons who had received one dose of a measles-containing vaccine and a Reff of 0.27 for those who received >2 doses of a measles-containing vaccine. That finding contrasted a Reff of 0.76 for unvaccinated persons."

All included studies also reported a very low attack rate (0% to 6.25%) for SVF cases.

These findings suggest that people with measles SVF have a very low risk of transmitting the disease. In measles outbreak situations, public health management of unvaccinated people could be prioritized over people with SVF, according to this review.

The measles virus is one of the most infectious pathogenic agents. Its basic reproduction number is 12–18, indicating that each infected person could infect 12–18 other susceptible persons.

Despite the number of deaths, measles vaccination has averted an estimated 57 million deaths in the 22 years since 2000. In 2022, measles caused an estimated 136,000 deaths globally and predominantly affected unvaccinated persons and undervaccinated children.

Because of effective measles (measles, mumps, rubella) vaccines and the absence of healthy carriers, 82 countries have achieved measles elimination through high immunization coverage.

On August 8, 2024, the CDC reported 211 measles cases in 27 jurisdictions in the United States. This is an increase from 2023 when there were 59 measles cases in 20 jurisdictions.

A probable reason for this infection rate increase is undervaccinated children.

KFF published data in July 2024 indicating nearly 75% of U.S. states had kindergarten MMR vaccination rates below the Healthy People 2030 target rate (95%) for the 2022-2023 school year.

In the U.S., measles vaccines are generally available at health clinics and pharmacies. However, the CDC does not recommend that everyone receive a third dose of the MMR vaccine during measles outbreaks.

Sub Title:

Measles virus transmission after vaccination failure is less than five percent

Reference:

CDC - Volume 30, Number 9—September 2024 Synopsis Onward Virus Transmission after Measles Secondary Vaccination Failure

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measles, vaccinations

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KFF measles vaccination map July 2024

100 Million African Children Receiving Measles and Rubella Vaccines

Karen McClorey Hackett — Tue, 14 May 2024 17:40:52 +0000

Reviewer:

Robert Carlson, MD

Gavi, the Vaccine Alliance, is collaborating with partners in Africa to reach up to 100 million children with measles and rubella vaccines in 2024.

As of May 14, 2024, FW Africa reported this expanded vaccination initiative encompasses Benin, Burkina Faso, Cambodia, Côte d'Ivoire, Eritrea, Ghana, Guinea, Guinea Bissau, Kyrgyzstan, Lao PDR, Liberia, Madagascar, Mali, Mauritania, Mozambique, Nepal, Rwanda, Senegal, Sierra Leone, Sudan, Tanzania, and Zambia are among the countries slated for rollout in 2024.

In 2024, preventive measles and rubella campaigns have been launched in countries such as Eritrea, Nepal, Tanzania, Burkina Faso, and Mali, with Sudan rolling out an MR introduction campaign.

Globally, routine immunization coverage for the first dose of Measles Containing Vaccine remains 2% below pre-pandemic levels.

During the current strategic period (2021-2025), Gavi has allocated $753 million to measles and rubella initiatives.

GAVI's ambitious objective comes with a concerning increase in measles outbreaks in 2024.

As of April 26, 2024, the U.S. CDC updated Travel Health Notice lists 51 countries reporting measles outbreaks.

In the United States, 21 jurisdictions reported 132 measles cases this year, led by the state of Illinois with 67. Furthermore, 81% of these cases were unvaccinated or unknown. In 2023, 20 jurisdictions reported 58 measles cases in the U.S.

And 53% of these measles cases were hospitalized (70 of 132 cases) for isolation or management of measles complications. In April 2021, the journal Pediatrics published a study indicating that treatment costs were $47,479 per case during a measles outbreak.

As of May 14, 2024, measles vaccines are generally available at clinics and pharmacies in the U.S.

Sub Title:

51 countries confirm measles outbreaks in 2024

Reference:

Gavi targets 100M children with measles and rubella vaccines

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Age Groups:

4 6 years

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measles, vaccinations

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Wednesday, May 15, 2024 - 05:15

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ECDC Africa diseases 2024

Vaccination Efforts Saved Over 154 Million Lives

Karen McClorey Hackett — Wed, 24 Apr 2024 17:45:29 +0000

Reviewer:

Robert Carlson, MD

Holly Lutmer PharmD

A study published today by The Lancet has revealed that global immunization efforts have saved an estimated 154 million lives over the past 50 years.

Most lives saved were those of infants, with 101 million lives saved.

The study, led by the World Health Organization (WHO), found that vaccination against 14 diseases has reduced infant deaths by 40% globally.

The 14 diseases that the study found immunization to be effective against include diphtheria, Haemophilus influenzae type B, hepatitis B, Japanese encephalitis, meningitis A, pertussis, invasive pneumococcal disease, polio, rotavirus, rubella, tetanus, tuberculosis, and yellow fever.

The measles vaccination significantly reduced infant mortality, accounting for 60% of the lives saved due to immunization.

"Vaccines are among the most potent inventions in history, making once-feared diseases preventable," said WHO Director-General Dr Tedros Adhanom Ghebreyesus in a press release on April 24, 2024.

"Thanks to vaccines, smallpox has been eradicated, polio is on the brink, and with the more recent development of vaccines against diseases like malaria and cervical cancer, we are pushing back the frontiers of disease. With continued research, investment, and collaboration, we can save millions more lives today and in the next 50 years."

"The study found that for each life saved through immunization, an average of 66 years of total health were gained—10.2 billion full health years gained over the five decades.

As a result of vaccination against polio, more than 20 million people can walk today who would otherwise have been paralyzed, and the world is on the verge of eradicating polio, once and for all.

These gains in childhood survival highlight the importance of protecting immunization progress in every country and accelerating efforts to reach the 67 million children who missed out on one or more vaccines during the pandemic.

Additionally, the WHO, UNICEF, Gavi, and Bill & Melinda Gates Foundation (BMGF) are unveiling the "Humanly Possible" campaign during the annual World Immunization Week 2024.

The worldwide communication campaign calls on world leaders to advocate for, support, and fund vaccines and the immunization programs that deliver these lifesaving products.

"It is inspiring to see what has been made possible over the last fifty years, thanks to the tireless efforts of governments, global partners, and health workers to make them more accessible to more people," said Dr. Chris Eias, president of Global Development at the BMGF.

"We cannot let this incredible progress falter. By continuing to invest in immunization, we can ensure that every child – and every person – has the chance to live a healthy and productive life."

Sub Title:

Humanly Possible campaign to scale up vaccination programs

References:

WHO study

Humanly Possible joint campaign

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Age Groups:

Infant

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Humanly possible vaccination awareness 2024

300 Measles Cases Forecasted in 2024

Karen McClorey Hackett — Sat, 20 Apr 2024 14:11:57 +0000

Reviewer:

Robert Carlson, MD

Over the past two decades, most measles cases have been related to infected, unvaccinated international travelers bringing the highly transmissible virus with them to the United States.

This year, the U.S. is at greater risk for measles outbreaks because 49 countries are reporting cases, and international travel has resumed full throttle.

For example, a significant international measles outbreak continues in India.

To better understand health risks in 2024, the U.S. CDC's Center for Forecasting and Analytics and the Division of Viral Diseases in the National Center for Immunization and Respiratory Diseases have analyzed measles data and created models to explore potential outbreak scenarios.

Looking at historical data on measles outbreaks, size, and distribution since 2001, the CDC anticipates the most likely number of cases this year is around 300.

Furthermore, the CDC estimates a 4% chance of more than 1,000 measles cases being reported in 2024.

As of April 19, 2024, 125 measles cases had been reported this year. About 69% of these cases (86 of 125) are outbreak-associated.

This analysis indicates that the number of outbreaks in 2024 is unlikely to be substantially more significant than those in prior years, such as 2011, 2014, 2018, and 2019.

So far, in 2024, there have been seven outbreaks (defined as three or more related cases). For comparison, the CDC reported four outbreaks during 2023.

The unfortunate outbreak leader is the city of Chicago, which has reported 63 measles cases in 2024.

The City of Chicago has one of the highest measles vaccination rates in the U.S., indicating most of these measles cases are travel-related.

Jeri Beales, RN MSN, informed Precision Vaccination News, "Because measles is one of the most contagious diseases known, outbreaks pop up in low, medium, and high-income countries, so even travelers on holiday to Europe should check vaccine records before going."

"If you lost your vaccine card from childhood, a simple blood test can check your immune status against measles," added Beales, with Destination Health Clinic near Boston, MA.

Since measles is a vaccine-preventable disease, the CDC recommends that most people protect themselves with an MMR vaccination, which is generally available at travel clinics and pharmacies in the U.S.

Sub Title:

Measles outbreaks in Chicago, New York, Philadelphia in 2024

References:

CDC - Assessing Measles Outbreak Risk in the United States

CDC - Level 1 - Practice Usual Precautions - Measles Outbreaks

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Sunday, April 21, 2024 - 05:45

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US CDC multi year measles outbreak trend April 4, 2024

AI Technologies Correctly Curtail Vaccine Misconceptions

Donald Hackett — Mon, 15 Apr 2024 19:05:03 +0000

Reviewer:

Robert Carlson, MD

New research being presented at the ESCMID Global Congress shows that ChatGPT, a free-to-use, and widely accessible AI-powered chatbot, could be an effective tool in reducing vaccine hesitancy among the general public.

Even though AI chatbots like ChatGPT were introduced in late 2022, they have been struggling with accuracy issues.

Furthermore, individuals who mistrust health professionals may use technology to address their concerns.

"Our findings showed that ChatGPT displayed a remarkable ability to respond to a wide breadth of commonly asked questions accurately... and misconceptions around vaccination," stated lead author Dr. Matthew Koh from the National University Health System (NUHS) in Singapore in a press release on April 10, 2024.

"In most instances, ChatGPT performed at the level of advice provided by professional organizations and guidelines."

To better understand the issues, researchers from the NUHS tested ChatGPT to see whether it could successfully answer common questions about vaccination.

A team of physicians who run infectious disease clinics asked ChatGPT to answer 15 commonly asked questions on vaccine hesitancy, including doubts about the efficacy of vaccines, concerns about adverse effects, and cultural concerns relating to vaccines.

Two independent infectious disease experts then assessed the AI-generated responses on vaccine hesitancy against recommendations from the U.S. Centers for Disease Control and Prevention Advisory Committee on Immunization Practices.

The researchers found that ChatGPT's overall output provided factual responses and reassurance regarding vaccine hesitancy concerns.

For example, ChatGPT accurately highlighted the indication for measles vaccination in low-incidence settings.

In addition, ChatGPT provided reassurances about allergy and influenza vaccinations.

"Overall, ChatGPTs' responses to vaccine hesitancy were accurate and may help individuals who have vaccine-related misconceptions," says Dr. Koh, an infectious diseases physician at the National University Hospital in Singapore.

"Our results demonstrate the potential power of AI models to assist in public health campaigns and aid health professionals in reducing vaccine hesitancy."

"We believe that ChatGPT should be used in conjunction with, or in addition to, a physician (pharmacist) consultation—the human response is still needed to contextualize the advice that is given to a specific individual's situation and for it to make the most sense and be the most helpful for the patient."

Note: AI-technology reviewed the grammar of this news article.

Sub Title:

ChatGPT's responses offered factual responses regarding vaccine hesitancy

Reference:

ChatGPT could help reduce vaccine hesitancy

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health, vaccines, vaccinations

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Monday, April 15, 2024 - 17:00

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by Franz Bachinger

U.S. May Lose Measles Free Status

Karen McClorey Hackett — Sat, 13 Apr 2024 10:31:09 +0000

Reviewer:

Robert Carlson, MD

After being designated measles-free for two decades, the United States risks losing its status due to recent measles outbreaks.

Over the past fifteen months, 338 cases of measles have been reported in the U.S. Among these cases, 96% were associated with measles virus importation.

Among the 326 import-associated measles cases, 61% occurred among U.S. residents who were eligible for vaccination but were unvaccinated or whose vaccination status was unknown.

Furthermore, in 2024 alone, seven measles outbreaks (3+ cases) have been reported in the U.S.

This year alone, the U.S. Centers for Disease Control and Prevention (CDC) has reported 121 measles cases in eighteen jurisdictions this year: Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York City, New York State, Ohio, Pennsylvania, Virginia, and Washington.

About 56% of these cases were hospitalized (68 of 121 cases).

Furthermore, in a Morbidity and Mortality Weekly Report published on April 11, 2024, the CDC says the increased number of measles cases in 2024 is related to unvaccinated travelers in a few key cities, such as:

The Chicago Department of Public Health confirmed 61 cases.

The New York State Department of Health confirmed four measles cases in NYC and one in Nassau County.

California has reported six confirmed measles cases in San Diego, Los Angeles County, and one at UC Davis.

Many of these measles cases in 2024 can be traced to people who recently visited any of the 49 countries the U.S. CDC has identified.

The CDC says increasing the 2-dose measles, mumps, and rubella (MMR) vaccination rate is essential to reduce these outbreaks.

Furthermore, enhanced efforts are needed to increase MMR vaccination coverage, encourage vaccination before international travel, identify communities at risk for measles transmission, and rapidly investigate suspected measles cases before outbreaks occur.

Although the risk of broad transmission is low, measles is highly contagious, and “pockets of low coverage leave some communities at higher risk for outbreaks,” the CDC noted.

Measles vaccines are available throughout the U.S. at health clinics and community pharmacies. Monovalent measles vaccines are offered in other countries.

Sub Title:

Measles outbreaks in Chicago, New York, California

References:

MMWR - Measles — United States, January 1, 2020–March 28, 2024

Measles Outbreaks in US and Abroad Prompt CDC Vaccination Alert

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MMR, vaccinations

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US CDC measles case trends April 12, 2024

School Vaccinations Increased When Nonmedical Exemptions Were Eliminated

Donald Hackett — Mon, 05 Feb 2024 22:22:58 +0000

Reviewer:

Robert Carlson, MD

Holly Lutmer PharmD

When New York Senate Bill 2994A was passed in June 2019, nonmedical vaccine exemptions for attending school were eliminated. This action was related to a previous measles outbreak in unvaccinated residents.

An analysis of the 2018-2019 measles outbreak in New York City estimated that around a quarter of young children in an affected community were susceptible to the measles virus, likely due to under-vaccination.

Since 2019, a positive vaccination trend has evolved in New York.

To calculate the impact of Senate Bill 2994A, an Original Investigation was conducted and published by the JAMA Network Open on February 2, 2024.

This investigation found implementing this Senate Bill was associated with absolute increases in mean vaccine coverage of 5.5% (95% CI, 4.5%-6.6%) in New York among nonpublic schools and 0.9% (95% CI, 0.7%-1.1%) among public schools.

This New York law's implementation was also associated with a 0.1% mean absolute decrease in medical vaccination exemption uptake at both public and nonpublic schools, with additional annual mean increases of 1% among nonpublic schools and 0.3% among public schools estimated through the 2021 to 2022 school year.

Additionally, these researchers found that Senate Bill 2994A implementation was associated with a slight decrease of 0.1% in medical exemption uptake among nonpublic and public schools, with subsequent annual mean decreases of 0.02% among these schools through the 2021 to 2022 school year.

The apparent differences between public and private schools have implications for the control and spread of vaccine-preventable diseases and suggest greater susceptibility to vaccine-preventable disease outbreaks among nonpublic schools, where diseases may spread among closed communities.

According to the researchers of this cohort study with interrupted time-series analyses, repealing nonmedical vaccination exemptions was associated with increases in mean vaccine coverage at schools outside of NYC.

Among these schools, evidence that coverage gains were offset by increasing medical exemptions was not found; instead, a small but significant decrease in medical exemptions associated with the implementation of Senate Bill 2994A was observed.

A new faculty start-up award from the Albany College of Pharmacy and Health Sciences supported this work. Corresponding Author: Margaret K. Doll, Ph.D., MPH, Albany College of Pharmacy and Health Sciences (margaret.doll@acphs.edu).

Sub Title:

Vaccine-preventable disease outbreaks reduced by increased vaccinations

Reference:

The JAMA Network Feb. 2, 2024

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Age Groups:

Adolescent

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school, vaccinations

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Saturday, February 10, 2024 - 15:00

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NYC schools 2024

64% More Measles Cases Last Year

Karen McClorey Hackett — Wed, 31 Jan 2024 10:20:48 +0000

Reviewer:

Robert Carlson, MD

Holly Lutmer PharmD

When measles was eliminated in the United States in 2000, most public health leaders pointed to effective vaccination efforts.

However, when measles cases began to appear in 2010, unvaccinated international travelers visiting the U.S. were identified as a global challenge in eliminating this airborne virus, according to the Centers for Disease Control and Prevention (CDC).

In recent years, measles outbreaks have become a worldwide health risk.

The World Health Organization (WHO) reported on January 29, 2024, that 534,672 suspected measles cases were reported in 169 Member States in 2023.

This data represents a 64% increase in measles cases compared to 2022.

As January 2024 ends, measles cases have recently been reported in Delaware, New Jersey, Missouri, Pennsylvania, Virginia, and Washington.

According to a COCA Now message issued on January 24, 2024, the U.S. CDC was notified of 23 confirmed U.S. cases of measles between December 2023 and January 23, 2024.

This new CDC data compares with only 48 measles cases during 2023.

This uptick in measles cases could also be related to student undervaccinations.

A CBS News investigation revealed on January 30, 2024, that at least 8,500 U.S. schools have low measles vaccination rates.

The report highlights that vaccination rates among kindergartners fall below the CDC's 95% threshold for community protection against measles.

The WHO recently wrote, Given the challenges related to the persistence of low coverage of the first and second doses of the vaccine against measles, rubella, and mumps (MMR), the increase in measles cases globally, and the occurrence of imported cases places everyone at risk.

The Pan American Health Organization / WHO urges Member States to continue with activities to increase and maintain adequate vaccination coverage against measles, rubella, and mumps. It reiterates that vaccination, epidemiological surveillance, and preparation of rapid response are needed to curtail measles outbreaks in 2024.

In late 2023, the CDC issued a Level 1 - Practice Usual Precautions, Travel Health Notice, identifying 47 countries at risk for measles exposure.

This CDC says travelers are at risk of measles if they have not been fully vaccinated two weeks before departure or have not had measles in the past and travel internationally to areas where measles is spreading.

In the U.S., measles vaccines are generally available at most health clinics and local pharmacies.

Sub Title:

8,500 schools at risk for substandard MMR vaccinations

References:

CNS News - 8,500 U.S. schools at greater risk of measles outbreaks

PAHO measles alert 2024

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MMR, vaccinations

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Fact checked:

Saturday, February 10, 2024 - 15:15

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US CDC Travel Health Notice Nov. 2023

Confirming Measles Outbreaks By Wastewater Testing in 2024

Karen McClorey Hackett — Mon, 29 Jan 2024 15:51:47 +0000

Reviewer:

Robert Carlson, MD

Throughout January 2024, twenty-three measles cases have been detected in various United States cities, as the Centers for Disease Control and Prevention (CDC) reported last week.

In Philadelphia's outbreak, public health leaders used multiple tactics to identify nine measles cases.

Since the City of Philadelphia is already participating in a U.S. CDC poliovirus surveillance program, they could have leveraged that innovative system to identify measles virus hot spots.

In September 2020, the CDC launched the National Wastewater Surveillance System to coordinate the nation's capacity to track the presence of viruses in wastewater samples collected across the country.

Measles wastewater surveillance relies on tests to find genetic evidence of DNA or RNA. When people are infected, their stools include pathogens that show up in sewage systems.

According to previous research studies, wastewater testing can identify the measles virus.

In September 2023, researchers concluded multiplex analysis using wastewater provides a fast and cost-effective way to monitor viral diseases in a population or environment.

In 2017, researchers detected measles virus RNA in wastewater where measles cases were identified.

The practical question was raised by an article written by Cassandra Willyardarchive in MIT Technical Review on January 26, 2024 .... about whether detecting measles in wastewater would have any public health value.

Cases tend to get noticed because measles is rarely asymptomatic, and the rash is distinctive.

"I actually think you could make the argument that measles is even more important to [detect] than covid or influenza or any of the other pathogens that we're looking for," says Samuel Scarpino, an epidemiologist at Northeastern University in Boston, MA.

With nearly 80% of U.S. households already connected to municipal wastewater collection systems, wastewater testing for measles is a logical use-case.

On November 30, 2022, the CDC announced it was expanding wastewater testing.

Dr. José R. Romero, Director of CDC.'s National Center for Immunization and Respiratory Diseases, indicated that poliovirus wastewater testing would continue into 2024 in cities like New York.

Because the U.S. has a very high measles vaccination rate, most cases are related to international travelers. This indicates airports and airplane wastewater systems are prime targets to integrate into the U.S. wastewater testing network.

Sub Title:

Wastewater surveillance can identify measles and polio viruses.

References:

Simultaneous detection of SARS-CoV-2, influenza A, respiratory syncytial virus, and measles in wastewater

Study: Polio and Measles Down the Drain

How wastewater could offer an early warning system for measles

US National Wastewater Surveillance System

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Measles, vaccinations

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Fact checked:

Tuesday, January 30, 2024 - 05:15

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US CDC National Wastewater Surveillance System 2024

South Africa's Measles Outbreak Continues

Karen McClorey Hackett — Thu, 17 Aug 2023 16:17:43 +0000

Reviewer:

Robert Carlson, MD

Over the past year, the Republic of South Africa has been confronted with a significant measles outbreak. Even with an aggressive vaccination program, new measles cases continue to be reported.

As of August 16, 2023, the National Institute for Communicable Diseases (NICD) has tested 6,616 serum samples for measles since epidemiological week 40, 2022, of which 1124 (17%) were confirmed positive.

Recently, the percentage of samples testing positive decreased to 9% in week #31.

However, in early August 2023, six laboratory-confirmed measles cases were detected nationwide.

Three measles cases were from Limpopo province, while Free State, Gauteng, and North West reported one case each.

There must be no new measles cases for 42 days to declare the measles outbreak over.

Worldwide, numerous countries have reported measles outbreaks in 2023. Measles is often transmitted from person to person through inhaling airborne micro-droplet respiratory secretions (from the nose or throat) from infectious patients.

Patients are infectious from one day before the onset of prodromal symptoms (usually about four days before the rash appears) until four days after the rash appears.

Clinicians across South Africa are urged to be on the lookout for measles cases and support the ongoing vaccination program. Globally, various measles vaccines are authorized for most people, including infants.

For more information about South Africa's measles outbreak including vaccination, please refer to this website.

In the U.S., measles vaccines are generally available at health clinics and pharmacies.

The U.S. CDC, the U.K., and Canada have issued various measles outbreak travel advisories to inform international travelers of their health risks.

As of August 3, 2023, a total of 19 measles cases were reported by 13 U.S. jurisdictions this year.

Sub Title:

Measles outbreaks are vaccine preventable in 2023

References:

SOUTH AFRICAN MEASLES OUTBREAK UPDATE 2023

Measles outbreak in SA summary - 2023

Prevention of secondary measles cases

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measles, MMR, vaccinations

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Friday, August 18, 2023 - 06:00

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WHO - South Africa measles outbreak map August 2023

Measles Elimination Requires Pre-Trip Vaccinations

Karen McClorey Hackett — Thu, 10 Aug 2023 21:07:16 +0000

Reviewer:

Robert Carlson, MD

The United States has maintained the elimination of measles since 2000, despite several outbreaks in various states such as Ohio.

Most measles outbreaks occur when unvaccinated or under-vaccinated people travel to and from the U.S., says the U.S. Centers for Disease Control and Prevention (CDC).

Measles cases worldwide increased by about 80% during 2022.

For example, India recently reported 57,550 measles cases over the past year.

Additionally, the CDC published a global Watch-Level 1 Travel Health Notice regarding measles outbreaks in Africa and other countries.

As of August 3, 2023, the CDC reported 19 measles cases in thirteen U.S. jurisdictions in 2023. In 2022, there were 121 measles cases.

Maintaining measles elimination in the U.S. requires continued investment in the measles vaccination program, which is instrumental to achieving elimination.

And healthcare providers and public health authorities need to remain vigilant to rapidly recognize measles and take steps to mitigate the spread within communities for continued measles elimination.

On August 10, 2023, the CDC urged all healthcare providers to ensure their patients are current on the measles, mumps, and rubella vaccine). Measles vaccines are available at health clinics and pharmacies in the U.S.

Furthermore, healthcare providers should consider measles a diagnosis in anyone with a fever (≥101°F or 38.3°C) and a generalized maculopapular rash with cough, coryza, or conjunctivitis who has recently been abroad, especially in countries with ongoing outbreaks.

Measles is highly contagious.

Around 90% of people who are not protected will become infected following exposure to the measles virus.

To better answer clinical questions, the CDC has scheduled a webinar for August 17, 2023, from 2:00 PM – 3:00 PM ET, at this Zoom Link: https://www.zoomgov.com/j/1603132944; Webinar ID: 160 313 2944; Passcode: 532989.

Sub Title:

Measles outbreaks continue in August 2023

References:

CDC - Measles Clinical Presentation, Diagnosis, and Prevention

CDC - Level 1 - Practice Usual Precautions

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Young Adults

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measles, vaccinations

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Friday, August 11, 2023 - 05:15

Image Caption:

U.S. CDC measles outbreak map August 2023

India's Measles Outbreak Exceeds 73,000 Cases

Karen McClorey Hackett — Wed, 21 Jun 2023 22:30:55 +0000

Reviewer:

Robert Carlson, MD

Holly Lutmer PharmD

The U.S. CDC's Emergency Preparedness and Response today issued Health Alert Network Health Advisory #CDCHAN-00493 regarding ongoing global measles outbreaks.

As the summer 2023 travel season begins, the Centers for Disease Control and Prevention (CDC) reminds clinicians and public health officials to provide guidance for measles prevention to international travelers and to be on alert for measles cases.

For example, India has reported 73,536 measles cases over the past year.

And popular travel destinations, such as London, England, have recently experienced measles outbreaks. The U.K. Health Security Agency reported from January through April 20, 2023, 49 measles cases have been confirmed.

Furthermore, the Pan American Health Organization estimated more than 1.7 million children in 28 countries and territories of the Americas did not receive an initial dose of the measles vaccine by their first birthday during the recent pandemic.

In the U.S., the CDC has been notified of 16 confirmed measles cases across 11 jurisdictions as of June 8, 2023, with 14 (88%) linked to international travel.

Previously, the Columbus, Ohio Department of Health announced its multi-month measles outbreak was declared ended in February 2023 after 85 confirmed measles cases in children, of which most were unvaccinated.

And there was a recent measles outbreak in Kentucky.

The Kentucky Department for Public Health confirmed three measles cases in 2023, and Jefferson County Public Schools conducted measles vaccination clinics for about 10,000 unvaccinated students.

Measles (rubeola) is highly contagious, as one person infected by measles can contaminate about 90% of their unvaccinated close contacts, says the CDC.

The good news is vaccination can protect most people from contracting measles while traveling abroad.

All international travelers, including most infants and preschool-aged children, should be fully vaccinated (2 doses) with a measles vaccine two weeks before departure, says the CDC's Level 1 - Practice Usual Precautions alert.

Globally, there are various measles-prevention vaccines offered in 2023.

Additional international measles outbreak news is posted by Vax-Before-Travel.

Sub Title:

Measles vaccines are available in most countries in 2023

References:

CDC measles cases 2023

CDC Health Alert Network CDCHAN-00493

Measles Outbreaks June 2023

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