Most U. S. Measles Cases Reported since 1996
Many Unvaccinated Because of Philosophical Beliefs
More measles cases have been reported in the United States since Jan. 1, 2008 than during the same period in any year since 1996, according to a report released today in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
Between January 1 and July 31, 2008, 131 cases were reported to CDC's National Center for Immunization and Respiratory Diseases (NCIRD). At least fifteen patients, including four children younger than 15 months of age, were hospitalized. No deaths have been reported.
In the decade before the measles vaccination program began, an estimated 3â€“4 million persons in the United States were infected each year. Of these, 400â€“500 died, 48,000 were hospitalized, and another 1,000 developed chronic disability from measles encephalitis.
"Measles can be a severe, life-threatening illness" said Dr. Anne Schuchat, director of NCIRD. "These cases and outbreaks serve as a reminder that measles can and still does occur in the United States."
Of the 131 patients, 112 were unvaccinated or had unknown vaccination status. Among the 112 unvaccinated U.S. residents with measles, 16 were younger than 12 months of age and too young for vaccination, and one had presumed evidence of measles immunity because the person was born before 1957.
Of the 95 patients eligible for vaccination, 63 were unvaccinated because of their or their parents' philosophical or religious beliefs.
Although immunization coverage rates for measles vaccine remain high, unvaccinated persons are at risk for measles, and sizeable measles outbreaks can occur in communities with a high number of unvaccinated persons.
Measles is consistently one of the first diseases to reappear when immunization coverage rates fall. Increases in the proportion of the population declining vaccination for themselves or their children might lead to large-scale outbreaks in the U.S. Currently, Israel and a number of countries in Europe -- including Switzerland, Austria, Italy, United Kingdom -- are reporting sizeable measles outbreaks among populations refusing vaccination.
"These cases resulted primarily from failure to vaccinate, many because of philosophical or religious belief," said Dr. Schuchat. "The vaccine against measles is highly effective in preventing infections, and high immunization levels in the community are effective at preventing or drastically decreasing the size of outbreaks."
Reports include cases from Illinois (32 cases), New York (27), Washington (19), Arizona (14), California (14), Wisconsin (7), Michigan (4), Hawaii (5), Arkansas (2), and Washington, D.C., and Georgia, Louisiana, Missouri, New Mexico, Pennsylvania, and Virginia (1 each).
Nine of the importations were in U.S. residents who had traveled abroad, and 8 were in foreign visitors. An additional 99 of the 131 cases had evidence of importation or were epidemiologically linked to importations. These import-related cases have largely occurred among school-aged children who are eligible for vaccination but whose parents have chosen not to vaccinate them. The source of 15 cases could not be determined.
Of the 131 cases, 17 were importations from the following countries: Switzerland (3), Italy (3), Israel (2), Belgium (2), India (2), Germany (1), The People's Republic of China (1), Pakistan (1), The Russian Federation (1) and the Philippines (1).
There were 55 cases of measles reported during 2006; 66 cases during 2005; 37 cases during 2004; 56 cases during 2003; and 44 cases during 2002.
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES