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Morning Briefing

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Friday, May 31 2019

Full Issue

As Measles Cases Surpass Previous High Mark, CDC Officials Worry Current Outbreak Threatens America's Elimination Status

When reporting the new cases, the CDC said on Thursday that if the current outbreak continues into the summer and fall, the United States could lose its “measles elimination status,” meaning the disease would be considered endemic in the country for the first time in a generation.

There have been more measles cases in the United States the first five months of 2019 than there were in all of 1992, when the last large outbreak occurred, federal health officials said on Thursday, in part because of the spread of misinformation about vaccines. The Centers for Disease Control and Prevention said Thursday that there had been 971 known cases of measles in the United States so far this year. That is eight more cases than in 1992, the previous high since vaccines became widely used, when 963 cases were reported in the United States all year. And it is a sharp jump from last year, when just 372 cases were reported, the center said. (Earlier Thursday, the C.D.C. mistakenly said that the previous high was in 1994.) (Stack, 5/30)

"What's causing these outbreaks is lack of vaccination," said Dr. Mark Roberts, chair of health policy and management at the University of Pittsburgh Graduate School of Public Health. Illnesses have been reported in 26 states, but the vast majority are in New York City. The city's outbreak, which began last October, is already the largest local measles outbreak in the U.S. in nearly 30 years. It started when some unvaccinated children visited Israel, where a measles outbreak is occurring, and came back to New York. (Stobbe, 5/30)

A country is considered to have eliminated measles when there has been an absence of continuous spread of the disease for more than a year. The United States achieved that status in 2000 through a massive sustained effort to vaccinate children. If this year ends that accomplishment, it would be an enormous public-health loss, experts said. “It means that a really very harmful infection had been eliminated, but we have now let it back into our country, and it is a threat to our babies and young children as they grow up,” said William Schaffner, an infectious-disease professor at Vanderbilt University who has taken care of measles patients. (Sun, 5/30)

One reason for worry about the current outbreaks, Dr. Clark said, is that people are still being exposed to measles in public venues, including doctors’ waiting rooms. Those are places in which exposures are common early in outbreaks, but not this many months in, when public-health officials usually have been able to tamp down widespread transmission, Dr. Clark said. “Those things should be brought under control, and they’re worrying signs if you continue to see them,” he said. “It makes us worried that somebody has been exposed to measles you weren’t aware of.” (McKay, 5/30)

To be sure, the recent uptick in new measles cases is a far cry from the 1950s, when millions of people caught measles and hundreds died each year from the virus, CDC data show. Vaccinations against the highly contagious virus are widespread across the U.S., with some 94% of kindergartners having received vaccination coverage, according to the CDC. (Allyn, 5/30)

Between September and May 29, there have been 550 confirmed cases in New York City. As of May 28, there were 254 confirmed cases of measles in Rockland County. Those outbreaks have continued unabated for nearly seven months. If they continue through summer and fall, CDC officials said the U.S. may lose its measles elimination status. (Weixel, 5/30)

And in other news on the measles outbreaks —

Amid the worst measles outbreak in more than two decades, New York City health officials have issued 123 civil summonses to people found to be noncompliant with an April emergency order requiring unvaccinated people in parts of Brooklyn to get the measles-mumps-rubella vaccine. Yet, the city’s Department of Health and Mental Hygiene hasn’t collected fines on any of the summonses. (West, 5/30)

Ten weeks after Facebook Inc. FB 0.45% pledged to fight vaccine misinformation, such content remains widely available across its platforms as the social-media giant grapples with how aggressively to limit the spread of hoaxes and deceptions. Facebook as of this week is still running paid ads for a prominent antivaccination group that suggests unethical doctors have conspired to hide evidence of harm vaccines do to children. (Horwitz, 5/30)

At the end of 2018, a 10-year-old girl arrived in Clark County from the Ukraine. She was taken to an urgent care clinic for a fever, cough and a skin rash that looked suspiciously like measles. Within two weeks, the girl and 12 more people tested positive for a strain of the measles virus that is currently running rampant in eastern Europe. A report from the federal Centers for Disease Control and Prevention shows the Washington-Oregon outbreak was first incubated in homes and churches, where it spread quickly before dispersing into the Portland and Clark County communities. The report provides the first official insight into how the outbreak spread throughout the Vancouver area, other than an ever-growing list of potential infection locations released during the early winter. (Harbarger, 5/30)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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