Public Health Experts Concerned About Rise in Measles Cases

A recent uptick in measles cases has physicians and public health officials worried about protecting young children from infection, as well as about the role of misinformation in driving the spread.

“Measles is not just some minor virus that all kids get in childhood. It’s not just some little fever or some little rash. It’s much more severe, and it’s much more dangerous,” said Sarah Lim, MD, of the Minnesota Department of Health, at a Tuesday briefing from the Infectious Diseases Society of America (IDSA).

The CDC recently told NBC Chicago that it was sending a team to the city, where the Department of Public Health confirmed five measles cases, four of which were identified in a shelter housing recently arrived migrants. The department vaccinated more than 900 shelter residents over the weekend.

At Sacramento’s UC Davis Medical Center emergency department, one infected child may have exposed some 300 people to the virus. Meanwhile, potentially hundreds of people in Michigan were exposed to the virus in late February and early March at two hospital emergency departments, two urgent care centers, and a pharmacy, according to local reports. Vaccination rates among toddlers in that state dropped to a record low of 66%.

A total of 17 states have reported 45 measles cases this year as of March 7, the CDC reported. In all of 2023, there were 58 cases. Many of the outbreaks have cropped up after exposure to the highly contagious virus in medical facilities.

Mostly, Lim said, unvaccinated U.S. travelers who bring back measles and infect other unvaccinated people at home are driving the rise in cases. At the same time, global measles cases are up because of the disruption in routine vaccination due to the COVID-19 pandemic. However, misinformation has also been playing a role, the experts noted.

Lim said that despite misinformation being “as old as vaccines themselves,” social media amplifies misinformation at rapid speeds. “The problem is that it’s like the old saying that ‘a lie can get halfway around the world before the truth can get its boots on,’ with the advent of social media,” she said.

Joshua Barocas, MD, of the University of Colorado School of Medicine in Aurora, urged parents to vaccinate their children if they had not yet done so. “If you are a parent who’s been on the fence, now is the time, given the outbreak potential and the outbreaks that we see, and I would also encourage healthcare workers to welcome people with open, non-judgmental arms,” he said.

Confusion about public messaging on the COVID-19 vaccine’s role in immunity and preventing spread may have hastened vaccine hesitancy in general, some research has indicated.

But on measles, the message was clear. According to the CDC, two vaccine doses would be 97% effective against measles.

“We do think that having two doses of MMR [measles, mumps, and rubella] provides lifelong immunity,” Lim said, with an exception for an early version of the vaccine in the late 1960s that “was not quite as effective.”

In terms of transmission, Lim pointed out that because the vaccine is so effective, “it typically would not have an effect on transmission, because you don’t actually get the infection in the first place.”

Ultimately, IDSA’s experts urged parents to consider how serious measles can be, with high fever, coughing, and a full-body rash among the symptoms. It has relatively high hospitalization and complication rates, with the possibility of pneumonia or encephalitis, among other serious risks.

“Some people don’t understand why we get so worried when we see measles cases increasing, and the reason is that even an uncomplicated case of measles is really awful,” Lim said.

Explaining this, Barocas added, might be the best way to counter misinformation directed at parents.

But with the year off to a worrying start, experts said we could be chipping away at years of efforts to eliminate measles in the U.S.

“We’ve maintained our measles elimination status for more than 20 years and it’s been an amazing public health achievement, and took a great deal of work in terms of vaccine programs, millions of parents getting their children vaccinated,” said Lim. “I think if we were to lose that, it would be an absolute tragedy, and it would be a real setback for public health in this country.”

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