CDC Report Shows Measles Cases are Rising in the United States

Measles cases are increasing at a rapid rate, and the antivaccination movement has brought back this potentially fatal disease that was eliminated in the United States in 2000.

New cases are continuously surfacing in the media of possible widespread measles exposures. In fact, a woman with a now confirmed case of measles attended the midnight showing of “Avengers: Endgame” at a movie theater in California and may have exposed the crowd.¹ Also, a cruise ship was quarantined in St. Lucia after a crew member was confirmed to have measles.²

A recent CDC report found that from January 1 to April 26, 2019 there were a total of 704 measles cases in 22 states across the US, which is the highest number since 1994.³ Among the 704 measles cases, 71% occurred in unvaccinated individuals, 11% received at least 1 dose of the measles, mumps, and rubella (MMR) vaccine, and the immunization status of 18% was unknown. In addition, 9% of the 704 patients with measles were hospitalized and 3% had pneumonia.

In the 704 cases, measles cases occurred in the following age groups: age 5-19 years: 29%; age 16 months-4 years: 24%; and age 20-49 years: 20%. Thirteen outbreaks have been reported in the US, and 6 of them were associated with underimmunized close-knit communities. New York state and New York City accounted for 67% of all cases reported in 2019.³

Of the 704 cases, 98% occurred in US residents.³ Forty-four measles cases were brought into the US by international travel, and 91% were in unvaccinated individuals or those with an unknown immunization status. Source countries of the measles cases include Philippines, Ukraine, Israel, Thailand, Vietnam, Germany, Algeria, France, India, Lithuania, Russia, and the United Kingdom.³

This report further emphasizes the importance of the MMR vaccine for measles prevention. Pharmacists can play an important role in ensuring that children and adults are up-to-date on the MMR vaccine. Children should get 2 doses of the MMR vaccine with the first 1 at age 12-15 months and the second at age 4-6 years.

Pharmacists should counsel patients that are traveling internationally to make sure they are vaccinated at least 2 weeks before traveling. Infants age 6 months through 11 months of age should receive 1 dose of the MMR vaccine before traveling internationally.⁴

Infants who receive 1 dose of the MMR vaccine before their first birthday should get 2 more doses (1at age 12-15 months and another dose separated by at least 28 days). Children age 12 months and older should receive 2 doses of the MMR separated by at least 28 days. Teenagers and adults without evidence of immunity against measles should get 2 doses of the MMR vaccine separated by at least 28 days.⁴

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References

• Yasharoff H. ‘Avengers: Endgame’ midnight showing crowd in California may have been exposed to measles. USA Today. https://www.usatoday.com/story/life/movies/2019/05/02/avengers-audience-may-have-been-exposed-measles-california/3649326002/. Published May 2, 2019. Accessed May 2, 2019.
• Scientology cruise ship quarantined in St. Lucia after measles case. CBS News. https://www.cbsnews.com/news/scientology-cruise-ship-quarantined-in-st-lucia-after-measles-case-2019-05-02/. Published May 2, 2019. Accessed May 2, 2019.
• Patel M, Lee AD, Redd SB, et al. Increase in Measles Cases-United States, January 1-April 26, 2019. MMWR Morb Mortal Wkly Rep 2019;68:402-404. DOI: http://dx.doi.org/10.15585/mmwr.mm6817e1.
• Measles, mumps, and rubella (MMR) vaccination: what everyone should know. CDC website. https://www.cdc.gov/vaccines/vpd/mmr/public/index.html. Last reviewed March 28, 2019. Accessed May 2, 2019.