Measles cases at Florida school continue to rise as 12 other states report cases
The number of measles cases in Florida is continuing to rise, as more states across the rest of the U.S. are reporting cases of the highly contagious virus.
Eight people have been confirmed to have measles in South Florida as of Feb. 25, NBC Miami reported. The cases are linked to Manatee Bay Elementary in Weston, Florida, part of Broward County.
The school first reported that a third grader with no history of travel was sick with the virus on Feb. 16. That number has since increased to at least eight cases. The ages of the other patients hasn't been made public.
Local authorities haven't confirmed if the infected children are unvaccinated, but experts told NBC Miami it is likely, as two doses of measles vaccine (the recommendation) are 97% effective.
The state's Surgeon General Dr. Joseph Ladapo has been criticized for his handling of measles at the school, telling parents in a letter last week that children who are not fully vaccinated are still permitted to attend school if parents choose to send them.
Measles was previously eradicated more than 20 years ago in the U.S. But childhood vaccination rates are falling, and so far this year, at least 13 states are reporting cases.
In order to prevent measles outbreaks, at least 95% of the population must have received two doses of the vaccine. But two-thirds of U.S. states, including Florida, have not hit this mark, TODAY reported in a segment aired Feb. 22. The last case of measles in Broward County was in 2019, and there was only one the whole year, NBC Miami reported.
Globally, measles cases were up 79% in 2023 compared to the prior year, according to the World Health Organization. There are currently multiple large measles outbreaks around the world. In a press conference on Feb. 20, WHO noted that by the end of 2024, more than half of countries would be at risk of a measles outbreak unless prevention measures are put in place.
“Measles is a highly contagious virus that can spread quickly through the general public if people are not vaccinated,” Dr. Sandra Kemmerly, infectious diseases specialist and system medical director for quality and patient safety at Ochsner Health in New Orleans, Louisiana, tells TODAY.com.
Here’s a look at how widespread measles is in the U.S. right now, why experts think it is making a resurgence, the symptoms to watch for and how to know if you are immune.
Measles hits the US in 2024
Measles was declared eradicated from the United States in 2000 due to a highly effective vaccination program.
“Over the last decade and a half, we saw an irregular but overall increase in the number of cases,” Dr. Linda Yancey, infectious disease specialist at Memorial Hermann Health System in Houston, Texas, tells TODAY.com.
The trend stopped abruptly in 2020 when the COVID-19 pandemic hit as everyone was isolating and protecting themselves against the coronavirus, she adds. But now, the U.S. is again seeing a rise in cases. Many people have missed vaccinations due to the COVID-19 pandemic, and anti-vaccination sentiment is on the rise, NBC News reported.
On Jan. 25, the Centers for Disease Control and Prevention (CDC) issued a health alert to warn the public about growing cases of measles.
The agency confirmed 23 cases from Dec. 1, 2023, to Jan. 23, 2024, including seven cases of international travelers and two outbreaks of more than five cases each, mostly in children and adolescents who had not been vaccinated.
“Worldwide, we are in the midst of a large measles outbreak,” Yancey notes.
There are currently large outbreaks in many Asian, Middle Eastern, African and European countries, a CDC spokesperson tells TODAY.com.
The World Health Organization recently warned of an "alarming" 45-fold increase in measles cases in Europe in 2023 compared to 2022, BBC reported.
“In Europe and western Asia, measles numbers went from under 1,000 in 2022 to 30,000 in 2023, and these numbers appear to be increasing in 2024,” Yancey adds.
Last month, health officials in the United Kingdom warned of measles spreading rapidly after confirming more than 200 cases in the West Midlands, according to a press release.
Where is measles in the US?
So far, the following U.S. states have recently reported cases of measles:
California — two cases, first case in Los Angeles County since 2020
Georgia — two siblings in metro Atlanta family, first case since 2020
Missouri — one case in Clay County
Maryland — one case in Montgomery County after international travel
New Jersey — one case in Camden County, first case since March 2023
Ohio — one case in Montgomery County
Pennsylvania — nine cases, eight in Philadelphia and one outside the city
Washington — six cases in Clark and Wahkiakum counties
Arizona — one case in Maricopa County
Minnesota — two cases in Twin Cities metro area
Is there a measles outbreak in the US right now?
An outbreak is defined by more cases occurring than what's expected, according to the CDC. While the nation is not experiencing a widespread outbreak, there are small pockets in the country, including Philadelphia and several Washington counties, that initiated outbreak investigations after discovering an increase in the number of related cases for this time of year.
“There have been a few small, isolated outbreaks mostly related to international travelers and children who have not been vaccinated,” Kemmerly explains. "Infectious diseases experts are on high alert as several cases of measles have been reported in the U.S. since December."
The last major outbreak of measles in the U.S. occurred in 2019 when there were 1,274 individual cases confirmed in 31 states, according to the CDC. This was the highest number of reported cases in the U.S. since 1992, with most cases among those who were unvaccinated.
Why has measles made a comeback in the US?
The decline in measles vaccination rates globally increases the risk of larger measles outbreaks worldwide, including in the United States, a CDC spokesperson explains.
“Because measles remains a common disease in many parts of the world, we are seeing cases brought into the United States by unvaccinated U.S. residents following international travel,” the spokesperson adds.
As the COVID-19 pandemic caused many children to miss their well visits, fewer children were vaccinated compared to before the pandemic.
The CDC estimates over 61 million doses of measles vaccines were either postponed or missed from 2020 to 2022 due to the pandemic.
“When community protection drops, we know that unvaccinated people are at risk,” a CDC spokesperson says.
The pandemic also fueled the anti-vaccine movement — despite infectious disease experts and health officials emphasizing to the public that vaccines are safe and prevent disease.
Last year, the CDC also found school vaccination exemptions were the highest on record among kindergarteners, with measles vaccination rates lower than pre-pandemic levels at 93.1%.
Experts say this is below the 95% threshold needed for herd immunity for measles, where enough of a population is vaccinated so that even if some get measles, outbreaks cannot occur.
“The current increase in cases is alarming and can most likely be explained by a decrease in the overall vaccination rate,” Kemmerly says.
Measles symptoms
Measles has several stages of infection that occur over two to three weeks.
The incubation period, or the time between exposure to a disease and symptoms starting, is usually one to two weeks. Symptoms then develop in stages, lasting about 10 days in total. Recovery also progresses in phases.
The first symptoms of measles last two to three days and are non-specific and mild, including:
Cough
Runny nose
Watery eyes
In the next phase, look for:
White spots over a red background inside the cheeks called Koplik spots. These skin findings are unique for measles (so if you see these lesions, it’s most likely measles and nothing else).
A red rash, usually three to five days after the first symptoms develop. It looks like small raised bumps that erupt on the face and near the hairline, then spread down to the rest of the body.
A high fever as the rash starts to appear
The bumps eventually clustering together, giving a “splotchy red appearance” all over the body, according to Mayo Clinic
Usually the rash lasts about a week. You'll know you're recovering if:
The rash gradually fades first on the face and last on the extremities.
The cough goes away.
The skin peels where rash appeared for about 10 days.
People are generally contagious four days before the rash develops to four days after, the CDC notes.
“Kids and adults will have a similar pattern of symptoms,” Yancey adds.
But some children, especially those not update with their vaccines or younger than 5, are more likely to experience complications, such as ear infections and serious infections, such as pneumonia and encephalitis, a life-threatening inflammation in the brain.
Approximately, one in five people with measles is hospitalized, according to the CDC.
Measles vaccine
“To prevent measles infection and importation, all U.S. residents should be up to date on their MMR vaccinations prior to international travel,” a CDC spokesperson tells TODAY.com.
The MMR vaccine protects against three infectious diseases: measles, mumps and rubella.
Typically, children get two doses early in life, starting the first dose at 12 to 15 months and the second dose at 4 to 6 years old (but they can receive it earlier as long as at least 28 days from first dose).
Adults who are not immune should get at least one MMR vaccine, but those who are at higher risk of contracting the disease, such as college teachers, health care workers and international travelers, should get two vaccines at least 28 days apart, according to the CDC.
The CDC emphasizes the vaccine is “highly protective.”
“One dose of the MMR vaccine provides 93% protection against measles and two doses provide 97% protection,” a CDC spokesperson explains.
For those who are unsure if they are immune to measles, the CDC says there are three main ways to find out:
Lab test: Ask for a blood test that looks for antibodies against measles. If the test is positive, this means someone was naturally infected in the past or were previously vaccinated.
Birth year: Adults born before 1957 are presumed to be naturally protected against measles (because they were infected as a child).
Written documentation: Adults not at high risk for exposure and preschool-age children are considered immune if they have at least one documented dose of a MMR vaccine that was given on or after their first birthday. Adults high risk for exposure and school-age children need two documented doses of the MMR vaccine to be presumed immune.
Do you need a measles booster?
No, if you received two doses of the MMR vaccine as a child according to the recommended schedule, you do not need a booster and are considered protected for life, according to the CDC.
This article was originally published on TODAY.com
