Measles Cases Are Rising Across the U.S., Led by Florida Outbreak
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Measles, a severe and highly contagious respiratory illness that was declared eliminated in the Untied States in 2000, appears to be making something of a comeback.
Over the past month, episodes of the infection (often characterized by a blotchy rash) have been popping up across the country.
In Florida, Broward County health officials are investigating multiple cases that occurred at an elementary school. In Ohio, public health officials have confirmed at least four infections so far this year. Michigan reported its first measles incident since 2019.
With cases also identified in Arizona, California, Georgia, Indiana, Louisiana, Maryland, Minnesota, Missouri, New Jersey, New York City, Pennsylvania, Virginia, and Washington, no U.S. region seems safe from the virus.
“We are very concerned about the spread of measles across the country right now,” says Patricia Stinchfield, RN, a pediatric nurse practitioner and president of the National Foundation for Infectious Diseases. “We have seen 35 cases already in the first two months of 2024, whereas last year for the whole year, there were 58 cases. So this is not a good trend.”
Measles is considered the most contagious vaccine-preventable disease. If one person has it, 9 out of 10 people of all ages around him or her will also become infected if they are not protected, according to the Centers for Disease Control and Prevention (CDC).
A Decrease in Measles Vaccinations May Be to Blame
The CDC maintains that the risk of getting measles for the majority of Americans is small because most of the U.S. population has been vaccinated and the number of cases is still relatively low.
But the danger is growing. Mark Kline, MD, an infectious disease expert and physician-in-chief at Children’s Hospital New Orleans, attributes the inching up of cases in part to a dip in vaccinations.
A CDC study from the fall of 2023 found that from the 2019–20 to the 2021–22 school year, state-required vaccines among kindergartners dropped from 95 percent to about 93 percent.
Dr. Kline views the uptick as a possible “canary in the coal mine,” indicating that there could be greater trouble ahead if we don’t take precautions.
“I think it is time that we recognize that the protection that we’ve been afforded for measles by virtue of vaccines is really fragile and can be lost,” he says. “Viruses like the measles are not gone forever — they can come back and are still capable of inflicting serious harm or even death.”
Increased Travel May Also Be Driving Measles Spread
The CDC further warns that more measles cases may occur as international travel grows, with people bringing measles back to the U.S. from abroad. Travel around the globe has boomed as Americans increasingly go abroad after staying closer to home during the pandemic.
A dramatic rise in measles cases beyond U.S. borders has increased the risk of transmission. On February 22, the World Health Organization shared data showing that measles outbreaks in Europe sharply increased in 2023 compared with the three years prior.
Dr. Kline notes that the two children who were recently treated for measles in New Orleans had brought the virus home with them from a trip outside the country.
A ‘Miserable’ and Potentially Disabling Illness for the Unprotected
People who get measles often feel “absolutely miserable,” according to Stinchfield. The CDC estimates that about 1 in 5 unvaccinated Americans who get measles are hospitalized.
Initial measles symptoms include a high fever that may spike 104 degrees F, a cough, runny nose, and red, watery eyes. Two to three days after symptoms begin, tiny white spots may appear inside the mouth.
After three to five days, a rash will break out, usually appearing as flat spots on the face at the hairline, then spreading downward to the neck, trunk, arms, legs, and feet.
The virus typically runs its course and clears in about 10 to 14 days.
While there is no cure, the National Foundation for Infectious Diseases recommends treatment with vitamin A as a potential way to reduce complications.
Children younger than 5 and adults older than 20 are more likely to suffer from complications, such as ear infections and diarrhea. In some cases, measles can lead to more serious issues, such as pneumonia and encephalitis (inflammation of the brain).
“Measles patients can get dehydrated and may need IV fluids. Light often bothers their eyes, so they have to stay in a dark room,” says Stinchfield. “Some of them are so sick, they have to go on ventilators. One in 1,000 of them will have neurological problems like seizures, deafness, blindness, and if they survive, it can lead to a lifetime of intellectual disability.”
Precautions to Take to Tamp Down Transmission
The good news is that the full two doses of measles vaccine are about 97 percent effective at preventing infection. If you happen to be in the small percentage who still get measles after vaccination, your illness is likely to be mild and you’re much less likely to spread the virus to others.
The CDC recommends all children get two doses of MMR (measles-mumps-rubella) vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age.
The illness is not limited to children, however. The World Health Organization estimates that 1 in 5 cases in 2023 were among adults ages 20 and older. Stinchfield suggests a wave of vaccine skepticism that began in the 1990s may explain in part why some people who are now adults are unvaccinated and more vulnerable to the virus.
She recommends that all adults check their vaccine records to make sure they are up-to-date with their vaccinations.
“This is a really good time for everyone to check their own vaccine status or their own measles disease history,” says Stinchfield. “If people have not had the measles vaccine, they really need to urgently go get one, especially if they’re in one of the states where measles is circulating.”
