CLEVELAND — The measles outbreak in the United States is now considered the largest in 25 years, according to a weekly report Monday from the Centers for Disease Control.
The CDC reported Monday that from January 1 to April 26, there were 704 confirmed cases of measles in 22 states, and that of those, more than 70 percent of people were unvaccinated.
“This is going to be one of the worst years and it’s not even half over yet,” said Dr. Frank Esper, a pediatric infectious disease specialist with the Cleveland Clinic.
Esper said that measles was declared eradicated in the U.S. in 2000 because of a “successful vaccination campaign that started back in 1963.” Still, there are several hundred cases of measles in the U.S. each year, including more than 600 in 2014.
“Because we keep getting these from outside the United States, we remain at risk,” Esper said. “So it’s always important for us to maintain our vaccine level.”
As of Monday, the Ohio Department of Health said no cases of measles had been reported in the state.
Esper said vaccination is critical to making sure measles doesn’t return to Ohio. The state’s vaccination rate for the MMR vaccine is in the bottom 25 percent of the country, Esper said, noting that the average vaccination rate for MMR is 91.5 percent.
“Now, not all of those people are not vaccinated because they want to be,” Esper said. “Some of those people who are not vaccinated, it’s because they can’t be. They have medical conditions or they’re allergic to the vaccine, or they’re too young to get the vaccine.”
That also includes people who have weakened immune systems due to chemotherapy, cancer or an organ transplant.
The best way to protect yourself and others, Esper said, is to get vaccinated if you are able.
“The reason it’s not 7,000, the reason it’s not 70,000, is because of everybody else who has gotten vaccinated,” Esper said.
While measles is often associated with a skin rash, runny nose or red eyes, Esper said it can be more dangerous for some people, even in the United States where it is relatively rare.
Esper said one of every ten small children with measles will get an ear infection, while one of every 20 will get pneumonia. In one out of a thousand cases, measles can lead to brain swelling. If someone survives that, Esper said, there can still be long-term hearing problems or developmental delays.
People born from the time the vaccine came out in the 1960s until 1989, when guidance on the vaccine changed, may have only had a single dose of the MMR vaccine. Esper said that’s 93 percent effective by itself, but a booster dose, usually given to children as toddlers, can push that to 97 or 98 percent effective.
“For those individuals who had one vaccine, you can talk to your physician as to whether or not there is any benefit to getting a second vaccine or not,” Esper said, noting that there could be a benefit if people are in outbreak circumstances or are traveling abroad to places where measles is more common.
For measles specifically, Esper said about 90 percent of people must be vaccinated to prevent outbreaks and have “herd immunity.” That’s because measles is highly infectious.
“It’s something that stays in the air. After you’ve coughed, after you’ve sneezed, it floats in the air for up to a couple hours,” Esper said. “So you can maybe leave the room, but somebody else comes in an hour later, they can get infected from you being in that area.”
Esper said the MMR vaccine is so effective that someone who is not vaccinated can get the vaccine up to a day or so after measles exposure, and that will prevent measles from taking root.
