America's 2019 Measles Outbreak Explained

After being eradicated for over 19 years, measles is making a comeback in America. Since January 2019, the highly-contagious disease has infected more than 700 people, mostly small children. The cases have emerged across the country, all the way from New York, which is facing its worst measles crisis since 2000, to Washington and California. According to the American Red Cross, as of April 26, 2019, 22 states have reported measles cases, and the number seems to be increasing daily. So what is measles, and why is the outbreak causing such anxiety? Read on . . .

The disease

Measles is an infectious disease that typically begins with a high fever, cough, runny nose, and red, watery eyes. Many people also lose their appetites and feel lethargic. About three to four days after the symptoms start, the person breaks out into a rash that begins on the face at the hairline and then spreads to the neck and the rest of the body. The flat red rash spots are often accompanied by small raised bumps and a high fever.

In healthy people, the recovery, which takes between two to three weeks, starts soon after the rash begins. However, for about 40 percent of patients — mainly kids under the age of five, people who are undernourished, or older adults — the disease often leads to pneumonia, which, if left untreated, could result in death. In some extreme cases, measles also causes blindness, a loss of hearing, and other long-term ailments.

How does measles spread?

Measles is an airborne disease that can spread through sneezing or coughing. Since the particles can remain suspended in the air for long periods, the measles virus — which can live for up to two hours — continues to spread long after the sick person has left the room. Because the tell-tale rash does not surface for four days, infected people can unwittingly continue to spread the disease to others.

Can measles be prevented?

Measles can be easily prevented through the MMR (measles, mumps, and rubella) vaccination, which is administered in two doses — the first at 12 to 15 months of age, and the second at 4 to 6 years of age. According to the US Centers for Disease Control (CDC), the vaccine is extremely safe and very effective against the disease. Its live, albeit weakened, strain of the virus causes the body's immune system to create antibodies that help protect against the disease when the person is exposed to actual measles.

How did measles reemerge in the US?

The recent outbreak is thought to have been caused by travelers picking up the virus in a country where the disease is still prevalent and exposing it to an unvaccinated community in the US. In New York, it was carried back by someone who had recently visited Israel, which is currently undergoing a significant measles epidemic, while in Washington, "patient zero" was infected by a strain that is currently circulating in Europe. The CDC believes the two carriers then came in contact with under-vaccinated, or non-vaccinated, children in both states, who caught the disease and spread it to others. In Southern California for example, measles appear to have been brought in by a Disneyland visitor who came to the theme park in mid-December.

Why are some kids not vaccinated?

While vaccinating children is mandatory in the US, some states allow exemptions for kids with weakened immune systems or for those who are allergic to the vaccine's components. Forty-eight states also provide exceptions for religious reasons, while twenty allow parents to make the decision. Though there have always been a few American parents that did not believe in the protection afforded by the shots, the "anti-vaccine" movement really started to gain momentum in 1988 after British physician Andrew Wakefield published a study linking the MMR vaccine to autism. While subsequent research showed that Wakefield, who later lost his license to practice in 2010, had no basis for this conclusion, the damage was done. According to a 2018 CDC report, the number of children that get none, or only some, of the recommended vaccinations has quadrupled in the past 17 years. While the total count is still relatively small, the upward trend is causing much concern among experts.

How are US health officials dealing with the outbreak?

To curtail the spread of the disease before it gets out of hand, US health officials are attempting to educate close-knit communities with high rates of unvaccinated children. They are also urging adults to consult with their physicians and get booster shots if deemed necessary by the doctor.

The US is not the only country fighting a measles outbreak. Thus far this year, 170 countries have reported 112,163 measles cases to the World Health Organization (WHO). This is a 300 percent increase from the 28,124 cases reported by 163 countries during the same time period in 2018. Madagascar is the hardest hit reporting an astounding 46,187 instances between January and April of 2019 and 800 measles-related deaths since September 2018. Ukraine has had 25,319 measles cases, while India has reported 7,246. Hopefully, health officials worldwide will be able to convince parents that vaccinating their children will protect, not harm, them.

Resources: CDC.gov, Vox.com