CDC to Healthcare Providers: Be on the Lookout for Measles

Nearly two dozen cases of measles were confirmed in the U.S. last month and the highly contagious disease is on the rise globally.
Published: February 8, 2024

The Centers for Disease Control and Prevention (CDC) is advising healthcare providers to be “on alert” for patients exhibiting symptoms of measles after nearly two dozen cases were reported in the United States in the last month.

In a letter sent to clinicians on Jan. 25, the CDC said between Dec. 1 and Jan. 23, it was notified of 23 confirmed measles cases, including seven “direct importations” by international travelers and two outbreaks with more than five cases each. Most of the cases were among children and teens who had not been vaccinated against the virus.

“Measles cases often originate from unvaccinated or under-vaccinated U.S. residents who travel internationally and then transmit the disease to people who are not vaccinated against measles,” the letter read. “The increased number of measles importations seen in recent weeks is reflective of a rise in global measles cases and a growing global threat from the disease.”

Global cases of measles have been on the rise in recent years, increasing by 18% from 2021 to 2022, according to a report released last year by the World Health Organization (WHO) and CDC. On Jan. 30, the Pan American Health Organization (PAHO) published an epidemiological alert urging countries to intensify vaccination activities, epidemiological surveillance, and rapid response preparedness for possible measles outbreaks given the increase in cases worldwide and in the U.S.

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Measles, a highly contagious virus declared eliminated in the U.S. in 2000, is marked by fever, flu-like symptoms, and an itchy rash. About one in five people in the U.S. who get measles will be hospitalized. For every 1,000 cases of measles, about 200 children may be hospitalized, 50 may get pneumonia, one child may develop brain swelling along with deafness or disability, and between one and three may die, according to the CDC.

The MMR vaccine, which also protects against mumps and rubella, was approved by the Food and Drug Administration (FDA) in 1963. However, the nationwide MMR vaccination rate has fallen by 2% over the past two school years after remaining at 95% for 10 years. A November CDC report found that exemptions for routine childhood vaccination among kindergarteners are at an all-time high.

Why Are Childhood Vaccination Rates Dropping?

Experts say there are several reasons for a drop in vaccination rates, including the spread of misinformation. A paper published in The Lancet in 1998 claimed the MMR vaccine caused autism. The paper has since been debunked and two dozen subsequent studies have found no link. During an outbreak in Columbus, Ohio, in 2022-2023, public health officials said many parents of unvaccinated children who were infected chose not to give their children the vaccine due to autism risks.

“Once you scare people, it’s hard to unscare them, so people then sort of started to back away from that vaccine,” Dr. Paul Offit, director of the Vaccine Education Center and an attending physician in the division of infectious diseases at Children’s Hospital of Philadelphia, told ABC News. “So we saw cases again.”

The COVID-19 pandemic also impacted vaccination rates. At the start of the pandemic, people were afraid to go to doctors’ offices which led to a delay in children being up to date on vaccinations. Hesitation to get the COVID vaccine has also spilled over to all childhood immunizations, experts say.

Dr. Esther Liu, chair of the department of pediatrics at the University of Maryland Baltimore Washington Medical Center, said the success of vaccines can sometimes have ironic consequences, The Daily Item reports.

“As parents, we want to protect our kids. That’s a very natural response because we don’t see the devastation of these actual illnesses because we have better control in this country. It’s easier to fear the vaccine more than the illnesses,” she said. “I really tell parents, ‘Make sure you understand what it is that we’re trying to protect your child from.’”

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