Measles Outbreaks Should Be a Wakeup Call

In 2019, U.S. measles cases hit highest level in 28 years.

toddler infected with measles

For parents who haven’t gotten their kids vaccinated, here’s a wakeup call: Measles outbreaks are on the rise.

In 2019, confirmed cases in the United States reached the highest level in 28 years. Overall in the U.S., there were 1,282 confirmed cases of measles in 31 states—Alaska, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, New Mexico, Nevada, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, Tennessee, Virginia, and Washington—as of December 31, 2019. This is the greatest number of cases reported in the U.S. since 1992 when 963 cases were reported for the entire year. It's also the highest number of cases since measles was declared eliminated in 2000, according to the Centers for Disease Control and Prevention (CDC). 

There were a total of 372 confirmed cases of measles across the country in 2018. Between 2015 and 2017, there were between 86 and 188 confirmed cases each year. In 2014 however, the number of diagnosed measles cases spiked to 667. The 2019 outbreak however, nearly cost the United States its measles elimination status, the CDC reported.

Measles signs, symptoms and side effects

Measles causes fever, rash, cough, runny nose and red, watery eyes but the possible complications of this infection, including, pneumonia, deafness, permanent brain damage and death, are far more serious. 

The most common side effects of the MMR (measles, mumps, rubella) vaccine, on the other hand, include mild rash, fever or temporary discomfort in the arm where the shot was given. This vaccine, and all others given to adults and children in the United States, have been tested exhaustively for safety and effectiveness. Overall, the decision to vaccinate should be a “no-brainer.”

Still, lingering misconceptions about vaccines and fears about a link between the MMR shot and autism (which stem from a false report that was retracted and discredited decades ago) are prompting an increasing number of parents to not vaccinate their children. As a result, measles is making a comeback.

The latest outbreaks

One of the most recent outbreaks of measles originated in Washington state, prompting the governor to declare a public health emergency in January 2019. As of April 24, 2019, there were 72 confirmed cases, predominantly in Washington’s Clark County near Portland, Oregon–a known anti-vaccine “hotspot” where there are another four confirmed measles cases related to the Washington state outbreak. Nearly all of those infected are children who had not been immunized against the disease. 

On January 29, 2019, New York health officials also confirmed that 64 children from Brooklyn’s Orthodox Jewish community were diagnosed with measles. The outbreak was triggered when unvaccinated children traveled to Israel where there is a large outbreak of the disease. When the young people returned home, the disease spread to other members of the community.

MMR vaccine safety

According to the CDC, measles was eliminated from the United States in 2000, largely thanks to the MMR (measles, mumps, rubella) vaccine. Study after study has shown that this vaccine is safe and does not cause autism in children who receive it.

In 2011, an Institute of Medicine (IOM) report, which examined eight vaccines given to both kids and adults, found that they are very safe. Then, in 2013, a CDC study examined the immune response to the vaccine in children during the first two years of life. They found no differences between kids with autism and those who did not have this condition.

More recently, a March 2019 study published in the Annals of Internal Medicine, analyzed the safety of the MMR vaccine even more rigorously. Researchers in Denmark used more children and more cases (hence more statistical power) to investigate concerns about a link between the vaccine and autism. They also included a larger number of children considered at high-risk for autism to address the specific claim that the MMR vaccines may be more dangerous for these kids.

The scientists evaluated whether the MMR vaccine increased the risk of autism in 657,461 children born in Denmark between 1999 and 2010. They tracked the kids until August 2013, documenting diagnoses of autism spectrum disorders and risk factors for these conditions, including parents’ ages, siblings with autism, method of delivery, smoking during pregnancy, preterm birth and low birth weight.

The study found no evidence of a link between the MMR vaccine and autism or an increased risk for these disorders—even among high-risk kids. 

Nevertheless, with increased travel to places where the vaccine is not available—and more parents opting not to vaccinate their kids—the number of measles cases is on the rise.

Pockets of unvaccinated kids

As of 2017, CDC data on median vaccination coverage revealed that about 6 percent of kindergarteners attending U.S. schools did not receive the MMR vaccine. Meanwhile, 5 percent of these students were not immunized against diphtheria, tetanus and pertussis and roughly 6 percent were not protected against varicella (chicken pox)—other vaccine-preventable diseases.

“This means every year children get severe illnesses and possibly even die from diseases that could have been prevented by a vaccine,” says Anthony Komaroff, MD, of Harvard Medical School.

According to Dr. Komaroff, some parents don’t immunize their children because they think the diseases being prevented are not common enough to worry about—or they’re concerned about vaccine safety. But the benefits of vaccination outweigh the risks. “Infectious diseases are still widespread around the world,” says Komaroff, and “all vaccines are carefully studied before they are licensed for routine use.”

The MMR vaccine is given in two shots, the first around the age of 12 to 15 months, the second around 4 or 5 years old.

The most common symptom of measles is an itchy rash, which starts at the head and spreads downward. According to the Cleveland Clinic, other symptoms include:

  • Sore throat
  • Runny nose
  • High fever
  • Muscle pain
  • Sensitivity to light
  • Red or bloodshot eyes
  • Cough

Measles can also cause ear infections, bronchitis and pneumonia. However, the most serious complication is encephalitis, which can be life-threatening.

There is no way to cure measles once someone is infected. “The only treatment centers around trying to lessen the severity of the disease and making your child as comfortable as possible,” says the Honor Society of Nursing (STTI). STTI recommends using a humidifier to ease sore throat and coughing and giving acetaminophen or ibuprofen for fever.

It’s hard to imagine that any American could die from measles in 2019, but anyone who has not been vaccinated is at risk. The good news: The way to stop more outbreaks is just a shot or two away.

More On

Weekly aerobic exercise may help reduce flu and pneumonia deaths


Weekly aerobic exercise may help reduce flu and pneumonia deaths
Adults should aim for 150 minutes of moderate cardio each week.
Why Is Gonorrhea Getting Harder to Treat?


Why Is Gonorrhea Getting Harder to Treat?
Guidelines have evolved to combat antibiotic-resistant gonorrhea.
6 Ways to Protect Kids with Asthma from EV-D68


6 Ways to Protect Kids with Asthma from EV-D68
Here's what the Centers for Disease Control and Prevention recommends.
The importance of diversity in clinical trials for hepatitis C


The importance of diversity in clinical trials for hepatitis C
Aja McCutchen, MD, does a deep dive into why hepatitis C seems to disproportionately affect Black people. She explains the importance of diversity in ...
Why you should get screened for hepatitis C


Why you should get screened for hepatitis C
Hepatitis C is a viral infection that can lead to severe liver damage and exist in the body for years without causing significant symptoms to appear.