Is measles elimination threatened?

December 16, 2013

On the 50th anniversary of an effective vaccine, experts are revisiting measles eradication in the United States.

 

On the 50th anniversary of an effective vaccine, experts are revisiting measles eradication in the United States.

Although the Pan American Health Organization recently confirmed that the elimination of endemic measles, as well as rubella and congenital rubella syndrome, was sustained through 2011 in the United States, international importation continues to threaten our health security, according to a recent announcement from the Centers for Disease Control and Prevention (CDC).

The number of US measles cases for 2013 is higher than it’s been in years. Usually, about 60 cases of measles occur each year nationally, but in 2013, 175 cases have occurred so far. These cases are virtually all linked to people who brought the infection home after traveling abroad.

A disease is considered eliminated when there is an absence of continuous disease transmission for a period greater than 12 months. People from abroad who are infected with the measles virus continue to cause outbreaks among unvaccinated US populations, including infants and young children. Prior to 1990, most of the imported cases were linked to Mexico, but now most are linked to Western Europe.

CDC officials explain that the extremely contagious disease is no less serious than it was before a vaccine was available 50 years ago. One in every 5 children with measles is hospitalized. Around the globe, 430 children die of measles every day.

One of the greatest threats here at home to continued eradication is parents’ refusal or hesitancy to vaccinate their children, according to a recent report. Delayed vaccination is almost worse than not vaccinating at all because it may add more person-years of susceptibility.

CDC officials counsel physicians to suspect measles in every child presenting with high fever and rash, especially if the symptoms coincide with recent international travel or exposure to international visitors.

 

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics eConsult.