Cases of measles are increasing, leaving experts worried.Share on PinterestA measles outbreak has infected at least 40 people in Washington and Oregon. Getty Images
A measles outbreak in the Pacific Northwest has continued to worsen and officials now estimate 51 people have been affected.
The outbreak has affected at least 50 people in Washington. One person has been affected in Oregon. A public health emergency in Washington was declared due to the outbreak, which started at the border of both states, near the Portland area.
On Monday, officials in Texas announced they are battling their own measles outbreak. In that state at least five people have been affected, including two children that were too young to be fully immunized.
However, Texas health department officials told Healthline they could not confirm that the outbreak was related to the one in Washington.
Why an eliminated virus returned
These outbreaks are just the just latest in recent years to appear in the United States despite the fact that the virus was declared “eliminated” by the Centers for Disease Control and Prevention (CDC) in 2000.
In recent years, distrust with the medical establishment have resulted in pockets of the country that have lower than normal vaccination rates. Some of these areas have been hit by measles outbreaks.
Last year, there were 349 cases of the measles in the United States that came from 17 outbreaks. That was the second-greatest number of annual cases reported since measles was considered to be eliminated in 2000.
Measles is a highly contagious virus, and the outbreak is compounded by lower-than-average vaccination rates in the region.
Symptoms of measles include a high fever, stuffy nose, red eyes, and rash. In severe cases, brain swelling, hearing loss, or even death can occur.
The disease normally lasts about two weeks. There’s no treatment for the disease, but in severe cases, hospitals can provide supportive care.
In this outbreak, health department officials in Washington are also trying to combat new misinformation over the use of vitamin A. They are warning residents that vitamin A is cannot treat or prevent a measles infection.
Why are measles outbreaks so hard to stop?
There are many reasons that the measles virus has been so difficult to full stop. Ranging from an increasingly connected globe to the rise of the anti-vaxx movement, here’s a breakdown of why the virus has made a return.
Reason 1: We live in a travel-friendly society
Measles can easily be contracted and spread by traveling or being exposed to travelers. Recent outbreaks in New Jersey and New York were linked to Israel and the Ukraine.
“People underestimate the risks associated with foreign travel,” said Dr. Julia A. Piwoz, who heads up the pediatric infectious diseases at the Joseph M. Sanzari Children’s Hospital for Hackensack Meridian Health in Hackensack, New Jersey.
Most people think about getting shots when they go on an African safari, for example, but don’t consider the risks when traveling to places such as France, Israel, Greece, England, or the Philippines, which are high-risk locales for measles.
“You don’t need to travel to any of the areas experiencing an outbreak to get measles — you can go to a local party or on a plane or go the mall and be exposed to someone who has and is spreading the disease,” Piwoz noted.
Reason 2: It’s highly contagious
The virus is highly infectious because it can linger in the air up to two hours after a carrier leaves a space.
It’s spread through the air by droplets via coughing or sneezing. People who aren’t immunized have a 90 percent chance of contracting the disease if they’re exposed to the virus.
Reason 3: Carriers may not know they have it right away
Measles can spread to others four days before a rash appears, and up to four days after, making it possible for an infected person to spread the disease when they don’t appear ill.
The early symptoms of measles may not be obvious, which can lead to, or exacerbate, outbreaks.
“This can look like many other more common respiratory illnesses,” Piwoz told Healthline.
Because the rash doesn’t appear until several days into the illness, people may not alter their routines and can expose others to the virus without knowing it.
During this outbreak, two people from Washington had to be quarantined after they traveled to Hawaii, while infected. Health officials said they weren’t infectious when they were traveling.
Public health officials are pushing for people in the Pacific Northwest to get vaccinated in order to stop the disease from spreading further.
Reason 4: Money and logistics
Another reason why stopping a measles outbreak is so challenging is due to the costs.
For every case, public health officials need to track down all the people who have been in contact with the person infected with measles. Studies have estimated a cost to taxpayers of more than $10,000 per case of measles, noted Nathan Lo, who published a study on measles vaccinations last year and is expected to graduate with his MD and PhD degrees from Stanford University this spring.
He co-authored a report in JAMA Pediatrics, published in 2017. The study found that a 5 percent reduction in the number of children, ages 2 to 11, who receive the MMR vaccine would triple the number of annual measles cases in that age group.
“Most of these are preventable through a very safe and effective vaccine,” Lo pointed out.
Reason 5: Pockets of unvaccinated people
In this recent outbreak, at least 34 of the people infected had not been vaccinated against the disease.
In Clark County, Washington, where nearly all the cases have been reported, the vaccination rate is just 78 percent.
This is far below the national average in the United States, where 91.1 percent of children between 19- and 35-months old receive the measles-mumps-rubella (MMR) vaccine.
Pockets with high numbers of unvaccinated children and adults have become a problem. These pockets helped lead to measles outbreaks in New York last year and Minneapolis in 2017.
While all U.S. states have laws that require vaccines for students, 18 states grant philosophical or religious-based exemptions for those who do not want to vaccinate due to personal, moral, or other beliefs.
Washington is one of the states that allow children to be exempt from having to receive the vaccine due to personal beliefs.
In fact, 7.9 percent of children in Clark County entering kindergarten received vaccine exemptions during the previous school year; 7.5 percent of kids in all grades in the state had vaccine exemptions. In Oregon, the rate of vaccine exemptions surged from 5.8 percent in 2015 to 7.5 percent last year— higher than the national average.
Last month Washington state lawmakers introduced legislation to ban exemptions based on personal belief.
“The outbreaks of measles are often in populations that are not vaccinated, often due to false information about the vaccine,” Lo told Healthline. “In fact, the measles vaccine is one of the best studied vaccines in history and is demonstrated to be very safe and effective.”
Despite warnings from public health officials for unvaccinated people in Oregon and Washington to get vaccinated, the outbreak has yet to be quelled.
“Measles is one of the most infectious viruses known to humanity, more than Ebola and the flu. Once an outbreak starts, it can be very hard to contain it,” Lo added.
“Measles is a serious and potentially fatal disease and can be prevented with a safe, effective, and widely available vaccine,” Piwoz agreed. “If you have questions about the vaccine or its safety, contact your healthcare provider, not ‘Dr. Internet.’”
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