Why Are Measles Outbreaks Getting Worse?

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    A microscopic view of Rubella. Rubella is an acute, contagious viral infection.

    Despite the high level of success with vaccines designed to prevent it, measles is seeing a recurrence in the United States, according to the Centers for Disease Control and Prevention (CDC).

    As of April 18, 129 people have been diagnosed with measles in outbreaks in 13 states this year. The majority of these people were not vaccinated, the CDC says.

    Although these outbreaks start outside the country, measles infection spreads rapidly among unvaccinated people, CDC director Dr. Tom Frieden said during an early afternoon press briefing.

    “Measles is still far too common in many parts of the world,” he said. “Globally, an estimated 20 million people get measles and 122,000 die from the disease each year.”

    The report was published in the April 25 issue of the CDC’s Morbidity and Mortality Weekly Report.

    Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, who also spoke at the news conference, said, “Measles has gotten off to an early and active start this year.”

    The 129 measles cases reported so far “are the most measles cases reported in the first four months of the year since 1996,” she said.

    “Today’s measles outbreaks are too often the result of people opting out. Most of the people, 84 percent of those who were reported to have measles thus far, were not vaccinated or didn’t know their vaccination status. Of the unvaccinated U.S. residents, 68 percent had personal belief exemptions,” Schuchat said.

    Areas with the highest number of cases include California with 58, New York City with 24 and Washington state with 13, Schuchat said. Thirty-four of all the cases were imported, involving U.S. residents who traveled overseas and foreign visitors. Half of those importations were from the Philippines, where there were about 20,000 cases and 69 deaths as of February, she said.

    Because measles is so contagious, the CDC recommends people of all ages keep up to date with their vaccinations. The agency recommends two doses of MMR (measles, mumps and rubella) vaccine for everyone, starting at age 12 months. In addition, infants aged 6 through 11 months should receive one dose of MMR vaccine before traveling out of the country, the agency says.

    Measles Symptoms

    According to the CDC, the symptoms of measles generally begin about 7-14 days after a person is infected, and include:

    • Measles Rash
    • Image of measles infection
    • Skin of a patient after 3 days of measles infection.
    • See Photos of Measles for additional images.
    • Blotchy rash
    • Fever
    • Cough
    • Runny nose
    • Red, watery eyes (conjunctivitis)
    • Feeling run down, achy (malaise)
    • Tiny white spots with bluish-white centers found inside the mouth (Koplik’s spots)

    A typical case of measles begins with mild to moderate fever, cough, runny nose, red eyes, and sore throat. Two or three days after symptoms begin, tiny white spots (Koplik’s spots) may appear inside the mouth.

    Three to five days after the start of symptoms, a red or reddish-brown rash appears. The rash usually begins on a person’s face at the hairline and spreads downward to the neck, trunk, arms, legs, and feet. When the rash appears, a person’s fever may spike to more than 104 degrees Fahrenheit.

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