“It's not a disease I want to start over'': Why is there a measles outbreak in the United States? | Infectious disease

MEagle epidemic in Florida Philadelphia The move comes after parents ignored recommendations to isolate their children and at least one prominent state official sowed confusion over how long unvaccinated children would be kept out of school. .

Outbreaks in Broward County, Florida, and Philadelphia both made news because children carried the disease into the broader community. 6 children got sick Manatee Bay Elementary School There were nine cases in Florida and nine cases in Philadelphia when children attended day care while infected.

“We're concerned because this is an alarming disease for a number of reasons,” said Dr. Paul Offit, director of the Vaccine Education Center and attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia (CHOP). Offit is also a recent author. Tell me when you're done: An insider's guide to deciphering coronavirus myths and navigating a post-pandemic world.

In Philadelphia, a measles outbreak occurred in January when a 7-month-old infant contracted the disease. while traveling abroad And against the advice of Chop's doctors, including Offit, he was taken to day care.

In Florida, a third-grader with no history of international travel was diagnosed with the disease and spread it to other students. Less than 92% Percentage of Broward County children who received recommended vaccinations against diseases such as measles. The Centers for Disease Control and Prevention (CDC) believes the vaccination threshold to prevent an outbreak is 95%.

Florida Surgeon General Joseph Ladapo Famous Covid-19 vaccine skeptics Appointed by Republican Governor Ron DeSantis, further disrupted efforts to contain the disease by telling parents they could ignore the CDC's recommendation to keep unvaccinated children home for 21 days.Radapo sent a letter To parents, he said, “Decisions regarding school attendance are left up to parents and guardians.''

Side effects from the measles vaccine are rare and usually temporary and not serious. However, the disease itself can have very serious consequences, including rare infections of the nervous system and death.almost 1-2 children per 1,000 infected people According to the CDC, death can occur from the disease or its complications. In rare cases, severe symptoms may appear several years later.

Regarding the symptoms of measles, Offit said: “The rash starts at the hairline and spreads to the face. It's like a bucket of rash was poured on your head,” she says, before spreading all over your body.

“There's always the cough, the conjunctivitis, the runny nose,” Offit said, adding: “The kids are sick. They look bad. They're miserable.”

As a child of the 1950s, Offit contracted measles himself (the first vaccine was introduced in 1963) and has personally treated cases of neurological devastation associated with measles infection.

Since the mid-20th century, measles vaccination has been so successful in the United States that some doctors have never contracted measles. Measles was eradicated in the United States in 2000. It has since become popular again, along with vaccine misinformation.

Notably, Offit said that while working on a team treating infants with measles in Philadelphia, he was the only doctor to see a measles case. He believes the vaccine has been so successful that few people remember what it's like to live with measles.

In addition to the risk of immediate death from measles, the following rare symptoms occur: Subacute sclerosing panencephalitis It may appear several years later. Progressive neurological disorders usually remain latent for 6 to 8 years before symptoms such as changes in personality or behavior, impaired motor function, or vision loss appear. Most children diagnosed with this disease die within 1 to 3 years. Offit has treated three such cases in her career.

In 2024, the CDC had received 20 measles cases by mid-February, marking a return to the pre-pandemic pattern of several dozen cases per year before the 2019 outbreak.

That year, the United States suffered its worst measles outbreak in nearly 25 years. Centers for Disease Control and Prevention (CDC) 1,274 measles cases confirmed, much of which was spread through under-immunized communities that were targeted by vaccine misinformation.Of these, 474 identified in new york in Orthodox Jewish communities in New York City and suburban Rockland County.

In 2020, these cases were completely overshadowed by the coronavirus disease (Covid-19) pandemic. Restrictions on social gatherings and widespread use of masks nearly eliminated non-coronavirus respiratory illnesses that year, including measles, influenza, and respiratory syncytial virus (better known by its acronym RSV).

But many of the factors that drove the spread of infections in 2019 are now back, and some are getting worse.a November 2023 National vaccination rates for state-mandated vaccines decreased from 95% in 2019-2020 to 93% in 2021-2022, according to a CDC report. It remained flat at 93% from 2022 to 2023.

Over the same period, the number of children applying for exemption from state vaccine mandates also increased by 0.4% from 2022 to 2023, accounting for 3% of all children, with increases occurring in 41 states.

Furthermore, similar to New York in 2019, the decline in vaccine uptake occurred in a concentrated manner.I saw a cliff in Hawaii 7.9% decrease Measles, mumps, rubella (MMR) vaccine uptake will increase in 2022-2023, while declines in polio, varicella (varicella), diphtheria, tetanus and acellular pertussis vaccine (DTaP) remain alarming .

The last recorded measles death in the United States was a 28-year-old woman in Washington state. Catherine Montantes. Montantes, who had been vaccinated, contracted measles in the waiting room of a local clinic and died in 2015. She had an autoimmune disease that made her immune system less sensitive to the measles vaccine.

Two doses of measles vaccine are 97% effective against the disease. This means that even vaccinated people can still get sick if measles spreads. Undervaccinated communities.

“The vaccine is a victim of its own success,” Offit said. “Don't mess with this disease. It's not a disease you want to start over again.”