Nearly 30% of all measles cases since early 2020 have been reported in the first quarter of 2024, according to a new report.
The spike this year “represents a renewed threat to elimination,” according to authors from the Centers for Disease Control and Prevention (CDC).
“Enhanced efforts are needed to increase routine U.S. vaccination coverage, encourage vaccination before international travel, identify communities at risk for measles transmission, and rapidly investigate suspected measles cases to reduce cases and complications of measles,” experts wrote in a new Morbidity and Mortality Weekly Report.
From January 2020 through March 2024, there were 338 measles cases in 30 jurisdictions. The median age was 3 years, and 58% occurred in children and adolescents. There were 155 people (46%) hospitalized, and 70% of those patients were under 5 years.
About 68% of cases since 2020 have been among people who are unvaccinated, 23% had unknown vaccination status and 9% had received at least one vaccine dose, according to the report.
About 96% of the cases were associated with importation from another country, most commonly from the Eastern Mediterranean and African World Health Organization regions.
During the first quarter this year, there were 97 cases. The average for the first quarter in 2020-2023 was five cases.
Several more cases have been added since the end of the quarter. The total stands at 113 cases in 18 jurisdictions — Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York City, New York state, Ohio, Pennsylvania, Virginia and Washington, according to the CDC.
Measles is highly contagious. It is transmitted through contact with infectious droplets or by airborne spread when an infected person breathes, coughs or sneezes, according to the CDC. The virus can remain in the air and on surfaces for up to two hours.
Measles can be especially dangerous in young children. The disease can result in complications like pneumonia, brain damage and deafness, and can be fatal.
The AAP and CDC recommend children receive their first dose of measles, mumps and rubella (MMR) vaccine between 12 and 15 months of age and a second dose between 4 and 6 years. Infants traveling internationally can receive the vaccine as young as 6 months.
A recent CDC study found 93% of kindergartners were fully vaccinated against measles during the 2022-’23 school year, and officials estimated about 250,000 kindergartners remain at risk.
Clinicians should consider measles as a diagnosis in anyone with a fever of 38.3 degrees Celsius (101 degrees Fahrenheit) or higher and a generalized maculopapular rash with cough, coryza or conjunctivitis who has been abroad recently, according to the CDC.
When considering measles, isolate the patient, notify the state, tribal, local or territorial health department, follow CDC testing recommendations and manage the patient in coordination with local or state health departments including appropriate post-exposure prophylaxis.
Resources
- Information from the AAP and Project Firstline on caring for patients who present with a febrile rash illness or suspected measles
- AAP Red Book chapter on measles
- AAP’s five-minute webinar Identifying Measles in the Pediatric Setting
- AAP’s 10-minute webinar Diagnosing Measles in the Pediatric Setting
- Information for health care providers from the CDC on measles
- CDC’s March 2024 health advisory on measles
- CDC measles fact sheet
- CDC guidance on measles infection prevention and control measures in health care settings
- AAP clinical report Countering Vaccine Hesitancy
- Information for parents from HealthyChildren.org on protecting your baby during measles outbreaks and what parents need to know about measles.
