JANUARY/FEBRUARY 2020. DISCOVER 57who seem to recover may have the virus
silently lurking in their brain, and up
to a decade later can develop SSPE
(subacute sclerosing panencephalitis), a
very rare but fatal disease of the central
nervous system.
Doctors say that roughly 95 percent of
people need to be vaccinated to prevent
measles outbreaks in a given commu-
nity. This provides what’s called herd
immunity, meaning enough people are
vaccinated to prevent the spread of the
disease. Although the MMR (measles,
mumps and rubella) vaccination rate is
about 94 percent nationwide, there are
large pockets with low immunization
rates across the country — due mainly
to poverty, lack of access to insurance
and doctors, and an increasing num-
ber of parents who willingly opt out of
vaccinating their kids.
Right now, many reported cases have
been linked to travelers who brought
the virus back to the U.S. from countries
with ongoing outbreaks. And globally,
there’s been an explosive resurgence of
measles, with nearly three times as many
reported cases through July 2019 as by
the same point in 2018. As of Oct. 10, the
countries most affected were Madagascar
(127,500), Ukraine (56,400), India
(53,000), the Philippines (39,700) and
Nigeria (27,000). In 2017, there were
110,000 measles deaths globally, mostly
among children under the age of 5.
While various factors contributed
to this rise, including civil unrest, lowawareness of the need to vaccinate,
skepticism about vaccines and lack of
availability, the common denominator
is a lowered rate of vaccine coverage.
“There were over 83,000 cases of measles
in just Europe alone, in a region with
access and education,” says Heidi Larson,
a former UNICEF official and director
of the Vaccine Confidence Project at the
London School of Hygiene & Tropical
Medicine. “It is shocking.”
But there are global and domestic
campaigns to strengthen confidence in
vaccines, tighten up religious exemptions
and focus on getting kids vaccinated. In
July, an international group of public
health leaders, including members of
the World Health Organization, released
the Salzburg Statement on Vaccination
Acceptance. The statement called for
search engines and social media organiza-
tions to prevent the spread of inaccurate
information on childhood vaccinations,
and urged governments to do more
to support mandatory immunization
programs.
“Our institutions are not prepared or
organized in a way to counter the new net-
works of disinformation on health,” says
Scott Ratzan, a statement coauthor and
a founder of the International Working
Group on Vaccination and Public Health
Solutions. “How do we get health pro-
fessionals and other policy[makers] to
understand the fundamental nature of
vaccines so we don’t go backwards, rather
than forward, in health progress?”Timeline of the 2019
U.S. Outbreak:
September 2018 An international
traveler arrives in Rockland County,
a suburban county north of New
York City, with a suspected case
of measles.
October 2018 Measles cases are
reported in Brooklyn and Queens,
two boroughs of New York City, an
outbreak suspected to have started
when an unvaccinated child became
infected while visiting Israel.
January 2019 The World Health
Organization lists vaccine hesitancy
as one of the top 10 threats to
public health in 2019. On the 25th,
Washington state officials declare
a state of emergency after measles
cases are reported in Clark County.
April 2019 New York City Mayor Bill
de Blasio declares a public health
emergency, and the city’s health
commissioner orders every adult
and child who lives or works in
affected areas to be vaccinated. On
the other side of the country, nearly
700 students and staff at UCLA
and California State University,
Los Angeles, are quarantined after
exposure to measles.
May 2019 A subsequent outbreak
occurs in three counties surrounding
Puget Sound, believed to have been
triggered by a traveler at the Seattle-
Tacoma Airport in April. That same
month, Maine eliminates religious
exemptions for vaccine requirements
for schoolchildren.
June 2019 New York enacts a law
similar to Maine’s.
July 2019 Salzburg Statement on
Vaccination Acceptance released.Measles Cases
per Million People:
Last 12 Months
Q50 or more (43 countries)
Q10-50 (41 countries)
Q5-10 (17 countries)
Q1-5 (35 countries)
QLess than 1 (51 countries)
QNo data
QNot available
WO Updated Oct. 14, 2019
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