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Measles Makes a Comeback in U.S. as 222 Cases Found in 2011

Measles Makes a Comeback in U.S. as 222 Cases Found in 2011
The skin of a patient after three days of measles infection. Photographer: Dr. Heinz F. Eichenwald/Center for Disease Control and Prevention

Measles surged in the U.S. to 222 cases last year -- more than a decade after it was deemed eliminated -- as travelers imported the highly contagious virus, the U.S. Centers for Disease Control and Prevention reported.

Residents of 31 states got measles in 2011, with 86 percent occurring in people who weren’t vaccinated against the illness that causes a head-to-toe rash, muscle pain, fever and bloodshot eyes. While immunizations enabled the U.S. to declare measles eliminated in 2000, the confluence of international travel and parents skipping vaccines for convenience or an unfounded fear about their safety triggered a resurgence, the Atlanta-based CDC said in its weekly public health report.

Almost half the cases directly brought in from another country came from Europe, primarily France, Italy, Romania, Spain and Germany, the CDC said. The number of people with measles was more than three times the average annual rate of 60 detected during the past decade, the public health agency said.

“Unvaccinated people put themselves and others at risk for measles and its complications,” since it remains widespread in most parts of the world, said Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases, during a conference call with reporters. “They particularly put at risk people who are too young to be vaccinated who can sometimes have the worst complications.”

A disease is considered eliminated when it no longer spreads naturally and year-round among a country’s population.

There were no deaths or cases of encephalitis, an inflammation of the brain, according to the CDC in its Morbidity and Mortality Weekly Report. The rate was the highest since 1996 when there were 508 cases.

2012 Increase

The recent increase in the U.S. continued in 2012, with 25 cases reported so far this year, Schuchat said. Last year, 20 million people worldwide got the measles and 164,000 died from it. There were 37,000 cases in Europe, making it particularly important for Americans who are planning to attend the Olympics in London or to travel on the continent to get immunized, she said.

About 85 percent of the people who contracted the measles would have been eligible for vaccination. Eighteen infants who were too young for the immunization got the disease, as did seven elderly patients thought to be immune. Among 66 patients ages 16 months to 19 years who were unvaccinated, 76 percent didn’t get the shot because of philosophic, religious or personal objections, according to the report from the CDC’s National Center for Immunization and Respiratory Diseases.

Just being in a room where a person with measles has been, even if they have already left or aren’t yet showing symptoms, can spread the disease, she said. It is also deadly, killing between one to three of every 1,000 people who contract it, she said.

Vaccination Exemptions

Many Americans don’t believe measles and other vaccination-preventable illnesses remain a threat, Schuchat said. Signing a form to exempt their children from the shot can be easier than getting the immunization, which is a common reason parents give to foregoing them, she said.

Doctors should be on the lookout for patients with measles, who typically seek medical care for the condition, the CDC said. Those who are infected should be immediately isolated to prevent transmission of the disease to those who aren’t vaccinated against it, the agency said.

“The clinicians in the country, pediatricians, internists, and family physicians, many of them have never seen measles,” she said. “In some of these outbreaks, the families went to doctors multiple times, visited emergency rooms, it took awhile for the cases to be diagnosed. During that period, measles was spread to other people.”

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