Diseases
> Measles
Measles History
References
to measles can be found as far back as the
7th century A.D. In fact, the disease
was described by Rhazes in the 10th Century
A.D. as "more dreaded than smallpox."
But all that changed in 1963 when the measles
vaccine was first licenced in the U.S.
Impact
of the Measles Vaccine
Prior
to 1963, almost everyone got measles; it
was an expected life event. Each year in
the U.S. there were approximately 3 to 4
million cases and an average of 450 deaths,
with epidemic cycles every 2 to 3 years.
More than half the population had measles
by the time they were 6 years old, and 90
% had the disease by the time they were 15.
This indicates that many more cases were
occurring than were being reported. However,
after the vaccine became available, the number
of measles cases dropped by 98 % and the
epidemic cycles drastically diminished.
Second
Measles Vaccine Dose
It
was discovered that, between 1985 and 1988,
many measles cases had occurred in children
who had been vaccinated. While there were
far fewer measles cases among vaccinated
children than among unvaccinated, the children
who received only one dose were not always
protected from the disease. This led to the
recommendation of a second dose for children
between the ages of 5 and 19 years of age
to ensure protection for those who had not
developed immunity from the first dose.
1989-1990
Measles Epidemic
A dramatic
increase in measles cases occurred between
1989 and 1991. During those three years,
55,622 cases were reported Most of the cases
occurred in children under 5 years of age,
with the number of cases among unvaccinated
Hispanic and African American populations
being four to seven times higher than among
non-Hispanic whites. This also marked the
first time the number of measles cases for
children under 5 years of age exceeded those
for the 5 to 19 years old group.
During this
period, 123 people died from measles-related
illnesses — almost half were under 5 years
old. Ninety percent of those who lost their
lives had not been vaccinated. The 64 deaths
in 1990 was the largest number that had been
seen in almost 20 years.
Measles
Outbreaks in Recent Years
Since
1993, the largest outbreaks of measles have
occurred in populations that refuse vaccination,
including communities in Utah and Nevada,
and in Christian Scientist schools in Missouri
and Illinois. Smaller outbreaks were reported
in unvaccinated preschool populations, vaccinated
school populations, among college students,
and in adult communities, but these outbreaks
were much smaller than those reported during
1989-1991. In recent years, outbreaks of
measles have been small (less than 50 cases)
and have chiefly involved high school and
college students who are unvaccinated or
have received only one dose of measles No
large preschool-type outbreak has been reported
since 1992.
Source
of Today’s Measles Cases
In
March of 2000, a group of expert consultants
convened by the CDC concluded that measles
is no longer endemic in the U.S. Rather,
all cases in the U.S. appear to be the result
of importations, with limited domestic spread.
This means that the only measles cases we
see in the U.S. today have been brought in
from other countries, usually Europe and
Asia. Due to an aggressive measles vaccination
program by the Pan American Health organization,
measles incidence is now very low in Latin
America and the Caribbean. Measles elimination
from the Americas appears to be an achievable
goal.
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Measles
Cases Imported into U.S. 1990-1999*
*
1999 data is provisional
Reported
Measles cases, 1950 -1998*
*1998 provisional data
from the World
Health Organization (WHO)
[CDC
Morbidity and Mortality Weekly Report (MMWR)]
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Postexposure
Prophylaxis, Isolation, and Quarantine
To Control an Import-Associated Measles
Outbreak -- Iowa, 2004
Vo. 53, No 41; 969-971
10/22/2004
Summary:
This report updates information about this
outbreak and provides details regarding
vaccination, quarantine, and other measures
used by Iowa public health authorities
to interrupt disease transmission in a
vulnerable population. The effective uses
of quarantine and isolation during the
outbreak underscore the utility of these
public health tools in halting communicable
disease transmission.
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Multistate
Investigation of Measles Among Adoptees
from China -- April 2004
Vo. 53, No 14;309-310
04/16/2004
Summary:
This report summarizes the preliminary
results of an ongoing multistate investigation
that has so far identified four confirmed
and five suspected cases of measles among
adoptees from China, underscoring the need
for health-care providers to remain vigilant
for measles and other vaccine-preventable
communicable diseases in children adopted
from international regions... See
Also Brief
Report: Update: Measles Among Adoptees
from China -- April 14, 2004
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Measles
Outbreak in a Boarding School - Pennsylvania,
2003
Vo.
53, No 14;306-309 04/16/2004
Summary:
This
report summarizes the results of the outbreak
investigation, which indicated that measles
continues to be imported into the U.S.
and that high coverage with 2 doses of
measles-containing vaccine (MCV) among
students was effective in limiting the
size of the outbreak. Health-care providers
should maintain a high index of suspicion
for measles, especially in those who have
traveled abroad recently, and recommendations
for 2 doses of MCV in all school-aged children
should be followed...
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Brief
Report: Imported Measles Case Associated
with Nonmedical Vaccine Exemption -- Iowa,
March 2004
Vo.
53, No 11;244-246 03/26/04
Summary: This report describes
the measles case, the public health response
to prevent secondary cases, and the impact
on the public health system...
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Public
Health Dispatch: Measles Epidemic -- Majuro
Atoll, Republic of the Marshall Islands,
July 13-Sept. 13, 2003
Vo. 52, No 37;888-889 09/19/2003
Summary:
During
July 13-September 13, 2003, a total of
647 clinically diagnosed measles cases
were reported on Majuro Atoll in the Republic
of the Marshall Islands (RMI)... This report
describes the clinically diagnosed measles
cases and the public health response to
stop the epidemic...
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Measles
Epidemic Attributed to Inadequate Vaccination
Coverage -- Campania, Italy, 2002
Vo.
52, No 43;1044-1047 10/31/2003
Summary:
This
report summarizes the preliminary results
of the investigation..., which attributed
the epidemic to inadequate vaccination
coverage. A coordinated effort is needed
to interrupt measles transmission in Italy...
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Measles
Outbreak -- Netherlands, April 1999
Vol
49, No 14;299 04/14/2000
Summary:
On
June 21, 1999, a cluster of five cases
of measles was reported among the 390 students
attending a religion-affiliated elementary
school in the Netherlands. Persons belonging
to this religious denomination routinely
do not accept vaccination.
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Measles
Outbreak -- Romania, 1997
Vol 46, No 49;115 12/12/1997
Summary:
During
December 1, 1996 - September 30, 1997,
a total of 20,034 cases of measles were
reported to the Ministry of Health (MOH)
in Romania; 13 cases were fatal. The outbreak
began in December 1996, peaked in May 1997,
then declined.
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Measles
Outbreak -- Southwestern Utah, 1996
Vol
46, No 33;766 08/22/1997
Summary:
During
April 9_July 7, 1996, a total of 107 confirmed
measles cases were reported from Washington
County, Utah -- one of five counties in
the Utah Southwest Health District (USHD).
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Measles
Outbreak Among School-Aged Children in
Juneau, Alaska, 1996
Vol
45, No 36;777 09/13/1996
Summary:
An
outbreak of measles among school-aged children
occurred in Juneau, Alaska, from February
16 through April 25, 1996.
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Measles
Outbreak in Guam, 1994
Vol
44, No 36;657 09/15/1995
Summary:
One
of the largest outbreaks of measles in
the United States and its territories since
1992 occurred in Guam during 1994. From
February 8 through June 25, 1994, a total
of 280 suspected, probable, or confirmed
cases of measles were reported to the Guam
Department of Public Health and Social
Services (GDPH).
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Interstate
Measles Transmission from Ski Resort -
Colorado, 1994
Vol
43, No 34;627 09/02/1994
Summary:
During
April 1 -May 25, 1994, a chain of measles
transmission began in Breckenridge, Colorado,
and extended into nine additional states;
a total of 247 measles cases were reported,
representing 36% of all U.S. measles cases
reported to the National Notifiable Diseases
Surveillance System. This report summarizes
the investigation of this chain of interstate
measles transmission.
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Outbreak
of Measles Among Christian Science Students
Vol 43, No 25;463 07/01/1994
Summary:
During
April 4_May 17, 1994, the largest U.S.
measles outbreak since 1992 occurred among
students in two communities that do not
routinely accept vaccination. This report
summarizes the investigation of and control
measures for this outbreak.
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Measles
in Duval County, Florida, 1991-1992
Vol
42, No 04;81 02/05/1993
Summary:
An
outbreak of measles occurred in northeastern
Florida (Bradford, Clay, Duval, Nassau,
Putnam, and St. Johns counties) in 1991
and early 1992. A total of 193 confirmed
cases of measles were reported to the Florida
Department of Health and Rehabilitative
Services (FDHRS).
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Measles
at International Gymnastics Competition
in Indiana, 1991
Vol 41, No 07;109 02/21/1992
Summary:
On September
7, 1991, the Indiana State Department of
Health (ISDH) was notified of three suspected
measles cases among athletes from New Zealand
(NZ) participating in an international
gymnastics competition September 6-15 in
Indianapolis (Marion County). This report
summarizes
the epidemiologic investigation of these
cases.
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