California has already reported more cases of measles this year than all of them in 2024. This is a worrying development as the nation has been suffering from the biggest outbreak of ultra-infectious diseases in decades.
The extent of the nationwide outbreak has lost measles from the untildestruction issue – rarely encountered by an entire American generation, but leading to looming public health concerns.
“Measles are completely preventable,” Dr. Elizabeth Hudson, Kaiser Permanente Southern California’s regional director of infectious diseases, told The Times.
The virus is spreading almost universally among people who have not been vaccinated or whose vaccination status is unknown, authorities note. However, MMR shots have long been present in the crosshairs of anti-vaccine activists and skeptics, as they are also given protection against mumps and rubella.
According to the state Department of Public Health, 17 cases of measles have been reported this year among California residents, up from 15 last year. Doctors are increasingly wary of measles, but it has been extremely rare for decades, with many doctors not encountering a single case.
Due to its recent rarity, many may be unfamiliar with how easily measles can spread, or the serious symptoms it may cause.
“This is more than just a mild childhood illness,” said Dr. Erica Pan, director of the California Department of Public Health, in a recent briefing to physicians.
Measles mortality rate is 1 for every 500 to 1,000 cases, Pan said. Over 145 people across the country have been hospitalized with measles so far this year, with federal data showing, with many hospitalized people requiring intensive care.
“This can cause very severe illnesses, and in many cases it causes viral pneumonia that is so severe that it requires intensive care,” Pan said.
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Measles is one of the most contagious viruses known to science. According to the US Centers for Disease Control and Prevention, simply staying in a room with an infected person can still catch it up to two hours after an infected person leaves.
The rise in confirmed measles incidents in California remains somewhat concerned with local public health officials, but pales in comparison to the significant outbreak that began in Texas earlier this year and has since spread across surrounding states.
Texas has reported at least 750 measles cases. New Mexico, 81; Kansas, 80; North Dakota, 28; and Montana, 23, according to the respective state health departments. Michigan has reported 15 cases. Ohio and Illinois, 10, Arkansas and Indiana, 8 years old.
According to the CDC, the overwhelming majority of measles cases are associated with outbreaks linked to close communities with low vaccination rates. The recent outbreak has occurred in areas with a prominent population of certain Mennonite Christian communities, and was linked to a large gathering in New Brunswick in Ontario, Canada last fall. Then in late January, in Texas and New Mexico. And more recently, according to the Associated Press, in Chihuahua, Mexico.
The Associated Press reported that Mexican and US officials say their outbreaks coincided with tensions seen in Canada.
According to the CDC, 95% of U.S. measles cases this year occurred among people who have not been vaccinated or have no known vaccination status. Approximately 29% of cases occurred in children under the age of 5, with an additional 37% between the ages of 5 and 19.
In all, the US has reported 1,227 confirmed cases of measles so far this year. This is already comparable to the highest annual total seen in this century. 1,274 were reported in 2019.
To find a higher total, we need to look back at generations. In 1992, 2,126 cases were reported nationwide.
“And they’re probably underreporting,” Pan said of the number of cases this year. She said doctors learned that most people affected by the outbreak of measles are reluctant to test themselves and their children.
Three measles deaths have been reported so far this year, according to the CDC. The two were school-age Texas children, according to state health officials. The other was an unvaccinated adult in New Mexico and did not seek medical care before dying, health officials there said.
According to the World Health Organization, one death has been reported in Mexico. The person was also not vaccinated. Over 3,300 confirmed and suspected cases of measles have been reported in Canada this year.
One infant, who had contracted measles before he was born premature, died in Canada earlier this month, according to Ontario’s chief medical officer Dr. Kieran Moore. The infant’s mother was not vaccinated.
Although the infant faced other serious medical complications that were not associated with the virus, measles “may have been a contributing factor for both preterm birth and death,” Moore said in a statement.
This year marks the first time a child has died of measles in the United States since 2003. In that case, the child had a rare genetic condition that impaired the immune system. It is also the first time that more than two people have died of measles in the United States in a year since the 1990s.
That is linked to an obvious rash, but health officials warn that measles can cause symptoms that cross the boundary from discomfort to danger. Measles can cause encephalitis or inflammation of the brain. And a few years after getting measles, people can develop subacute sclerotic pan encephalitis, or SSPE, later.
“This is a really rare time to see many of these deaths, and you can see healthy children in the US before they have vaccine-preventable deaths,” Pan said.
Measles can cause what is called “immune amnesia.” “The truth is, it can suppress people’s immune systems for several years after they’ve had that measles infection,” Pan said.
Measles outbreaks in Texas, Kansas and New Mexico are so severe that state health officials recommend early vaccination of six-month-old babies in the most intense counties. These officials recommend a second dose for more children earlier than a typical schedule.
The standard CDC recommendation is to receive the first of two measles vaccine shots when the child turns 1 year old, unless he is traveling internationally.
In California, there are no recommendations for additional or accelerated vaccine doses due to no active measles outbreaks, Pan said. Most of the California measles incident this year involves people who traveled internationally.
Supporting the issue is California’s relatively high vaccination rate among kindergarteners. From 2023-24, 96.2% of California kindergarten children were vaccinated against measles, according to the CDC.
The latest figures are down slightly from 96.5% seen in the previous year, but above levels seen before 2014-15, when the outbreak of severe measles related to Disneyland prompted state legislators to tighten vaccination requirements for school-going children.
Experts aim to get a vaccination rate of 95% for measles to prevent the outbreak.
Today, the case rates for measles in California remain far lower than national rates. But that doesn’t mean that the nation is immortal.
There are settings where unvaccinated people can gather together, such as homeschooled children’s group outings.
Another vulnerable setting is the doctor’s office. In 2008, an unvaccinated 7-year-old boy returned to San Diego from a trip to Switzerland, got sick, went to school and was taken to a pediatrician. Investigators found that measles spread to 11 other children who have not been vaccinated or too young to be vaccinated.
According to a report released by the CDC, fewer than one infant, had been hospitalized for two days. Another infant flew to Hawaii while contagious.
California counties also have measles vaccinations for kindergarteners, which are below the 95% target. From 2023-24, San Diego County rates were 94.8%. San Bernardino County is 93.5%. Santa Cruz County counties are 91.8%. Kern County is 90.7%.
In 2017, measles outbreaks in Los Angeles County concentrated in the Orthodox Jewish community, with many patients living in Westside LA, the Santa Monica Mountains and the San Fernando Valley. In early 2019, California’s biggest measles outbreak took place in Butte County, which began after a man visited the Philippines.
It was in the late 1980s and early 1990s that measles last caused numerous deaths nationwide. Between 1989 and 1991, the CDC found that approximately 55,000 cases and more than 130 measles-related deaths were suspected.
In California, the epidemic was the worst between 1988 and 1991. State health officials reported 18,000 cases, 3,500 hospitalisations, hospitalisations and 70 deaths. The major problem identified at the time was that poor parents could not afford vaccinations for their children. One of the nation’s biggest outbreaks of 1989 involved primarily kindergarten children in Los Angeles.
In light of the outbreak, the CDC’s Advisory Committee on Immunization Practices recommended a second dose of the measles vaccine between the ages of 4 and 6. In 2000, authorities declared that measles was no longer being transmitted locally and continuously in the United States, and new cases were only found when someone was infected overseas.
LA County has recorded four measles among residents so far this year from everyone last year. Most cases this year involved either travelling internationally or in the country where measles communities suffer from communicating. According to the local Ministry of Public Health, most cases this year were related to either traveling internationally or in the country.
There were also two cases reported among non-county residents this year, including a toddler traveling to Los Angeles International Airport on a flight from South Korea who had returned to Orange County.
In 2024 there were six non-LA County residents who had suffered measles while traveling through LA County. The four travelled to Los Angeles International Airport while they were infected.
“With the rise in measles cases nationwide and worldwide, it is important for unprotected individuals to consider precautions. Vaccinations provide the best protection. Plus, anyone exposed should monitor their symptoms.”
Symptoms include fever, rash, cough, red and watery eyes. People can be transmitted from about four days before the rash begins to four days afterwards.
Healthcare providers said anyone suspected of having measles should call before calling a healthcare provider before going to the doctor’s office.
The rash traditionally starts at the hairline and, according to pan, travels down the body.
Last month, Kaiser saw one case of measles in the Santa Clarita area. Health officials said on the afternoon of May 29 that people could be exposed to contagious individuals at Costco, Trader Joe and Walmart.
“The MMR vaccine protects against measles, mumps and rubella, with excellent safety records. Hundreds of millions of children receiving vaccines safely around the world,” she said in a statement to the Times.
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