Worldwide Measles Spotlight:  February 9, 2019

The worldwide measles outbreak continues to spread in various countries, reported the US Centers for Disease Control and Prevention (CDC) on February 1, 2019.

The CDC, along with the World Health Organization (WHO), Pan American Health Organization (PAHO), and Public Health England (PHE) generally point to 2 reasons the measles virus is an uncontrolled threat to countries around the world in 2019. 

The 2 most identified causes are an increase in the number of international travelers who get measles abroad and then bring this contagious virus home, and/or the further expansion of under-vaccinated communities. 

As an example, on February 7, 2019, the WHO reported year-end totals for 2018, which showed 82,596 people in 47 countries had confirmed measles cases. 

And, the WHO reported measles killed 72 children and adults in the European Region in 2018. This total was 3 times higher than in 2017.   

Listed below are the Measles Spotlight updates for the week ending February 9, 2019:

USA:  The CDC says 101 individual cases of measles have been confirmed in 10 states, as of February 1, 2019:

• Atlanta, GA: The Georgia Department of Public Health (DPH) has confirmed measles in three residents of the metro Atlanta area.
• California:  Los Angeles County officials confirmed 1 case of measles in a person during 2019.
• Colorado:  A Denver adult has been identified as having been contagious with measles from January 9 - 14, 2019, after having traveled internationally.
• Connecticut:  The Connecticut Department of Public Health (DPH) today announced that it has confirmed a second case of measles in a New Haven County adult.  Both cases were hospitalized and have been released.
• Hawaii:  DOH investigated 2 imported cases of measles in unvaccinated visitors, who were exposed in other states to an “infected international guest,” according to a medical advisory sent to healthcare providers January 16 by State Epidemiologist Sarah Park. 
• Illinois: State health is reporting a 2nd local case of measles. 
• New Jersey: As of January 2019, the New Jersey Department of Health confirmed 33 measles cases.
• New York City: As of February 6, 2019, there have been 67 confirmed cases of measles in the Orthodox Jewish community in Brooklyn since October’18.
• Rockland County, NY:  As of February 4, 2019, there were 130 confirmed measles cases, and free MMR vaccinations are available for residents. 
• Rochester, NY:  The Monroe County Health Department says it is aware of 3 non-lab confirmed cases of measles, in addition to 4 previously announced, which increases the total number of measles cases during 2019 to 7.
• Oregon: The Oregon Health Authority has confirmed three more Multnomah County residents, bringing the total number of cases in Oregon to 4 during 2019.
• Texas:  During 2019, 7 measles cases have been confirmed in Texas. Denton County Public Health confirmed 1 measles case and the State Health Department confirmed 6 measles cases. 
• Washington: Clark County Public Health is continuing its measles outbreak investigation. Since Jan. 1, we have identified 53 confirmed cases and 7 suspect cases.

The Americas: As of January 18, 2019, 6 countries reported confirmed measles cases between December 2018 and January 2019. 

• Brazil: Between EW 6 of 2018 and EW 2 of 2019, there were a total of 10,274 confirmed cases, including 12 deaths. The CDC reaffirmed a Level 1 Travel Alert 2019. 
• Chile:  Between EW 45 of 2018 and EW 2 of 2019, there were 24 confirmed measles cases, of which 7 were imported and 17 were import-related.
• Columbia:  During EW 2 of 2019, the most recent cases under investigation are in the departments of La Guajira and Norte de Santander and in the districts of Barranquilla, Bogotá, and Cartagena. The CDC reaffirmed a Level 1 Travel Alert 2019. 
• Costa Rica: CR is carrying out a special vaccination program for children between 15 months and under 10 years old.
• Honduras: The Honduran Ministry of Health said that there were approximately 3,266,931 adults (34% of the total population) susceptible to measles and mumps because they never received the MMR vaccine as children.  The CDC reaffirmed a Level 1 Travel Alert 2019.
• Venezuela: During 2018, Venezuela had contributed 68 percent (5,525/8,091 cases) of the measles cases reported in the Americas and most of the measles-related deaths (73/85).  Due to the collapse of the health system, the CDC recommends all travelers to Venezuela be up to date on the MMR vaccine. The CDC reaffirmed a Level 3 Travel Alert 2019.

The World:  More children in the WHO European Region are being vaccinated against measles than ever before; but progress has been uneven between and within countries, leaving increasing clusters of susceptible individuals unprotected. 

• Australia: 11 measles cases reported in NSW during 2019.
• England: Public Health England published its measles and rubella elimination strategy for 2019. The CDC reaffirmed a Level 1 Travel Alert 2019.
• France: The CDC reaffirmed a Level 1 Travel Alert 2019. 
• Georgia:  The National Center for Disease Control (NCDC) and Public Health stated that 312 cases of measles were reported during 2019.  
• Greece:  The CDC reaffirmed a Level 1 Travel Alert 2019. 
• Indonesia:  The CDC issued a Level 1 Travel Alert. 
• Israel:  In response to the 2018 measles outbreak throughout Israel, doctors have issued notices during 2019 that unvaccinated children are prohibited from attending school until MMR vaccination proof is provided. The CDC reaffirmed a Level 1 Travel Alert 2019.
• Italy:  The CDC reaffirmed a Level 1 Travel Alert 2019. 
• Kazakhstan: The CDC issued a Level 1 Travel Alert on January 22, 2019, in response to a measles virus outbreak in the country of Kazakhstan. 
• Madagascar:  From 4 October 2018 to 7 January 2019, 19,539 measles cases and 39 “facility-based” deaths were confirmed by the WHO. The CDC reaffirmed a Level 1 Travel Alert 2019.
• Philippines:  The Department of Health confirmed outbreaks of measles in the National Capital Region (NCR) and in Central Luzon. Cases of measles in NCR rose by 550 percent from January 1 to February 6, 2019, compared to the same period last year, said Health Secretary Francisco Duque. More than 2 million Filipino children are at risk of getting infected with measles due to lack of immunization. The Philippines saw a four-fold jump in measles cases from 4,000 cases in 2017 to 21,000 cases last year.  
• Poland: The National Institute of Hygiene recorded 339 infections in 2018, with most of the cases reported during November and December.
• Portugal: The Directorate General of Health announced 37 measles cases have been confirmed since November 2018.
• South Korea: A total of 30 confirmed measles were reported on January 21st.  
• Thailand:  285 measles cases including one death have been reported from 31 provinces during 2019. The CDC reaffirmed a Level 1 Travel Alert 2019.
• Ukraine:  "Attack" on acting health minister in Ukraine blocking supply of vaccines. Health officials report additional 3,450 cases (1,502 adults and 1,948 children) during the third week of 2019, bringing the total to 8,498 cases to date. Ukraine announced a quarantine at the Lukyanivska pre-trial detention center due to a measles outbreak. The CDC reaffirmed a Level 1 Travel Alert 2019.
• Vietnam:  The Preventive Medicine Department in Ho Chi Minh City has reported 60 measles cases during 2019.

Measles is a highly contagious viral disease, without specific antiviral treatment available. Measles starts with fever, runny nose, cough, red eyes, and sore throat. It’s followed by a rash that spreads over the body, says the CDC.

Measles is often brought into the United States by unvaccinated people who become infected in other countries, says the CDC. These international travelers then spread measles upon their return, which cause outbreaks in the USA. 

International travelers can request a vaccine appointment with a pharmacy at Vax-Before-Travel. 

In the USA, there are 2 approved measles vaccines, MMR-II and ProQuad.

The CDC Vaccine Price List provides private sector vaccine prices for general information.

And, measles vaccine discounts can be found here. 

Vaccines, similar to medications, can cause side effects, says the CDC.

Significant vaccine side effects should be reported to the CDC.