US measles cases top 1,200 as UK loses 'measles free' status

With 21 new cases recorded in the past week, the US Centers for Disease Control and Prevention (CDC) today reported that 2019 measles totals rose to 1,203 in 30 states.

The number of people who have been hospitalized this year due to measles in the United States remains at 124, with 64 people having reported complications, including pneumonia and encephalitis.

The CDC is currently tracking six outbreaks (defined as three or more cases) in Texas, California, Washington state, and three separate outbreaks among religions communities in New York state. More than 75% of the cases this year are linked to outbreaks in New York state and New York City, the CDC said.

The largest outbreak is in the Orthodox Jewish community of Brooklyn and Queens. As of Aug 12 the New York City Department of Health (NYC Health) confirmed 653 since September of 2018.

That outbreak, like most that have occurred in the United States this year, has been linked to infected travelers from the Ukraine and Israel. A large measles outbreak in the Philippines has also been behind some US infections.

UK loses measles-free status

In other measles news, the World Health Organization (WHO) stripped the United Kingdom of its measles-free status, just 2 years after the country earned the designation.

Public Health England (PHE) said today the WHO determined that measles transmission was re-established throughout the UK after 2018 saw 991 confirmed cases in England and Wales—double the number of cases recorded in 2017. The same strain of measles virus was also detected in 2017 and 2018, which connotes established virus transmission, PHE said.

"While coverage of the first dose in the UK has reached the WHO target of 95% for children aged five, coverage of the second dose is at 87.4%," PHE said in a blog post, referring to the measles, mumps, and rubella (MMR) vaccine. MMR vaccine coverage must be at 95% for both doses, as measles is highly infectious, and even one infected person can start an outbreak among vulnerable populations.

PHE cited concurrent outbreaks in European countries, and the risk posed by unvaccinated travelers, as the main reason for the UK resurgence.

The UK's National Health Service (NHS) began routine measles immunization in 1968, and public trust in the NHS's vaccine program is at an all-time high, PHE said. Still, the NHS is mandating checks on vaccination status, including checking on the MMR vaccine status of 10- and 11-year-olds at general practitioner appointments.

"Losing the elimination status is a stark reminder of how important it is that every eligible person gets vaccinated. It provides an opportunity to raise awareness of the potential risks posed by measles, the importance of vaccination and timely reporting of suspected cases to limit further spread," PHE said.

Last week, the WHO announced that the first 6 months of 2019 produced more measles cases than any year since 2006."There have been almost three times as many cases reported to date in 2019 as there were at this same time last year," the WHO said at the time. "This follows successive yearly increases since 2016, indicating a concerning and continuing upsurge in the overall measles burden worldwide."

Countries reporting the most measles activity are Ukraine, the Democratic Republic of the Congo, and Madagascar.

See also:

Aug 19 CDC update

Aug 12 NYC Health update

Aug 19 PHE blog

Aug 12 CIDRAP News story "Global measles outbreaks make 2019 a record-setting year"

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