Worldwide Measles Spotlight: February 24, 2019

According to reports by numerous media and governmental organizations, the worldwide measles outbreak continues to expand. 

In the USA, there are 3 leading measles hot-spots: 

• Clark County, Washington: as of February 23, 2019, Clark County Public Health has identified 65 measles cases.
• New York City, NY: As of February 19, 2019, there have been 90 measles cases.
• Rockland County, NY: As of February 20, 2019, there are 138 measles cases. 

These state-based totals (293) exceed the US Centers for Disease Control and Prevention (CDC) data from February 14, 2019, which confirmed just 127 measles cases in 10 states. This data disparity is generally related to reporting timing.

And, the leading international measles hot-spot is the Philippines, where 11,459 people have contracted measles and 189 have died during 2019.

Listed below are various measles updates for the week ending February 24, 2019.

USA:  

Atlanta, GA:  The Georgia Department of Public Health confirmed 3 measles cases in greater Atlanta area during 2019.

California:  California’s public health officials are alerting doctors and other medical providers to be on the lookout for measles after Los Angeles County confirmed 1 case of measles during 2019. Each person who gets measles can transmit it to up 12 to 18 people, said Dr. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Medical Center.

Colorado:  A Denver adult has been identified as having been contagious with measles from January 9 - 14, 2019, after traveling internationally.  

Connecticut:  The Connecticut Department of Public Health announced that it has confirmed a second case of measles in a New Haven County adult.

Hawaii:  The Department of Health confirmed two cases of measles in 2019. According to a medical advisory issued to health care providers Jan. 16 by state epidemiologist Sarah Park, the cases occurred in visitors who were exposed to an infected international guest.

Illinois:  As of February 19th, the health department reported 4 cases of measles during 2019.

Kentucky:  1 measles case was confirmed by the Barren River District Health Department, which is near Bowling Green. According to public health reports, the unvaccinated child had recently traveled outside the country.

New Jersey:  The NJ Department of Health confirmed 33 outbreak-associated measles cases, including 30 in Ocean County and 3 cases in Passaic County with a direct epidemiologic link to the outbreak community. NJ has declared this measles outbreak ‘over’.

New York City:  As of February 19, 2019, there have been 90 confirmed measles cases. The neighborhoods that are affected include Bensonhurst, Borough Park, Midwood/Marine Park, and Williamsburg. According to JPost, the NYC Department of Health and Mental Hygiene sent out a public announcement urging members of the Orthodox Jewish community to vaccinate against measles, especially before a trip to Israel.

Monroe County NY:  The Monroe County Health Department confirmed a total number of 7 measles cases. 

Rockland County, NY:  As of February 20, 2019, there are 138 confirmed reported cases of measles in Rockland County.

Oregon:  There are 4 confirmed measles cases in Multnomah County, as of February 7, 2019, but there may be a 5th case.   “We are notifying people who were potentially exposed out of an abundance of caution,” Multnomah County deputy health officer Dr. Jennifer Vines said in a press release. “The good news is that measles is not spreading from Clark County to the Portland metro area.”

Texas:  As of February 14th, eight measles cases have been confirmed during 2019. The Texas DSHS Public Health Region for the Houston area is urging healthcare providers to consider measles when diagnosing patients because of early identification, along with immunization, is key to preventing measles from spreading. 

Washington:  As of February 23rd, Clark County Public Health reported 65 confirmed measles cases during 2019.

The Americas:

Brazil:  Unable to curb measles transmission, Brazil is in imminent risk of losing its status as a country free of the disease, which was awarded 3 years ago by PAHO. Health Minister Luiz Henrique Mandetta acknowledges the risk and says if the country loses its measles-free certification from PAHO, Brazil's public health and the economy will suffer. Brazil registered 10,302 cases of measles in 11 states in 2018. Currently, three states Amazonas, Roraima e Pará, continue to report new cases in 2019. The CDC reaffirmed a Level 1 Travel Alert regarding Bazil’s ongoing measles outbreak for 2019.

Vancouver, BC, Canada:  A total of 10 measles infections have been identified as of February 22, 2019.

Columbia:  The Norte de Santander district has declared a public health calamity along its frontier with Venezuela. Colombian officials say their system is strained by the estimated 1 million Venezuelans that have already entered the country. The CDC reaffirmed a Level 1 Travel Alert regarding an outbreak of measles in Colombia. Travelers to Colombia should make sure they are vaccinated against measles with the MMR vaccine.

Costa Rica:  An international visitor brought measles to Costa Rica. The last measles case reported in Costa Rica was during 2014.

Honduras:  During September 2018, the Honduran Ministry of Health said there were approximately 3,266,931 adults (34% of the total population) susceptible to measles because they never received the MMR vaccine. The CDC has reaffirmed a Level 1 Travel Alert for 2019.

Mexico:   Jorge Alcocer Varela, Secretary of Health reported that there is no health alert for measles. But, 776,000 children in Mexico were not vaccinated because there was a shortage of biological. Mexico’s first National Vaccination Week of 2019 is set for the start of February. The Biological and Reagents of Mexico will provide a reserve of 554,000 doses of the vaccination, and another 200,000 will be provided by the health services of Pemex. 

Venezuela:  The national coverage rate for the second dose of the measles vaccine was estimated at 52% according to the last reports from the Venezuela Ministry of Health. According to a CDC report published on January 30, 2019, Venezuela had contributed 68 percent of the measles cases reported in the Americas and most of the measles-related deaths (73/85), as of October 23, 2018.   The CDC reaffirmed Venezuela’s Level 3 Travel Alert for 2019.

The World:

New data for 2018 released by the World Health Organization (WHO) European regional office shows the highest number of measles cases in a decade, but that more children than ever before have been vaccinated. In a statement, the WHO said measles killed 72 children and adults in the European Region in 2018.

Australia:  A NSW woman has become the 14th person in less than 2 months to be diagnosed with measles, as of February 22, 2019. 

England:  Childhood vaccination rates in ­London are continuing to fall amid concerns about the spread of “anti-vaxxer” misinformation. Only 81.2 percent had received the 1st MMR vaccination by the time they were 2 years of age, according to the most recent figures from Public Health England (PHE). The MMR figures were down on the 85.1 percent rate in ­London in 2017-18, which was the lowest in England. In the UK, there were 953 measles cases during 2018. The US CDC has maintained its Level 1 Travel Alert for the UK regarding measles for 2019. 

Ethiopia:  Measles is endemic in Ethiopia with outbreaks reported annually. Health officials said over 3.3 million children will receive the measles vaccine.  As of February 11th, the 2nd dose of measles vaccine will be provided today in the whole of Ethiopia to the children aged 15 months.   

France:  An unvaccinated French child on holiday in Costa Rica is suspected of reintroducing measles to the Central American country. Previously, French health authorities warned of measles cases (18) at the Val-Thorens ski resort. The CDC reaffirmed a Level 1 Travel Alert for France for 2019.  

Georgia:  An outbreak of the measles has prompted the Georgian government to draft a provisional response to containing the disease. The vaccination will be free of charge for all citizens of Georgia, announced Georgian Health Minister David Sergeenko at a media briefing. Director of the National Centre for Disease Control (NCDC) Amiran Gamkrelidze has called on the public to ensure they are vaccinated to avoid contracting the disease. During 2018, three people died from the measles, while there 2,000-2,200 cases throughout the year, Gamkrelidze stated, "From the beginning of January, 312 cases of the disease have been identified,” during 2019.

Greece:  There is an ongoing measles outbreak in Greece. As of October 2019, 3,150 measles cases were reported in all 13 Regions. Initially, the outbreak mainly affected Greek Roma but as it progressed it spread to non-minority Greek nationals. The majority (80.4%) were unvaccinated. The CDC reaffirmed a Level 1 Travel Alert for 2019.

Indonesia:  According to media reports on February 18th, Indonesia has confirmed 4,897 measles cases. The CDC issued a Level 1 Travel for Alert for 2019. 

Israel:  The Ministry of Health informs the public of exposure to a measles patient at a family care center, Clalit Health Fund, during early February 2019.  The CDC reaffirmed a Level 1 Travel Alert for 2019, saying ‘Travelers to Israel should make sure they are vaccinated against measles with the MMR vaccine.’

Italy:  The EU health Commissioner Vytenis Andriukaitis pointed the finger at the Italian government on February 19, 2019, saying decisions on vaccination should be based on science. Italy recently faced severe measles outbreaks, with 4,978 cases reported between February 2017 and January 2018. The CDC reaffirmed a Level 1 Travel Alert for 2019.

Kazakhstan:  Measles has been confirmed in more than 1,600 citizens of Kazakhstan, as of February 1, 2019. The CDC issued a Level 1 Travel Alert regarding measles on January 22, 2019.

Madagascar:  The WHO says that an epidemic of measles in Madagascar has caused more than 900 deaths, and there have been more than 68,000 cases of the disease since the outbreak began in September 2018. According to WHO spokesman Tarik Jasarevic, the vaccination rate is estimated to be less than 60 percent. The CDC reaffirmed a Level 1 Travel Alert for 2019.

Philippines:  The Department of Health said it recorded 11,459 confirmed cases of measles with 189 fatalities from January 1 to February 20, 2019. Health Secretary Francisco T. Duque III said, “The Department of Health is working side by side with other government agencies in quickly responding to mitigate the Measles outbreak. This government is conducting massive information dissemination and immunization campaign to encourage Filipinos to get vaccinated. Getting vaccinated is the best way to protect yourself and your community”, Secretary Duque said. 

South Korea:  A measles outbreak has struck at least 31 people in South Korea in the past month, and is likely to continue. The latest confirmed cases were in Ansan in Gyeonggi Province, Seoul, and South Jeolla Province, with earlier cases confirmed in Daegu as well as North Gyeongsang and Gyeonggi provinces.  According to a report by the Korea Centers for Disease Control and Prevention (KCDC) during January 2019, more than 500 people entered South Korea through direct flights in 2017 after contracting contagious diseases abroad.

Thailand:  Health officials have reported 613 cases from 47 provinces through February 4, 2019. The CDC suggests travelers to Thailand receive the MMR vaccine.

Turkey:  The number of people diagnosed with measles disease in Turkey reached 510 in the first 9 months of 2018, the WHO reported.  Historically, Turkey has reported a very high rate of immunization. According to the Health Ministry, 96 percent of the population was vaccinated in 2017. 

Ukraine:  Some 3,142 measles cases were registered in Ukraine on February 9, 2019. In total, 18,170 people, including 7,808 adults and 10,362 children, got measles in Ukraine from December 28, 2018, to February 8, 2019. The highest incidence rates are in Lviv, Vinnytsia, Rivne, Khmelnytsky regions, and in the city of Kyiv. The CDC reaffirmed a Level 1 Travel Alert 2019.  

Vietnam:  Measles has been reported in 664 patients in 2019. In late 2018, the ministry launched an additional measles-rubella vaccination campaign for 4.2 million children aged between 1 and 5. Ho Chi Minh City reports only 76.2% of children have been vaccinated with 2 measles vaccines, reported Dr. Nguyen Tri Dung, Director of Ho Chi Minh City Preventive Health Center at the Conference on February 22, 2019. 

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

International travelers can request a pre-trip vaccine counsling appointment 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.