The Centers for Disease Control and Prevention is urging clinicians to be alert for measles cases after the extremely contagious disease was found in 23 people recently in the U.S., including two in Georgia.
Most people in the U.S. are vaccinated for measles but the rate has been slipping since the pandemic began. The rising number of unvaccinated Americans is making the country more vulnerable to the disease, which was declared eliminated in the U.S. in 2000, according to the CDC.
In Georgia, an estimated 88% of young children have received at least one dose of the recommended vaccination for measles, mumps and rubella, known as the “MMR” vaccine, according to the American Academy of Pediatrics. That coverage rate is down from 93% in 2019.
Because measles is so contagious, to ensure the whole community is protected requires that about 95% of the population be vaccinated, health officials say. The CDC estimates 91% of young children in the U.S. have gotten at least one dose of the MMR vaccine.
Due to a recent rise in cases, the CDC said this week that health care providers should be on alert for symptoms of measles, which some doctors and providers might not immediately recognize or suspect.
While children are required to get several vaccinations before attending public school, exemptions in Georgia and most other states can be given for both medical and religious reasons.
Back in 2019, 3% of kindergartners had an exemption in Georgia from at least one vaccine, which was the same overall percentage for the U.S. During the 2021-2022 school year, exemptions rose to 5%, falling to 4% during the 2022-2023 year, the most recent school year available. The national rate was 3%.
Dr. Joanna Dolgoff, a Paulding County pediatrician said parents are generally open to the MMR vaccine, just as for other routine childhood vaccines.
Dolgoff said she takes the time to reassure parents who may be reluctant that there have been multiple studies on the MMR vaccine’s safety and effectiveness. Studies have shown it does not lead to an increased risk for autism, as some parents have feared in the past.
Even so, vaccination rates for the MMR vaccine falling below 90% is “very concerning,” she said. “This can lead to a reemergence of diseases such as what we are seeing with measles.”
The CDC said the agency has been notified of 23 confirmed cases in the U.S. from Dec. 1 through Jan. 23, with most of the cases in children who had not been vaccinated. A state-by-state breakdown is not available but the Georgia Department of Public Health has confirmed two cases in a metro Atlanta family. Two weeks ago, state health officials announced the first confirmed case of measles in an unvaccinated person who was exposed while traveling out of the country. DPH later confirmed a second case in the same family.
Measles symptoms typically appear 7 to 14 days after being infected but it can take as long as 21 days.
Since 2020, there have been between 13 and 121 measles cases in the U.S. annually, according to the CDC. But in 2019, the U.S. saw nearly 1,300 measles cases across 31 states, making the highest number since 1992 and a record since being considered eliminated in the country. The 2019 outbreak in the U.S. included an outbreak of 11 cases in Cobb County, which was contained.
According to the CDC, most measles cases in the U.S. occur when unvaccinated or partially vaccinated Americans travel internationally, contract the disease, and then spread it to those who are unvaccinated upon their return. U.K. health officials on Monday urged millions of parents to book their children for missed MMR vaccines during a sharp increase in the number of measles cases there.
Other countries with ongoing measles outbreaks include Yemen, India and Ethiopia.
The first symptoms of the virus typically include high fever, cough, runny nose, and watery eyes. Then a rash of tiny, red spots breaks out. It starts at the head and spreads to the rest of the body.
Measles can cause serious health complications, such as pneumonia and brain inflammation, especially in children younger than 5 years of age, according to the CDC. About one in every five people in the U.S. will be hospitalized. One to three of every 1,000 people with measles will die even with medical care, according to the CDC.
The CDC also recommends patients with suspected measles cases be isolated from other patients and be tested to confirm the case of measles. Other recommended steps include making sure patients are up-to-date on measles vaccines, especially before international travel.
Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected, according to the CDC. Measles spreads through the air when an infected person coughs or sneezes. The virus can stay in the air or on surfaces for up to two hours after an infected person has left the room.
Infected people can spread measles to others from four days before through four days after the rash appears, according to the Centers for Disease Control and Prevention.
However, the vaccine is very effective in preventing a measles infection. About 95% of the people who receive a single dose of MMR will develop immunity to all three viruses. A second dose boosts immunity, typically enhancing protection to 98%.
