The current measles outbreak is raising questions as to whether physicians should take a stronger stance against parents who choose not to vaccinate their children.
“A family vacation to an amusement park—or a trip to the grocery store, a football game or school—should not result in children becoming sickened by an almost 100% preventable disease,” said Dr. Errol Alden, executive director of the American Academy of Pediatrics, in a statement released Friday. “We are fortunate to have an incredibly effective tool that can prevent our children from suffering. That is so rare in medicine.”
The current outbreak began at a California amusement park and has spread across multiple states and Mexico.
The Centers for Disease Control and Prevention recommended health providers ensure all patients are up to date with their measles, mumps and rubella, or MMR, vaccinations. Also recommended to physicians: consider measles as a diagnosis for anyone with related symptoms who has recently traveled abroad or had contact with someone with a rash. It also warned young physicians who may not consider a measles diagnosis because they may have never seen a case of measles due to the success of vaccination programs.
At least 67 people have been diagnosed with measles since the first cases of the highly contagious diseases were found at Disneyland just before Christmas, according to figures from the California Department of Public Health from Jan. 22.
The majority of cases are in California, where 59 people have been infected. In a health alert released Friday afternoon, the CDC confirmed 51 cases of measles have been linked to the current outbreak, with three found in Utah, two in Washington, one each in Arkansas, Colorado, Nebraska and Oregon, as well as one case in Mexico.
Those infected ranged in age from 7 months to 70 years old.
The current outbreak sheds light once again on the vaccination issue, in particular parents who decide not to vaccinate their children against mumps, measles and rubella.
According to the California Department of Public Health, vaccination status was documented for 34 of 59 California cases. Of that number, 28 were found not to have been vaccinated, including six infants who were too young for immunization.
Experts say measles outbreaks can usually be traced to people who contracted the disease while travelling abroad and then spread it to the unvaccinated once they return to the U.S.
For years, states have required schoolchildren to receive vaccinations before being allowed to attend public school. Cases of such diseases as measles, pertussis, polio, mumps, rubella and others once responsible for hundreds of deaths a year in the U.S. were largely eliminated here. But cases of measles have been trending upward in recent years. In 2014 there were 644 people infected with measles in the U.S., the highest number of cases since the disease was declared eliminated in 2000.
As a whole, measles vaccination rates have remained high among U.S. schoolchildren. Median vaccination coverage for the 2013-14 school year in 49 states and the District of Columbia was 95% for two doses of the MMR vaccine, according to an October report from the CDC.
But parents can choose to exempt their child from vaccination for either religious or philosophical reasons in 48 states. Overall, the median exemption rate among 46 states for the 2013-14 school year was 1.8%, according to the CDC report, but it warned exemption levels vary.
Clusters of communities have formed in recent years where immunization levels are well below what experts say is the threshold to maintain what is known as “herd immunity,” when a high enough proportion of a population is vaccinated to provide protection for those who are not immune.
Measles is a highly contagious airborne disease, transmitted by contact with an infected person through coughing and sneezing. Those who are infected are considered contagious from up to four days before a rash starts through four days after. The virus can linger on surfaces and in the air up to two hours after an infected person has left a location.
Follow Steven Ross Johnson on Twitter: @MHsjohnson
