The Boston Globe

Scientists waryof measles threat

Outbreaks surge in areas of US

- By Apoorva Mandavilli

Measles, a highly contagious but preventabl­e disease, is resurging in pockets of the United States, a warning of the dangers of the strengthen­ing antivaccin­e movement.

The Centers for Disease Control and Prevention has recorded more cases this year than the 58 tallied in all of 2023, although the agency is not expected to release exact numbers until Friday. On Monday, the agency advised health care providers to ensure that unvaccinat­ed patients, especially those traveling internatio­nally, stay updated on their immunizati­ons.

The number of cases is likely to keep rising because of a sharp spike in measles worldwide, along with spring travel to some regions with outbreaks, including Britain, said Dr. Manisha Patel, chief medical officer at the CDC’s respirator­y disease division.

Nearly all the cases in the United States so far are related to unvaccinat­ed travelers. “We’re not going to see widespread measles cases going throughout the country,” Patel said. “But we do expect additional cases and outbreaks to happen.”

Measles is among the most contagious of diseases; each infected person can spread the virus to as many as 18 others. The virus is airborne and can stay aloft up to two hours after an infected person has left the room, spreading rapidly through homes, schools, and child care facilities.

In Chicago, one case of measles at a migrant shelter has grown to 13, prompting the CDC to send a team to help contain the outbreak. (Two additional cases in the city appear to be unrelated.)

In Florida, seven students at an elementary school contracted measles even as the state’s surgeon general, Dr. Joseph Ladapo, left it to parents to decide whether unvaccinat­ed children should attend school.

In southwest Washington, officials identified measles in six unvaccinat­ed adult members of a family living in two counties. And in Arizona, an internatio­nal traveler infected with measles dined at a restaurant and transmitte­d the virus to at least two others.

Measles was eliminated in the United States in 2000, and American children generally must be immunized to attend school. Yet sporadic cases lead to larger outbreaks every few years. But now a drop in vaccinatio­n rates, exacerbate­d by the coronaviru­s pandemic, has experts worried about a resurgence.

When vaccinatio­ns lag, “the first disease to appear is measles, because it’s highly infectious,” said Dr. Saad Omer, dean of the O’Donnell School of Public Health at UT Southweste­rn in Dallas.

Nine of 10 unvaccinat­ed people in close contact with a measles patient will become infected, according to the CDC.

Measles is far less deadly in countries with high immunizati­on rates and good medical care. Fewer than 3 of every 1,000 American children with measles will die as a result of severe complicati­ons such as pneumonia or encephalit­is, the swelling of the brain.

Still, about 1 in 5 people with measles may end up in a hospital.

Because widespread measles outbreaks have been rare, most Americans, including doctors, may not recognize the vibrant red rash that accompanie­s respirator­y symptoms in a measles infection. They may have forgotten the impact of the disease on individual­s and communitie­s.

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