Measles outbreaks in the US and abroad

February 12, 2024

This post guest authored by Patricia Toro, MD MPH

There have been measles outbreaks in 12 states so far this year (CA, WA, MO, OH, PA, NJ, DE, MD, GA), and we anticipate there will more outbreaks over the coming months.  Measles outbreaks are fueled by both higher US and global rates of measles and lower vaccination levels.

Measles, also called rubeola, is a virus transmitted through the air much like influenza or COVID-19. Measles used to be very common, but due to widespread vaccination efforts, there have been very few cases in the US for the last two decades. Even with widespread immunity, measles remains deadly, killing over 200,000 worldwide each year, mostly children in developing countries.

Worldwide immunization campaigns against measles were interrupted during the early years of the COVID-19 pandemic. The consequence of that is large outbreaks of measles, mostly in developing nations. These outbreaks, combined with an extremely high contagiousness of the virus itself  - 9 out of 10 individuals without immunity to measles will become infected if exposed – has increased the spread of measles.

The World Health Organization has reported a 30-fold increase in 2023 in measles cases across Europe. This has resulted in 21,000 measles hospitalizations and 5 measles deaths. And cases are increasing.

Often, measles outbreaks in the US are found to originate in unvaccinated travelers from other countries who did not know they were infected, like a recent outbreak in Philadelphia. The traditional response to these cases is to ensure that children and individuals at high risk for infection are vaccinated. This is important not only for the health of individuals, but also to preserve our health infrastructure. There are few hospital beds in the US that can appropriately support an airborne virus that is this contagious.

Instead, some groups have inaccurately spread the alarm about these vaccines – falsely claiming that the vaccines are dangerous when the measles vaccine has an extensive track record for safety and is very effective. Fully vaccinated individuals (who had 2 doses of the vaccine), have an approximately 97% protection against infection if exposed. Even if vaccinated individuals are infected, they usually have milder symptoms. Immunity from measles vaccination is long-lasting, and those who have had two shots do not need boosters. Measles vaccine is given as an MMR shot that provides protection against measles, mumps and rubella.

It is only a matter of time before North America starts to see even more outbreaks and cases, unfortunately.

Implications for employers:

• Remind employees that measles vaccinations, usually obtained in childhood, have no cost sharing as preventive care.

• Employers can work with their carrier and/or wellness vendor to highlight the safety and efficacy of measles vaccinations.

• Remind employees how to report a measles case or exposure appropriately within their organization.

• Have a workplace and operations plan ready in case of a possible exposure or case. Measles is highly contagious and those who are exposed and not immune are highly likely to become ill.

Thanks for reading.  You can find previous posts in the Employer Coverage archive

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Tomorrow: Heart risk and cancer screenings remain depressed since the pandemic