Five things to know about the measles epidemic

The number of new cases of measles in the country is increasing, with the United States on the brink of the worst year since public health officials said the disease was eliminated in 2000.

On Thursday, the current outbreak has sickened 555 people in 20 states.

And as memories of previous measles outbreaks have faded, the anti-vaccine movement has made a comeback among the group's concerns about vaccine safety.

All of this has created a conflict that involves public health services, schools, religious communities and even Congress.

Here are five things to know about the measles epidemic.

States take the lead on prevention

The measles virus is mostly spread in pockets of unvaccinated children. This sharp increase has led to opposition to state laws that allow people not to immunize their children for moral or religious reasons.

Virtually all states grant derogations to persons with religious beliefs against vaccination, with 17 states providing exceptions for religious, personal or philosophical beliefs.

In Washington, where 74 cases of measles were confirmed, state legislators introduced a bill banning philosophical exemptions for the measles, mumps and rubella vaccine. The measure was passed in the House earlier this year and was recently sent to the Senate.

On the east coast, the Maine legislature is waiting for chamber votes in both houses for a bill that would eliminate all non-medical exemptions. A similar proposal is being developed in Oregon, despite strong anti-vaccine opposition in some parts of the state.

Arizona Governor Doug Ducey (R) has pledged to fight legislation that would expand exemptions in the state, which already has exceptions for religious and personal reasons.

The anti-vaccination movement is under pressure

The epidemic has informed opponents of vaccination.

"The anti-vaccine lobby has gone from a marginal group to a group with its own media empire," said Peter Hotez, dean of the National School of Tropical Medicine at Baylor University's College of Medicine.

He added that the anti-vaccine lobby was spreading misinformation, generally unopposed, and that the number of people falling ill had reached a critical point.

And the United States is not alone. Measles is spreading worldwide and this year the World Health Organization declared for the first time that vaccine hesitancy was among the top 10 health threats in the world.

Anti-vaccination activists have compared public health measures, such as the ban on unvaccinated children's schools, with the persecution of Jews by the Nazis.

Del Bigtree, general manager of an anti-vaccination group called ICAN, was wearing a yellow Star of David at a rally in Texas last month.

His actions have been criticized by the Anti-Defamation League and by officials of the Auschwitz Memorial in Poland.

"It is simply wrong to compare the fate of the Jews of the Holocaust to that of anti-vaxxers. Groups defending a political or social agenda must be able to assert their ideas without trivializing the memory of the six million Jews slaughtered in the Holocaust, "said Jonathan Greenblatt, General Manager of the Anti-Defamation League.

Outbreaks concentrated in specific groups

As of April 8, New York City had confirmed 285 cases of measles in Brooklyn and Queens since the beginning of the outbreak in October. Most cases involve members of the Orthodox Jewish community.

The outbreak has prompted New York City Mayor Bill de Blasio (D) and public health officials to declare a health emergency and to urge families to vaccinate their children against measles or to pay fine of $ 1,000.

Hotez compared the epidemic within the Orthodox Jewish community to a similar outbreak of measles among Americans of Somali origin in 2017 in Minneapolis, when the state confirmed 79 cases the number the most high in 30 years.

According to the State of Minnesota's Department of Health, more than 80% of the cases involved unvaccinated Somali-born American children, whose parents had long been recipients of anti-vaccine propaganda.

Congress focuses on social media

Lawmakers on both sides of the aisle are studying how misinformation campaigns can spread so quickly and turn to social media.

"There is a lot of misleading and incorrect information about vaccines circulating online, including through social media," Sen. Lamar AlexanderAndrew (Lamar) Lamar AlexanderOvernight Health Care – Presented by PCMA – Sanders Unveils New Bill Medicare for All with Support for Other Dems 2020 | White House slams deployment of Sanders | Drug manufacturers, intermediaries on insulin pricing bipartisans senators propose a bill to expand the tax credit for electric vehicles Congress is ready to fight climate change (R-Tenn.), Chairman of the Senate Health Committee, said at a recent hearing at Capitol Hill.

"Charlatans and Internet fraudsters who claim that vaccines are not safe are tackling unfounded fears and parents' daily struggles, and they create a danger to public health that is entirely preventable," Alexander said. .

Chairman of the House Intelligence Committee Adam SchiffAdam Bennett SchiffSchiff and Nunes urge the Department of Justice to give information to Mueller Dems repressing the White House by hinting that they are "not smart enough" for Trump Trolling's tax returns to Bill Barr shows how language is twisted into politics MORE (D-Calif.) In February, Sundar Pichai, CEO of Google, and Facebook, CEO Mark ZuckerbergMark Elliot ZuckerbergHillicon Valley: The Mueller report will be released Thursday | YouTube adds information on September 11 to Notre-Dame fire video | New details on the case against Assange | Thousands sign a petition to ban Trump on social media | Conservatives support technology in the fight against GOP Reed Hastings of Netflix and Erskine Bowles leaving Facebook board Hillicon Valley: White House threatens to veto network neutrality bill | UK imposes new strict rules on technology platforms | Facebook eliminates white nationalist groups amid pressure | Senators call on FTC to "take action" against tech giants PLUS On the question.

Schiff has expressed concern that YouTube, which belongs to Google, and Facebook, Instagram, will be "broadcast and recommend messages that discourage parents from vaccinating their children, posing a direct threat to public health, and reversing the progress made in the fight against against vaccination ". preventable diseases. "

But until now, no legislative solution has been proposed and technology companies have voluntarily started to control themselves.

For example, last year, Pinterest began to suppress the results of research on vaccinations. YouTube said it would start by removing videos with "limit content" that "disinforms users in a detrimental way."

Measles can have short- and long-term health effects

According to the Centers for Disease Control and Prevention, nearly 90% of non-immune individuals will be infected if they are exposed to the virus.

For 1,000 children with measles, one or two will die. Death rates from measles have dropped with vaccination, but this could change if vaccination rates decreased further.

The disease can also have long-term effects on health. About 10% of children with measles also develop ear infections that can lead to permanent hearing loss.

Up to one in 20 children with measles contract pneumonia, the leading cause of measles deaths in young children.

Some rare complications are more serious: about 1 in 1,000 people in the United States with measles get encephalitis, or inflammation of the brain, which can cause convulsions and leave the victim deaf or intellectually disabled.