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TThe United States has seen more cases of measles in 2019 than most years in the last decade, but public health officials have said it is too early to talk about an epidemic. US Centers for Disease Control and Prevention officials released the latest figures this week, indicating that as of March 22, the most recent date for which data were available, 228 measles cases had been identified. in the country. Just two full months in 2019, the United States has surpbaded the number of cases in seven years out of the last nine.
At this rate, 2019 could be the worst year in 10 years. But the number of cases the country witnesses may be misleading. The CDC declared measles "eliminated" in 2000. The fact that we are seeing them now means that something has gone wrong – and that many cases of measles may look like a pandemic.
CDC figures, combined with reporting on measles outbreaks in the country, such as Washington's, have fueled fears that immunization advocates may push us to the brink of a deadly public health crisis. But Dr. Thomas Clark, deputy director of the Division of Viral Diseases at the CDC, tells reverse that one or two outbreaks can have a considerable impact on the number of cases in a given year, which contributes to this perception.
"The most important thing to know about measles is that it has been eliminated from this country and our hemisphere, that is, there is no supposed measles," he says.
** Case dated March 7, 2019. The number of cases is preliminary and can be modified. The data is updated weekly.
But when measles appears, either because an American travels abroad and catches it, or another country brings it to the United States, the disease spreads in susceptible individuals and turns into an epidemic. That's what happened at Disney World in 2015, in Washington in early 2019 and in an Amish community in Ohio in 2014 – hence the huge outbreak of cases that year.
In all three scenarios, large numbers of unvaccinated people were fertile ground for infection of an epidemic – and that's all there is to it. Clark notes, however, that such cases do not necessarily indicate a kind of epidemic at the national level. With so few cases of measles in the United States each year, a few isolated outbreaks can cause an outbreak and can make headlines because of their scarcity.
"It depends on when people are traveling and where they are going," says Clark. "We have to worry that this year is not bad, but it is about the spread of measles around every import," he added.
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This year's major epidemic in Washington also highlights a clear link with anti-vaxxers, as people who decide not to vaccinate their children – whether for misinformation, their religious beliefs or both – contribute to create conditions conducive to measles epidemics.
However, under the impetus of epidemics, state-level political leaders have been behind a number of successful efforts to ban exemptions for non-medical vaccines. The Washington State House has pbaded a bill banning non-medical exemptions, and Oregon lawmakers are considering adopting a similar bill. And on Tuesday, a New York judge refused to let 44 unvaccinated students return to school after a measles outbreak in Rockland County.
In addition to CDC's role in compiling data on measles outbreaks, Clark highlights the critical role of public health authorities at the state level in investigating exactly how they occur, helping to prevent them from becoming infected. breed.
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"Since measles has been eliminated from this country, it is important that every imported case be identified and that all contacts, or potential contacts, be contacted and that you determine whether they have been vaccinated or are susceptible," he said. he. This work is the responsibility of state investigators, and the CDC supports them in these efforts.
"We had a team in the state of Washington earlier this year," says Clark.
And while this year's numbers already seem extremely high, he says the response of states and the federal government has not been so unusual, including new state laws banning vaccine exemptions.
After the Disney Worls incident, for example, California pbaded a law severely restricting vaccine exemptions. After all, vaccines are the only sure way to prevent measles outbreaks.
That being said, Clark notes that sometimes, the plus point of these outbreaks is that they can prompt state governments to take action to ban vaccine exemptions:
"Sometimes it takes an epidemic for someone to ask these questions."
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