Measles cases exceed 700 as epidemic continues unabated

Last Wednesday, the C.D.C. stated that the number of cases had exceeded the previous peak of 667 set in 2014. This year's outbreak is the largest since the disease was declared eliminated in the United States in 2000. In 1994, there were 963 cases .

Its elimination in 2000 meant that the measles virus was no longer circulating in the United States, as it had probably done since European settlers introduced it for the first time into this hemisphere in the 15th or 16th century. Every year after 2000, a few cases arrived overseas, either from immigrants or tourists returning to the country, but each outbreak was stifled.

More than 94 percent of US parents are vaccinating their children against measles and other diseases, said Dr. Robert Redfield, director of the BC Health Center, on Monday.

His agency "is working to reach the low percentage of individuals reluctant to the vaccine," he said. "Vaccines are safe and do not cause autism."

About 100,000 children in this country under the age of 2 have not been vaccinated, he said, which means they are vulnerable to this epidemic.

Some infants are not immune because their parents avoid vaccination. Others can not be protected because they are allergic to the components of the vaccine or take, for example, cancer drugs or organ transplants that suppress their immune system.

"We must unite as a country to eliminate measles again," said Dr. Redfield.

This year's generalized epidemic has been caused by people infected with measles who have arrived in the country since last year, the C.D.C. I said. Measles strains detected most often came from Ukraine, Israel and the Philippines.

Communities have begun to take extraordinary measures to reduce the rate of infection and combat resistance to vaccination.

Mayor of New York City, Bill de Blasio, declared the state of emergency and threatened residents of four Brooklyn postal codes of a $ 1,000 fine. they refused to vaccinate. The city authorities closed a Yeshiva nursery school for violating vaccination orders.

Rockland County, NY, at the center of another outbreak, had initially banned unvaccinated children at all covered public places, including schools, shopping malls, supermarkets, restaurants, and places of worship. .

After a court quashed this decision, the county excluded from public spaces people with symptoms of measles or who had recently been exposed to the disease, threatening them with a fine of up to $ 25,000. at $ 2,000 a day.

There have been no confirmed measles deaths in the country, but officials said it was only a matter of time.

Even with modern medical care, the disease usually kills about one in 1,000 victims, according to C.D.C.

Pneumonia and encephalitis – swelling of the brain – are the most common serious complications and epidemics among malnourished children who can not receive modern hospital care have a mortality rate of 10% or more, according to the World Health Organization.

Measles is one of the most contagious diseases. The droplets contaminated with the virus can float in the indoor air for up to two hours after an infected person coughs or sneezes. Up to 90% of exposed people will catch the virus if they are not immunized.

The vaccine is considered very safe and two doses are effective at about 97% to confer immunity. The vaccine is normally given at ages 1 and 5, but during epidemics it can be given by pediatricians to healthy children as early as six months of age.

Globally, measles cases have dropped by 80% between 2000 and 2016, with the number of deaths rising from 550,000 to 90,000 per year. But two years ago, cases began to rebound, under the combined effect of poverty, war, vaccine shortages and, in some countries, hesitation about vaccination. .

Earlier this month, the W.H.O. said that there were three times more cases of measles in the world this year than in the first three months of 2018.

Epidemics of tens of thousands of cases have recently occurred in poor or war-torn countries, such as Madagascar, Ukraine and Yemen. But the number of cases is also increasing in rich countries with modern health systems, such as Israel, the United Kingdom, France, and Italy. Deaths from measles have occurred in these countries.

Before measles vaccination was generalized in the United States in 1963, nearly four million Americans had measles each year; C.D.C. I said. Of the approximately 500,000 cases reported annually to medical authorities, about 48,000 were hospitalized, 4,000 had encephalitis, and 400-500 had died.

At the national level, since the mid-1990s, over 91% of American children have been vaccinated against measles.

Anyone born before 1957 is thought to have had the disease as a child and to be immunized there.

Americans born between 1957 and 1989 are in an intermediate position. Some received the first vaccine against the "killed virus", which turned out late and was replaced by a vaccine against the "weakened virus". Until 1989, it was common to give a blow; now children have two.

An injection of the new vaccine confers immunity of 93% on the whole population, while two injections allow to reach 97%, which is considered more than enough to prevent the virus from spreading.

However, the immune system of each individual is different, some Americans concerned about the current epidemic have visited their doctor for a simple blood test that can show how immune they are against measles, mumps and rubella.

Vaccination levels vary from one state to the next, largely depending on the ease with which state legislatures obtain exemptions. All states allow exemptions for children who are allergic to the vaccine, whose immune system is compromised or who have another medical reason to avoid it.