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The return of measles

Illustration: Rebecca Zisser/Axios

Measles — declared eradicated in the U.S. in 2000 — has roared back at a record pace this year.

Why it matters: Most Americans have no firsthand experience with measles and that lack of familiarity, along with the online success of the anti-vaccine movement, is giving a deadly but easily preventable virus an opening to spread.

So far in 2019:

  • 695 confirmed cases of measles in 22 states.
  • More than 70 new confirmed cases reported in just the past week.
  • 5 states reporting ongoing outbreaks as of Monday (at least 3 cases in one place counts as an outbreak).

We may be a victim of our own success in squelching what used to be a ubiquitous virus that is extremely contagious.

  • According to the CDC, prior to 1963, between 3 to 4 million were infected each year and nearly all children got measles by the time they were 15 years old.
  • A CDC spokesperson tells Axios that among reported cases, an estimated 400 to 500 people died annually prior to widespread vaccination, 48,000 were hospitalized and 1,000 suffered encephalitis (swelling of the brain) from measles.

Now, due in large part to vaccination efforts that began in 1963, most Americans have no experience with the virus.

  • Parents may be fooled into thinking that measles is a relatively mild disease, similar to the flu, and think vaccination is unnecessary or not a priority.
  • This is not only wrong, but it could have deadly consequences.
"Parents may think that many vaccine-preventable diseases are mild, but there’s no way to tell how serious a disease may be for a child," CDC spokesman Jason McDonald tells Axios via email. But measles can be particularly hazardous for babies and young children, he says.
  • From 2001-2013, 28% of children younger than 5 years old who had measles had to be treated in the hospital, McDonald said, referring to relatively small outbreaks related to measles patients who traveled to the U.S. from areas where the disease is still active.
  • "Some children develop pneumonia (a serious lung infection) or lifelong brain damage."

Different vaccine-hesitant communities added together are causing vaccination rates to fall below effective immunity levels, Anthony Fauci, who leads the National Institutes of Allergy and Infectious Diseases, tells Axios.

“It is kind of like all of the stars are in the right pace for the disaster we’re seeing now because we’re having multiple factors combining together to give us these outbreaks,” Fauci says.

The situation is worrying enough in New York State alone that the CDC issued a stark warning Wednesday: "The longer these outbreaks continue, the greater the chance measles will again get a sustained foothold in the United States."

The bottom line: One relatively morbid source of hope, however, are the widely-reported health impacts from the ongoing outbreaks, with children in intensive care units and an El Al Airlines flight attendant in a coma.

“I think unfortunately the best motivation… is that we’re having these outbreaks and people are really getting seriously ill,” Fauci says. “Those are the things that are going to jolt people into reconsidering this.”

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