CDC: US could lose measles elimination status

There’s a “reasonable chance” the United States will lose its measles elimination status in October because of ongoing measles outbreaks in New York, according to Dr. Nancy Messonnier, director of the US Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases.

“It certainly is incredibly frustrating and upsetting to the public health community that we may lose measles elimination status, because we do have a safe and effective vaccine,” Messonnier said.

When the World Health Organization declared in 2000 that the United States had eliminated measles, it was hailed as one of the biggest public health achievements in the nation’s history. Losing that elimination status would be a black eye to the United States, public health experts said.

“We’re embarrassed. We’re chagrined,” said Dr. William Schaffner, a longtime adviser to the CDC on vaccine issues.

WHO removes a country’s elimination status when measles has been spreading continuously for one year. A measles outbreak in New York City started on September 30, 2018, and has caused more than 600 confirmed cases of measles. An outbreak in nearby Rockland County, New York, started the next day and has caused more than 300 cases.

Those two outbreaks have largely been among children in the ultra-Orthodox Jewish community whose parents have refused to vaccinate them.

Twenty-nine other states have had measles outbreaks in the past 12 months, but those were much more short-lived than the ones in New York.

CDC plans on releasing a detailed statement next week about the country’s measles elimination status, according to Messonnier.

Schaffner, an infectious disease expert at Vanderbilt University, said he thinks it’s highly unlikely the measles outbreaks will be over before September 30.

This week, the CDC announced 12 new cases of measles, most of them in New York. Schaffner said things will likely only get worse when children there go back to school early next month and begin congregating again in close quarters.

Losing measles elimination status “is a big deal in terms of reputation and prestige,” said Dr. Paul Spiegel, director of the Center for Humanitarian Health at Johns Hopkins University.

It also could have ramifications worldwide. Spiegel, a former senior official at the UN Agency for Refugees, said it could undermine longstanding US efforts to convince other countries to double down on vaccinating their citizens.

“If we are not able to take care of our own backyard, how can we tell others what to do?” he said.

When vaccine rates plummet, death and disability from measles increases. In 2017, there were 110,000 measles deaths globally, mostly among children under age 5, according to WHO. Measles can also cause blindness and encephalitis, or swelling of the brain.

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