Measles Report from Florida Department of Health July 2018

Measles is a highly contagious disease among persons who are susceptible. The Florida Department of Health investigates all individuals with measles who spend time in Florida while infectious, including residents and visitors. However, only Florida residents are included in Florida’s case counts reported to the CDC.

State activity:

  • Two Florida residents and one visitor with confirmed measles associated with international exposures in Brazil and France were investigated in July.
  • The two Florida residents and were exposed to measles while traveling abroad. They had no measles vaccinations prior to exposure.
  • The visitor was exposed prior to arriving in the United States and had unknown vaccination status.
  • Thus far in 2018, a total of four Florida residents and three visitors with measles have spent time in Florida while infectious.
  • Contact investigations are conducted for both Florida residents and visitors with measles to determine the vaccination status of those potentially exposed to measles and to detect and prevent transmission.
    • In July, a total of 404 contacts who had possible exposure to measles were identified.
    • No outbreaks of measles were reported.
    • Contact investigations are important for every case of measles to determine the vaccination status for those potentially exposed to measles and to detect and prevent transmission.
  • Vaccination is the best way to prevent measles infections.In July, the two Florida residents with measles were never vaccinated prior to exposure and the visitor had unknown vaccination status.
  • In May, a total of 944 contacts were identified who had possible exposure to a case of measles.
    • In 2017, all measles cases (n=3) were exposed to the measles virus outside of Florida.
  • Vaccination is the best way to prevent measles infections. In May, two cases were never vaccinated against measles and two cases had unknown vaccination status.
  • Due to generally high vaccination rates, cases of measles in Florida residents are rare but occur every year and are most often associated with international travel.
    • The number of reported measles cases in Florida residents has remained at less than 10 cases per year since 2010.
    • In 2017, all measles cases (n=3) were exposed to the measles virus outside of Florida.
  • To learn more about measles, please visit http://www.floridahealth.gov/measles.

National activity:

  • Even though measles has been eliminated in the United States, cases occur every year, mostly among unvaccinated individuals. As of July 14, the CDC has reported 107 confirmed cases of measles so far in 2018. In 2017, the CDC reported a total of 118 cases.
  • In 2017, Minnesota experienced a large outbreak of measles in a community with low measles vaccination coverage that affected a total of 65 individuals. For detailed information on this outbreak see page 10.
  • The two dose measles vaccination schedule has been successful at decreasing cases, and measles was eliminated from the United States in 2000.

International activity:

  • Recently, increased measles activity has been reported all over the world. In May 2018, multiple measles outbreaks were reported in the Americas, Asia, Africa, Europe, and the Pacific.
  • The CDC has issued a Level 1 Travel Alert for several countries with measles outbreaks, including Greece, England, Serbia, Indonesia, Democratic Republic of the Congo, Italy, Ukraine, the Philippines, Romania, and France. Travelers to these countries should make sure they are vaccinated against measles with the MMR (measles, mumps, and rubella) vaccine. For more information, please visit https://wwwnc.cdc.gov/travel/notices.
  • In 2015, more than 100 people from 14 states had been reported to have the measles. Most of the cases had been part of a large outbreak linked to an amusement park in California and a day care in Chicago. Five infants attending a KinderCare Learning Center in Chicago develped measles according to local news sources.

    The initial confirmed case reported visiting Disneyland Resort Theme Parks in Orange County, CA, from December 17 through December 20, 2014. From December 28, 2014, through January 21, 2015, 51 confirmed cases of measles linked to this outbreak have been reported to CDC, 42 from California and 9 from six other states (3 in UT, 2 in WA, 1 in OR, 1 in CO, 1 in NE, and 1 in AZ). At this time, no source case for the outbreak has been identified, but it is likely that a traveler (or more than one traveler) who was infected with measles overseas visited one or both of the Disney parks in December during their infectious period. Disney and other theme parks are international attractions, and visitors come from many parts of the world, including locations where measles is endemic. The  multi-state outbreak underscores the ongoing risk of importation of measles and the need for measles vaccine coverage.

    Measles was almost eliminated in the US in the year 2004 with only 37 reported cases.

    What are the signs of the Measles?

    Fever, cough, runny nose, conjunctivitis followed by a rash appearing first on the face then spreading to the rest of the body.

    Why is Measles so serious?

    Measles can cause severe health complications, including pneumonia, infection of the brain, and death.

    The Measles virus is extremely contagious.

    Measles can remain in the air of a room for 2 hours after the contagious person has left the area. People can spread the virus even before they know they are sick. Infected people are contagious from 4 days before their rash starts through 4 days afterwards. Measles is transmitted by contact with an infected person through coughing and sneezing.

    Every year, measles is brought into the United States by unvaccinated travelers (Americans or foreign visitors) who get measles while they are in other countries. They can spread measles to other people who are not protected against measles, which sometimes leads to outbreaks. This can occur in communities with unvaccinated people.

    Why have there been more measles cases in the United States in recent years?

    A: In 2008, 2011, 2013 and 2014, there were more reported measles cases compared with previous years. CDC experts attribute this to:

    • more measles cases than usual in some countries to which Americans often travel (such as England, France, Germany, India, the Philippines and Vietnam), and therefore more measles cases coming into the US, and/or
    • more spreading of measles in U.S. communities with pockets of unvaccinated people.

    What can you do to protect yourself and your family from getting the measles?

    Check to be sure that you and your family members have received 2 doses of measles vaccine.

  • Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective.

    AS an adult, do I need this vaccine?

    You do NOT need the measles, mumps, rubella vaccine (MMR) if:
    • You had blood tests that show you are immune to measles, mumps, and rubella.
    • You are a man born before 1957.
    • You are a woman born before 1957 who is sure she is not having more children, has already had rubella vaccine, or has had a positive rubella test.
    • You already had two doses of MMR or one dose of MMR plus a second dose of measles vaccine.
    • You already had one dose of MMR and are not at high risk of measles exposure.
    • You are a college student, trade school student, or other student beyond high school.
    • You work in a hospital or other medical facility*.
    • You travel internationally, or are a passenger on a cruise ship.
    • You are a woman of childbearing age.
    You SHOULD get the measles vaccine if you are not among the categories listed above, and:

     

    Before any international travel, infants 6 months through 11 months of age should have at least one dose of MMR vaccine. Children 12 months of age or older should have two doses separated by at least 28 days.  Infants who receive a dose of MMR vaccine before their first birthday should receive 2 more doses of MMR vaccine.

     

    Q: How effective is the measles vaccine?

    A: The measles vaccine is very effective. One dose of measles vaccine is about 93% effective at preventing measles if exposed to the virus and two doses is about 97% effective.

    Q: How effective is the measles vaccine?

    A: The measles vaccine is very effective. One dose of measles vaccine is about 93% effective at preventing measles if exposed to the virus and two doses is about 97% effective.

     

    Q: Could I still get measles if I am fully vaccinated?

    A: Very few people—about three out of 100—who get two doses of measles vaccine will still get measles if exposed to the virus. Experts aren’t sure why; it could be that their immune systems didn’t respond as well as they should have to the vaccine. But the good news is, fully vaccinated people who get measles are much more likely to have a milder illness, and they are also less likely to spread the disease to other people, including people who can’t get vaccinated because they are too young or have weakened immune systems.

     

    Q: Do I ever need a booster vaccine?

    A: No. People who received two doses of measles vaccine as children according to the U.S. vaccination schedule are considered protected for life and do not ever need a booster dose.

    Adults need at least one dose of measles vaccine, unless they have evidence of immunity. Adults who are going to be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers, should make sure they have had two doses separated by at least 28 days.

     

    Q: Am I protected against measles?

    A: You are considered protected from measles if you have written documentation (records) showing at least one of the following:

    • You received two doses of measles-containing vaccine, and you are a(n)—
      • school-aged child (grades K-12)
      • adult who was not vaccinated as a child and will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers.
    • You received one dose of measles-containing vaccine, and you are a(n)—
      • preschool-aged child
      • adult who was not vaccinated as a child and will not be in a high-risk setting for measles transmission.
    • A laboratory confirmed that you had measles at some point in your life.
    • A laboratory confirmed that you are immune to measles.
    • You were born before 1957.

     

    Q: What should I do if I’m unsure whether I’m immune to measles?

    A: If you’re unsure whether you’re immune to measles, you should first try to find your vaccination records or documentation of measles immunity. If you do not have written documentation of measles immunity, you should get vaccinated with measles-mumps-rubella (MMR) vaccine. Another option is to have a doctor test your blood to determine whether you’re immune, but this option is likely to cost more and will take two doctor’s visits. There is no harm in getting another dose of MMR vaccine if you may already be immune to measles (or mumps or rubella).

    Q: How common was measles in the United States before the vaccine?

    A: Before the measles vaccination program started in 1963, we estimate that about 3 to 4 million people got measles each year in the United States. Of those people, 400 to 500 died, 48,000 were hospitalized, and 4,000 developed encephalitis (brain swelling) from measles.

     

    Q: Is measles a concern for the United States?

    A: Yes. Since measles is still common in many countries, this disease will continue to be brought into the United States. Measles is highly contagious, so anyone who is not protected against measles is at risk of getting the disease. People who are unvaccinated for any reason, including those who refuse vaccination, risk getting infected with measles and spreading it to others, including those who cannot get vaccinated because they are too young or have specific health conditions.

     

    Source: CDC