Texas has not reported any new outbreak-related cases of measles in almost a month. This is a hopeful indication that one of the biggest outbreaks the US has seen in decades is beginning to slow down. However, the measles threat has not declined as new outbreaks and rising cases in other states are added to the national tally.
In the US, at least 89 confirmed cases have been reported in the US since the beginning of July, but data from the Centers for Disease Control and Prevention show that there have been more cases of measles than most years since the disease was ruled out and declared quarter-century ago.
And this year’s total – 1,356 confirmed cases since January – is higher than in over 30 years. There have been 32 outbreaks this year, accounting for almost 90% of all cases since January. Only 10 states remain in the zero cases reported this year.
The start of the school year in the US poses new threats due to the spread of measles amid a record year of incidents and delayed vaccination rates.
Experts say the decline in childhood vaccination rates across the US, coupled with the continued spread of measles in the US and the massive outbreak of neighbouring Canada and Mexico, sparked concerns as children began to gather for new grades.
“No one has a crystal ball, but there are situations where the number of cases is increasing,” says Dr. Katherine Trois, an infectious disease epidemiologist at Usels Houston.
On Saturday, Wisconsin reported nine new cases. All are related to the same exposure during a trip to another US state. The state’s health department has not released details about cases, including vaccination status in the particular state they travelled to “balance individual privacy for what the public should know.” And because the risk of community spreading is considered low, Dr. Ryan West Elgard, chief medical officer of the Wyconsin Department of Health, reported Monday, owing to communication failure.
However, new data published last week by the CDC shows that Wisconsin kindergarteners have the lowest coverage of the measles-mumpsulvera (MMR) vaccine. Only 84.8% of kindergarteners achieved two recommended doses of last year’s MMR vaccine. This is well below the 95% threshold required to prevent the occurrence. CDC data show that only Alaska and Idaho had lower MMR vaccination rates.
“When I get back to school, a lot of the kids come together and the measles is very infected,” Troyge said. “So if you take your child with you and one of them happens to have measles, that’s the perfect way to spread the virus.”
She said the decline in vaccination rates would leave more children vulnerable.
“If more children are at risk, there’s a greater chance that measles will spread,” she said.
Wisconsin is one of only 15 states that allow parents to exempt school children from necessary vaccines for “reasons of personal conviction,” as well as religious beliefs and medical reasons. CDC data shows that around 3.6% of kindergarteners were able to miss out on at least one necessary vaccine. Wisconsin’s exemption rate was more than doubled at 7.6%.
The American Academy of Pediatrics says non-medical exemptions for school vaccination requirements should be eliminated. This is a long-standing position the organization has recently reaffirmed.
“Exempting children from vaccination for non-medical reasons is problematic for healthcare, public health and ethical reasons, creating unnecessary risks for both individuals and communities,” the AAP leader wrote in a policy statement last month. “While certainly there are families who value rejecting the vaccine and having the option to send their children to school, non-medical exemptions threaten the safety of the entire school community and change the burden of protecting the child to parents of children who are medically vulnerable, immunocompromised, or unable to be vaccinated for medical reasons.”
A new outbreak of measles was announced last week in Osceola County, Michigan, with the original case arising from an individual exposed to measles while traveling out of state. This is the third outbreak in the state, with at least 27 cases reported this year.
Wyoming also reported a batch of new measles cases on Saturday. Four new cases in Carbon County have been exposed to individuals with measles infection, bringing the state’s total to a maximum of seven.
Wyoming Department of Health Data shows Carbon County had the lowest vaccination rate among state children in 2023, ranking 21 of 21 of 23 counties, with only 66% of toddlers earning at least one dose of the MMR vaccine.
According to the Wyoming Department of Health, “estimates for the range of vaccinations at the county level are important.
Experts say that families with similar sociocultural beliefs live close to each other, so experts say that unvaccinated individuals tend to be geographically clustered.
“This phenomenon is more likely to lead to disease outbreaks when vaccine-preventable diseases are introduced into these communities,” the AAP leader wrote in a policy statement. “Outbreaks that begin with low vaccination communities can spread beyond these communities, particularly for diseases such as measles, water cells, and whooping cough, to other communities with a lower or wider population.”
While starting a school year poses new risks, it also creates opportunities for trusted community leaders to encourage and promote vaccinations, experts say.
“We know that if a vaccine clinic is being held in schools, it will increase (coverage) by making it easier for parents to vaccinate their children,” Troyge said. “School nurses are respected, so having them talk about how important a vaccine is is another strategy.”
