Thirty-two confirmed measles cases in California residents so far this year has state Department of Public Health managers scrambling. Cases have occurred throughout California. This time last year, only three measles cases had been reported.
“Immunization is the best defense against measles, with 99 percent of persons developing immunity after two doses,” says Dr. Ron Chapman, state health officer and director of CDPH. “With an outbreak in the Philippines and measles transmission ongoing in many parts of the world outside of North and South America, we can expect to see more imported cases of this vaccine-preventable disease.”
Imported cases can spread to the community, especially among unvaccinated persons, including infants too young to be vaccinated.
The 32 measles cases have been reported in Alameda (1), Contra Costa (4), Los Angeles (10), Orange (6), Riverside (5), San Mateo (1), San Diego (4) and Santa Clara (1) counties.
High immunization rates in California have kept preventable childhood diseases, such as measles, at record lows during the past 20 years. Since 2000, when measles was declared eliminated in the United States, the number of cases per year in California has ranged from 4-40 cases. In that time, almost all measles cases in the United States have been linked to travel to areas of the world where measles still circulates.
Among the California cases with onset in 2014, seven had traveled to the Philippines, where a large outbreak is occurring, two had traveled to India and one had traveled to Vietnam, where measles is endemic.
Measles is a highly contagious viral disease that is spread through the air when someone who is ill with the disease coughs or sneezes. Symptoms begin with a fever that lasts for a couple of days, followed by a cough, runny nose, red, watery eyes and rash. The rash typically appears first on the face, along the hairline, and behind the ears and then affects the rest of the body. Infected people are usually contagious for about eight days, four days before their rash starts and four days after. Complications can include diarrhea, ear infections and pneumonia. Death can occur from severe complications. Infants, pregnant women and immunocompromised persons are more susceptible to complications from measles.
“We want to do everything we can to prevent measles cases and we must do everything possible to limit the disease from spreading,” said Chapman.
Children are recommended to get their first dose of MMR (measles, mumps and rubella) vaccine at 12 to 15 months. The second dose of MMR is usually administered before children start kindergarten at 4 to 6 years. Immunized adults do not need boosters. However, anyone born since 1957 who has not had two doses of vaccine may still be vulnerable to measles and should ask their doctor about getting immunized.
Unvaccinated Californians who are traveling outside of North or South America should receive MMR vaccine before they go. Infants who are traveling can be vaccinated as young as six months of age (though they should also have the two standard doses of MMR vaccine after their first birthday).
Individuals getting ready to travel abroad can find helpful information about travel vaccines on the Centers for Disease Control and Prevention website