5 things to know about measles
The anti-vaccine movement might be in trouble.
California Gov. Jerry Brown signed a bill to impose one of the strictest school vaccination laws in the country in light of the measles outbreak in Disneyland.
Two Democratic senators introduced the bill after the outbreak, which spread to more than 100 people in the U.S. and Mexico. They aim for it to raise immunization rates in under-vaccinated pockets of the nation's most populous state.
Immunologists say California's overall vaccination rate is high enough to maintain herd immunity, or the minimum vaccination rate needed to protect a community as a whole from a contagious disease. Still, some suburbs have seen sizable declines with 50 percent--nearly half of the 92 to 94 percent recommended for herd immunity.
Even as this bill goes into effect, some raise questions about measles and vaccines designed to protect against it: How contagious is measles? Who is at risk? Why now?
Here are some answers as per health agencies and medical experts.
1. The U.S. is having another banner year with measles.
The Jersey City case, confirmed by state officials over the weekend, makes New Jersey the 15th state with a case of measles since the start of the year. In January, 102 cases were reported in 14 other states.
To date, 178 people from 24 states and the District of Columbia reported having measles, according to the Center for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases. At least 117 cases, or about 66 percent, were linked to the outbreak at Disney Land in Anaheim, Calif.
Many more cases were reported last year. In fact, 2014 was a record year for measles in the U.S. Twenty-seven states reported 644 cases.
That was the highest total since the infectious disease was eliminated in the U.S. in 2000.
2. Yes, measles was once eliminated in the U.S.
In 2000, the U.S. declared measles was no longer endemic within the country, the way malaria is endemic to Nigeria or Haiti. Medical experts define measles elimination as going a year or more without continuous transmission of a disease within a geographic area, according to the CDC.
They attributed the elimination to the use of vaccines.
In 1978, the U.S. set a goal to eliminate measles by 1982. The nation didn't meet that goal, but it managed to reduce disease rates dramatically. In 1981 alone, the U.S. saw 80 percent fewer measles cases reported than the year before.
There was a set back in 1989, when there were measles outbreaks among vaccinated school-aged children. The Advisory Committee on Immunization Practices and other medical boards recommended that children get a second dose of the measles-mumps-rubella vaccine. The number of cases per year dropped even more through the end of the 20th century.
That doesn't mean that there were no measles cases reported over the following decade. There were 63 reported cases between 2000 and 2007. That number jumped to 140 reported cases in 2008, when the U.S. had three large outbreaks and several smaller ones.
The CDC attributed the spread to unvaccinated people — many spurred by an anti-vaccines movement — in the affected communities.
3. Outbreaks could happen anywhere.
The Disney Land outbreak isn't necessarily an anomaly. Medical experts say anyone who isn't vaccinated can contract measles and expose others to the disease.
An unvaccinated traveler who contracts it in another country, for example, can spread it when entering the U.S. and coming in contact with another unvaccinated person.
Glenn Fennelly, chair of the Department of Pediatrics at Rutgers New Jersey Medical School, said the majority of U.S. cases involve people who are not vaccinated. Those who are not vaccinated include infants under 1 year old, people with chronic diseases such as cancer or AIDS whose immune systems could not withstand vaccination, and those with religious exemptions.
Some parts of New Jersey are more vulnerable than others: Monmouth County had 92.6 percent of children vaccinated, the lowest for the 2013-14 school year, followed by Hunterdon County with 93.1 percent and Warren County with 94.2 percent.
For Fennelly, the differences from county to county are like "splitting hairs, but the point is, if a non-immune child or adult is exposed, there's a 90 percent chance they're going to be infected."
4. Measles is highly contagious and, among children, potentially deadly.
Measles spreads through the air when someone coughs or sneezes. Some of the early symptoms include a fever, runny nose, cough, red eyes and a sore throat, according to the CDC. Soon after that, a rash spreads throughout the body.
The disease can lead to other complications, such as pneumonia, ear infections or diarrhea. The CDC estimates that 3 in 10 people who get measles also suffer one of those complications.
For some, measles can lead to swelling of the brain and convulsions that can leave a child deaf or mentally disabled. This happens to one out of 1,000 children who contracts measles, according to the CDC. About one to two out of every 1,000 who get measles die from it.
5. The MMR vaccine does not cause autism.
One of the most common claims within the anti-vaccine movement about the measles, mumps and rubella vaccine is that it can lead to autism. The claim stems from a research paper that has since been debunked.
The research was detailed in a paper by Andrew Wakefield and published by the British medical journal Lancet in 1998. In his research, Wakefield claimed to have examined 12 children with intestinal disorders, and who had developed severe mental disorders after a period of normal development, according to the New York Times.
Wakefield contended that the combined vaccine led to chronic intestinal measles infection and then brain damage. His solution? Splitting the vaccine into three separate shots and having them administered over a longer time frame.
A medical investigation, however, found that Wakefield was not forthcoming about several conflicts. He had patented a measles vaccine in 1997 that could have taken off if the combined MMR vaccine had been withdrawn. His research was partly funded by lawyers representing parents who were suing vaccine makers.
The Lancet retracted the research in 2010. Wakefield lost his medical license.
Fennelly said that of all the arguments against vaccination, the autism claim is the most common one he hears. But there are other claims, many of which he said have no scientific basis.
His rule of thumb is to check whether the claim could be traced to a legitimate medical journal: "If it's not in a peer-reviewed medical journal, it's probably not accurate."
The Associated Press contributed to the reporting of this article.
Steph Solis: 732-643-4043; firstname.lastname@example.org; @stephmsolis