Even though the United States has maintained measles elimination status for almost 20 years, the Centers for Disease Control recently issued an advisory regarding the disease’s problematic resurgence.
As of March 21, a total of 64 measles cases had been reported in 17 states: Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York, Ohio, Pennsylvania, Virginia, and Washington.
That figure is higher than the number reported for all of 2023, which saw 58 cases.
Measles (rubeola) is a serious and highly contagious disease, but health officials in the Fredericksburg area say if you’ve been vaccinated, you are protected. To date, the only case reported this year in Virginia was confirmed to be an individual in Northern Virginia who had traveled overseas.
“We have not seen any confirmed cases of measles in the Rappahannock Area Health District in 2024,” said Allison Balmes-John, population health manager at RAHD. The RAHD provides required childhood immunizations for those without health insurance or a provider that offers them.
Virginia is well covered by the MMR vaccine, with 95% of kindergartners’ records reflecting fully vaccinated status, said Meredith Robinson, a vaccine-preventable diseases coordinator for the Virginia Department of Health.
Added Robinson: “If you are fully vaccinated, you are considered immune.”
One person infected with measles can infect 9 out of 10 unvaccinated individuals with whom they come in close contact. The virus can linger in the air for up to two hours.
“We know from the CDC’s health advisories that the increase of cases domestically, the majority, are related to international travel,” Robinson said. She noted it follows a global increase in measles cases in areas with typically low rates, like Europe.
The CDC recommends that children over 6 months old traveling internationally should be vaccinated regardless of destination.
Measles spreads when an infected person coughs or sneezes. Symptoms usually begin seven to 12 days after exposure and include a high fever, a cough, watery eyes (conjunctivitis) and a runny nose. Measles is also known for its characteristic rash that begins at the hairline and spreads down the body. Infected people can spread measles to others from four days before through four days after the rash appears.
Populations at the highest risk of severe complications — including death — from measles are children under 5, pregnant women and those with compromised immune symptoms. One out of five unvaccinated people who get measles will require hospitalization. Complications can range from ear infections to pneumonia to encephalitis (inflammation of the brain).
The current recommendation is that children receive an initial dose of the vaccine (in either MMR or MMRV) between 12 and 15 months of age. A second dose should occur between the ages of 4 and 6.
According to the CDC, vaccinations dipped during the coronavirus pandemic. Over 61 million doses of measles-containing vaccines were postponed or missed from 2020 to 2022 due to COVID-19-related delays in supplementary immunization activities.
“Most of the cases we see in Virginia are linked to international travel by unvaccinated people who return from abroad while infectious,” Robinson said. A 2021 outbreak in the Commonwealth appears to have been isolated among a group of Afghan evacuees, she added.
If someone suspects a measles case, the infected person must avoid contact with high-risk groups and notify a health care provider immediately.
“Be sure to call ahead so you can be isolated,” Robinson said.
Suspected measles cases can be tested by the state public health lab or through a private lab and then reported to the VDH so that contact tracing can begin. Once identified, individuals who have been exposed are contacted to assess their immune status.
For those unsure of their vaccination status, Robinson urges following up with a health care practitioner or contacting VDH to obtain records.
