Measles — United States, 2005

Morbidity and Mortality Weekly Report. 2006;55(50):1348-1351. 

In This Article

Editorial Note

The epidemiology of measles in 2005 supports previous conclusions that endemic transmission of measles has been eliminated in the United States.[8,9] Measles incidence was low (less than one case per million population), measles cases were geographically isolated, and 95% of cases were linked to importations (i.e., internationally imported or U.S-acquired, import-linked cases). In addition, no predominant and recurring viral genotype was detected, and the measles genotypes detected, in most circumstances, had been circulating within the country of presumed exposure.[10]

Half of all the cases in 2005 are traceable to one unvaccinated U.S. resident, who was infected during a visit to Romania of less than 2 weeks. This outbreak was the largest documented in the United States since 1996. All but two of the 34 patients in this outbreak were unvaccinated. The outbreak occurred because measles was imported into a population of children whose parents had chosen not to vaccinate their children because of safety concerns, despite evidence that that measles-containing vaccine is safe and effective.[4] A major epidemic was averted because of high vaccination levels and a low rate of vaccine failure in the surrounding community. The cost of containing this outbreak was estimated at $167,685.[5] This outbreak and other cases reported during 2005 likely could have been prevented had existing ACIP vaccination recommendations been followed.[4] The index case traveler should have been vaccinated with 2 doses of measles-containing vaccine before departure; exposed school-age children and personnel working in health-care facilities also should have had the recommended 2 doses before exposure.

The epidemiology of measles in 2005 highlights the need to maintain the highest possible measles vaccination coverage in the United States and to continue to address the concerns of those who choose not to be vaccinated or who choose not to vaccinate their children. Because 100% coverage in U.S. residents might never be achieved and because communities of unvaccinated persons continue to exist, accurate surveillance and rapid response to outbreaks are essential to preventing widespread transmission of imported measles. Moreover, providing assistance to other countries to control measles globally can limit the risk for imported measles in the United States.

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