MEasles outbreaks in Florida and Philadelphia have emerged as parents ignored advice to quarantine their children and at least one high-profile state official sowed confusion about how long to keep unvaccinated children out of school.
Both the outbreaks in Broward County, Florida, and Philadelphia made news after children brought the disease into the broader community. Six children became ill Manatee Bay elementary in Florida, and nine in Philadelphia after a child attended daycare while infected.
“It’s a concerning disease for a number of reasons, so I’m concerned,” said Dr. Paul Offit, director of the Vaccine Education Center and attending physician in the infectious diseases department at Children’s Hospital. of Philadelphia (Chop). Offit is also the recent author of Tell Me When It’s Over: An Insider’s Guide to Deciphering Covid Myths and Navigating Our Post-Pandemic World.
A measles outbreak was sparked in Philadelphia in January when a seven-month-old child contracted the disease during a trip abroad and, contrary to the advice of Chop’s doctors, including Offit, was taken to day care.
In Florida, a third-grader with no history of international travel was diagnosed with the disease and spread to other students. Less than 92% of children in Broward County had received recommended immunizations against diseases such as measles. The Center for Disease Control and Prevention (CDC) considers 95% the immunization threshold to prevent outbreaks.
Florida Surgeon General Joseph Ladapo, a known Covid-19 vaccine skeptic appointed by Republican Governor Ron DeSantis further disrupted efforts to contain the disease when he told parents they could ignore the CDC’s advice to keep unvaccinated children home for 21 days. Ladapo sent a letter to parents who say he “leaves school attendance decisions to parents or guardians.”
Side effects from the measles vaccine are rare, usually transient and not serious. However, the disease itself can have very serious consequences, including rare neurological infections and death. About one to two children per 1,000 infected will die from the disease or its complications, the CDC said. In rare cases, serious conditions can develop years later.
Offit described the symptoms of measles this way: “the rash starts at the hairline and spreads to the face. It’s like a bucket of rash has been poured over your head,” spreading throughout the body.
“It’s invariably associated with coughing, conjunctivitis and runny nose,†Offit said, adding, “and kids are sick — they look sick, they feel miserable.”
Offit, a child of the 1950s, was himself infected with measles (the first vaccine was introduced in 1963) and has personally treated cases of neurological devastation linked to measles infections.
Since the mid-20th century, measles vaccination in the US has been so successful that some doctors have never even seen the disease. Measles was eradicated from the US in 2000. Since then, the disease has reemerged, alongside vaccine misinformation.
Notably, Offit said that when he worked on the team that treated the child with measles in Philadelphia, he was the only doctor who had seen a case of the disease. He believes vaccines have been so successful that few people remember what it was like to live with measles.
In addition to the immediate risk of death from measles, a rare condition is mentioned subacute sclerosing panencephalitis can manifest itself years later. The progressive neurological disorder lies dormant for six to eight years before symptoms appear, which usually include personality and behavioral changes, motor function disorders and blindness. Most children diagnosed with the disease die between one and three years later. Offit has handled three such cases in his career.
By 2024, the CDC had received 20 cases of measles by mid-February – marking a return to the pre-pandemic pattern of several dozen cases per year, before a major outbreak in 2019.
That year, the US suffered its worst measles outbreaks in about 25 years. The Centers for Disease Control and Prevention (CDC) identified 1,274 cases of measlesMany spread through under-immunized communities targeted by vaccine misinformation. Among them, 474 cases were identified in New York in Orthodox Jewish communities in New York City and suburban Rockland County.
These cases were completely overshadowed in 2020 by the Covid-19 pandemic. Restrictions on social gatherings and the widespread use of masks nearly eliminated non-Covid-19 respiratory illnesses that year, including measles, influenza and the respiratory syncytial virus, better known by its acronym RSV.
But many of the factors that caused cases to spread in 2019 have now returned, and some have worsened. a November 2023 A report from the CDC shows that national vaccine coverage for state-required vaccines decreased from 95% in 2019-2020 to 93% in 2021-2022. In 2022-2023 it remained flat at 93%.
During the same period, the number of children claiming exemptions from state vaccination mandates in 2022-2023 also increased by 0.4% to 3% of all children, with increases occurring in 41 states.
Moreover, like New York in 2019, those declines in vaccine uptake were clustered. Hawaii saw a steep slope Decrease of 7.9% in the uptake of the measles, mumps and rubella (MMR) vaccine between 2022 and 2023, and a lower but still alarming decline in the number of polio, varicella (chickenpox) and the diphtheria, tetanus and acellular whooping cough vaccines ( DTaP).
The last recorded measles death in the US was of a 28-year-old Washington woman named Catherine Montantes. Montantes, who had been vaccinated, died in 2015 after being exposed to measles in the waiting room of a local clinic. She suffered from an autoimmune disease, which made her immune system less sensitive to the measles vaccine.
Two doses of the measles vaccine are 97% effective against the disease, meaning even vaccinated people can contract the disease if it spreads in an under-vaccinated community.
“Vaccines are victims of their own success,” Offit said. “Don’t mess with this disease, this is not a disease you want to relive.”