US measles cases highest since 2000 as anti-vaccination movement surges

America tops the list of high-income countries where children have not received inoculations

A vial of the measles, mumps, and rubella virus vaccine, or MMR, is pictured at the International Community Health Services clinic in Seattle, Washington. The US state is battling a resurgence in the once rare disease. Reuters
A vial of the measles, mumps, and rubella virus vaccine, or MMR, is pictured at the International Community Health Services clinic in Seattle, Washington. The US state is battling a resurgence in the once rare disease. Reuters

America recorded 695 cases of measles in 2019, the most of any year since the disease was declared eliminated at the turn of the century, officials said on Wednesday.

The surge comes amid a growing global movement against inoculation, with about 169 million children missing the vital first dose of the measles vaccine between 2010 and 2017, a UNICEF report said before the launch of a campaign to reinforce the message that vaccines are safe.

The UN Children’s Fund found the United States topped the list of high-income countries in which children had not received their first round of immunisation, at more than 2.5 million.

It was followed by France and Britain, with more than 600,000 and 500,000 unvaccinated infants respectively over the same period.

The new tally of American measles cases confirmed by US authorities surpassed the previous high of 667 reached in 2014.

In richer nations, a resurgence of the once-eradicated, highly contagious disease is linked to the growing anti-vaccine movement, which the World Health Organisation has identified as a major global health threat.

The anti-vax phenomenon has adherents across Western countries but is particularly high profile in the US, where it has been fuelled by medically baseless claims spread on social media.

“The high number of cases in 2019 is primarily the result of a few large outbreaks – one in Washington State and two large outbreaks in New York that started in late 2018,” the Centres for Disease Control and Prevention said in a statement.

People infected with the virus brought it to the United States from Israel and Ukraine and passed it on to members of their communities, many of whom had not been vaccinated.

Although New York and Washington State have been the main areas affected, cases have been found in 22 states.

“A significant factor contributing to the outbreaks in New York is misinformation in the communities about the safety of the measles/mumps/rubella vaccine,” CDC said.

In a separate statement confirming the new record, Health and Human Services Secretary Alex Azar said: “measles vaccines are among the most extensively studied medical products we have, and their safety has been firmly established over many years.”

He added that next week, during National Infant Immunisation Week, his department will carry out “a comprehensive campaign to reinforce the message that vaccines are safe and effective.”

In New York, an Orthodox Jewish community in Brooklyn has been hardest hit. They were infected by visitors from Israel, where an outbreak began a year ago.

Earlier this month, New York’s mayor, Bill de Blasio, declared a public health emergency in parts of Brooklyn, ordering all residents to be vaccinated to fight measles.

The New York county of Rockland declared a similar emergency in March.

Washington state’s Clark County has seen the outbreak concentrated among a Russian-speaking community. After a child brought the virus back from Ukraine in December it spread to 74 other people, mostly children, through schools, supermarkets and a bowling alley.

Washington, in the country’s northwest, declared a state of emergency in January over its outbreak of the airborne infection, which causes fever, coughing and rashes and can be deadly in rare cases.

Worldwide, measles cases rose 300 per cent over the first three months of 2019 compared with the same period last year, the United Nations said.

Two doses are required to protect children from the disease. But global rates of first dose were reported at 85 per cent in 2017, falling to 67 per cent for the second dose. The WHO recommends 95 per cent coverage for ‘herd immunity’.

Tens of thousands of cases have been reported in Africa and Europe. Ukraine alone has identified more than 30,000 cases and 11 deaths since January.

About 110,000 people, most of them children, died from measles in 2017, a 22 per cent increase from the year before, the UN children’s agency UNICEF said.

Among low and middle-income countries, UNICEF put declining coverage down to lack of access, poor health systems, complacency and, in some cases, fear or scepticism over immunisation.

In this bracket, Nigeria had the greatest number of unvaccinated children younger than one year, with almost 4 million, followed by India (2.9m), Pakistan and Indonesia (1.2m each) and Ethiopia (1.1m).

“If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child in rich and poor countries alike,” UNICEF executive director Henrietta Fore said in a statement.

Updated: June 25, 2019 11:40 AM


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