Measles Outbreak Fits Pattern, Doctor Says

By Dan Sorenson, The Arizona Daily Star, Tucson

May 2–Pima County’s measles outbreak, the second-largest in the country, fits the dominant pattern of having connections to either Switzerland or Israel, says a CDC doctor who expects the measles outbreak to expand.

Most of the 64 measles cases reported nationwide by the end of last week were traced to either visitors from other countries with outbreaks or U.S. residents who returned from countries with outbreaks, Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases said in a teleconference Thursday.

She said officials believe that 54 of the 64 cases are tied to overseas visits, with the sources split between five U.S. citizens who had visited another country and picked up the virus there and five involving foreign nationals who were visiting the United States. The center is a division of the Centers for Disease Control and Prevention, better known as the CDC.

Tucson’s 16 confirmed cases are thought to be tied to a Swiss woman visiting Tucson who was admitted to Northwest Medical Center for treatment of pneumonia that was a complication of the measles. She has since been released and returned home, according to the Pima County Health Department.

Switzerland and Israel were named as the two primary sources, both of which have had measles outbreaks this year, Schuchat said .

Schuchat said Switzerland and Israel have another similarity to the United States in that while all three countries have very high rates of measles vaccination for children — 95 percent or above — all have growing pockets of children who are not being vaccinated for religious or other personal reasons.

In the case of one family in Washington state that reportedly attended a religious conference there, eight children in the family have come down with the measles; two of those children have been hospitalized.

Schuchat and Dr. Jane Seward, deputy director of the National Center for Immunization and Respiratory Disease, said a substantial percentage of the known U.S. cases have been connected to medical settings — doctors’ offices and hospitals.

So far, there have been no fatalities in the United States from this measles outbreak, but Schuchat said in the years before immunization of U.S. children it was typical for as many as 400 to 500 U.S. children to die from measles-related complications — usually pneumonia or encephalitis — every year.

Pima County health officials have been urging people who haven’t had the measles or haven’t received two measles (or the combination MMR — measles, mumps, rubella) vaccinations at least one month apart to get vaccinated. They are also urging that infants between 6 months and 1 year of age to get vaccinated; the standard practice has been to not vaccinate children until their first birthday, but Pima County’s chief medical officer, Dr. Michelle McDonald, said the vaccine can be given earlier.

She also recommends vaccinations for anyone having contact with pregnant women, infants under 1 year of age, or immunocompromised people.

“If you live with someone who cannot be vaccinated, you do them a big favor by getting vaccinated yourself,” McDonald said.

People who were vaccinated with the early version of the vaccine, introduced in the late 1950s and used in the 1960s, may also have limited or no immunity and require vaccination. McDonald said the early vaccine has not proved as effective as the more recent MMR vaccine.

McDonald also said one in 20 people — 5 percent — who received only one of the two-shot MMR vaccine series will typically be found to be lacking immunity.

The Pima County Health Department is continuing to add new free immunization clinics and has received assistance from the CDC, in the form of vaccine, and a $50,000 emergency appropriation by Gov. Janet Napolitano.

If you go

What: Pima County Health Department free measles clinics.

When: 8 a.m.-3 p.m. Saturday.

Where:

–Morris K. Udall Park, 7290 E. Tanque Verde Road.

–Rillito Racetrack Park, 4698 N. First Ave.

–Kino Sports Complex Soccer Fields, behind UPH Kino Hospital, 2500 E. Ajo Way.

Who should get the shots:

–Infants 6 months to 12 months of age.

–Children 1 to 6 years old who have not had two vaccinations at least four weeks apart.

–Health-care, child-care and school workers who don’t have proof of immunity or a verifiable record of two MMR (measles, mumps, rubella) vaccinations.

–Anyone having contact with pregnant mothers, infants under 1 year of age, or immunocompromised people.

–Others without immunity.

Bring immunization records.

National statistics

The U.S. confirmed measles-case totals for 2001-2006, from the Centers for Disease Control and Prevention:

Year Cases

2006 55

2005 66

2004 37

2003 56

2002 44

2001 116

* The total number of U.S. confirmed measles cases for 2008, as of April 25, is 64. But CDC officials predicted that 2008 measles cases will likely exceed the total for 2001.

cases by states

The states with confirmed measles cases and their totals as of April 25 (except as noted):

State Cases

Arizona 16*

California 12

Hawaii 3

Illinois 1

Michigan 4

New York 23*

Pennsylvania 1

Virginia 1

Washington 8***

Wisconsin 4

* updated total, ** 22 of whom are in NYC, *** added this week.

–Contact reporter Dan Sorenson at 573-4185 or dsorenson@azstarnet.com

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