Urgent Call for Vaccinations After Tennessee Reports First Measles Case Since 2019

With the school year starting and the fall season in full swing, it’s prime time for illnesses to spread through communities. Just recently, Tennessee reported its first measles case in over four years, involving an individual who had traveled internationally and spent time in Kentucky while infectious. Although the infected individual has fully recovered and no additional cases have been reported in the state, this serves as a reminder of how quickly and dangerously these diseases can spread.

According to the latest update from the Centers for Disease Control and Prevention (CDC), the U.S. has recorded 262 measles cases this year, with 13 outbreaks reported. Of these cases, 70% are associated with ongoing outbreaks, which can have a deadly impact if you’re not vaccinated.

Measles by the Numbers

So far in 2024, cases have been reported in 32 jurisdictions nationwide. What’s concerning is that around 40% of reported cases are in children aged five and under, the age group most vulnerable to severe complications from the disease. The CDC also reports that 88% of all measles cases involve individuals who are either unvaccinated or whose vaccination status is unclear. Only 4% of patients who contracted measles had been fully vaccinated with the two recommended doses of the measles, mumps, and rubella (MMR) vaccine.

Hospitalizations among those infected were of the highest concern from the CDC. It reports that more than 42% of patients required hospitalization, either for isolation or for managing complications related to measles, such as pneumonia or encephalitis.

The Importance of Vaccination

It’s not a comeback you want to see, and one that the World Health Organization warns we could experience more often. Between 2021 and 2022, measles cases were estimated to increase by 18%. Also, between 2021 and 2022, the number of countries experiencing measles outbreaks increased from 22 to 37, and deaths from measles increased by 43%. However, between 2021 and 2022, an estimated 57 million measles deaths were estimated to have been prevented by measles vaccination.

These numbers are proof that vaccines work to fight against this disease. While the measles vaccine is highly effective, it does require two doses to provide full protection. Individuals who are unvaccinated, partially vaccinated, or whose immunity has waned are at a much higher risk of contracting and spreading the virus.

Parents should ensure their children receive the MMR vaccine on schedule, and those traveling internationally should verify that their vaccinations are current. As international travel increases with the upcoming holidays, maintaining high vaccination rates will be crucial in preventing the spread of measles worldwide.

What Happens If You’re Not Vaccinated

If you contract the virus, the outcome can be extremely dangerous. Measles is a highly contagious disease that presents symptoms 7 to 14 days after infection, including high fever, cough, runny nose, and red, watery eyes. A rash typically appears 3 to 5 days later, spreading from the face to the rest of the body, often accompanied by a high fever. Complications, especially in young children, pregnant women, and immunocompromised individuals, can include ear infections, pneumonia, encephalitis, and in some cases, death. Severe complications can lead to hospitalization, and long-term risks include subacute sclerosing panencephalitis (SSPE), a fatal condition.

A National Health Priority

With a recent increase in measles cases across the U.S., public health authorities are monitoring cases closely, particularly in areas with low vaccination rates. The CDC and state health departments are working to contain outbreaks and prevent further spread, but the risk remains in communities where vaccination coverage is low. Tennessee’s recent case highlights the interconnected nature of public health — what happens abroad can quickly impact local communities.

If you have questions about measles or want to learn more about vaccines, it’s best to contact your health provider. They can provide you with the information you need to help ensure you and your family are protected.

Sources:

Tennessee Department of Health

CDC: Measles Cases and Outbreaks

CDC: Measles Symptoms and Complications

The National Library of Medicine: A Review of the Resurgence of Measles, a Vaccine-Preventable Disease, as Current Concerns Contrast with Past Hopes for Measles Elimination

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Dr. Casey

Can an “Eliminated Disease” Become Un-eliminated?

Did you know that there are certain diseases that are considered eliminated in some parts of the world? If you are anything like me or my students, your first thought might be — How? Or maybe just — Wow. Or, I am sure there are plenty of people out there whose first thought is — Prove it, and/or — Yeah, right. Regardless, it is a pretty amazing concept to think about: Eliminating. A. Disease. But before I get too far ahead of myself, I want to explain what I mean by “elimination.”

Control, Eliminate, Eradicate

These are three important terms in public health and in general healthcare when it comes to diseases, so I want to take a minute to explain them one at a time.

Control. Control means using treatment and taking actions to make the outcomes of a disease better and to minimize its spread. Think about influenza (the flu), for example. Seasonal flu comes around every year, and we cannot completely prevent it (although vaccines help a lot!). So, we control the flu by doing things like: avoiding contact with people who are sick, washing our hands frequently, and disinfecting shared surfaces, among other things.

Eliminate. Elimination means stopping a certain disease from being transmitted in a specific location or area, but not removing the disease worldwide. Basically, clearing a region of a specific disease. In the United States, we can thank Dr. Jonas Salk and the vaccine he developed for eliminating polio. Actually, polio has been eliminated from almost every country in the world, which is a good lead in to the next term…

Eradicate. A disease is declared eradicated when it is not found or transmitted anywhere in the world. It seems practically impossible. In fact, only two infectious diseases have been completely eradicated…ever. The only human disease that has been officially eradicated is smallpox (in 1980). I will probably come back to smallpox sometime because it is a fascinating and amazing journey, but for now, the main thing to know is that, thankfully, it is something we do not have to worry about!

What Diseases Have Been Eliminated in the U.S.?

In the U.S., the following human diseases are considered eliminated: smallpox, malaria, polio, rubella, mumps, diphtheria, and measles, with several other diseases close to reaching that status. This means that, even though there might be some cases of these diseases here and there, there have been no ongoing disease transmissions for over a year. We have had so much success eliminating many of these diseases largely thanks to vaccines that have given people protection from being infected. However, back to our original question…

Can a Disease Lose Its Elimination Status?

Unfortunately, the answer is YES. Elimination does not mean that a disease cannot come back to a region or area, but usually, cases of that disease would come in from another place (like visitors bringing germs along). When an event like this happens, the next steps really depend on what the community is like. For example, if visitors bring in a few cases of the mumps, but members of the community are all up to date on their vaccines (which include mumps), then these outsider cases probably won’t have a huge effect on the people there. However, if members of the community have started thinking they aren’t at risk for mumps because no one ever gets it where they live, and they have stopped getting vaccinated for it, then they are far more likely to catch the mumps that are now in their area, and to spread it to others who have lowered their guards and stopped vaccinating.

Why Is This Important Right Now?

Understanding the importance of how diseases spread — and right under our noses without us suspecting anything — is critical. Right now, we are seeing an example of this every day when it comes to the measles. As a refresher, measles is a serious, even life-threatening virus that is mainly transmitted through the air (when people cough or sneeze, for example) and through other close contact. Measles is one of the most contagious of all infectious diseases! The Centers for Disease Control and Prevention (CDC) say that up to 9 out of 10 susceptible people who have close contact with a measles patient will develop measles. The disease is especially common among children, but measles can be prevented through a combined vaccine often called “MMR” (meaning it vaccinates against measles-mumps-rubella). Just one does of MMR vaccine is around 93% effective at preventing measles!

In fact, in large part due to measles vaccines, measles was declared eliminated in the U.S. in 2000. Unfortunately, the case isn’t closed. Right now, we are getting closer and closer to measles being “un-eliminated” in the U.S. as the numbers of measles cases continues climbing. Between January 1, 2020 and March 28, 2024, the US has had 338 documented cases of the measles. But, 29% of those cases were in just the first quarter of 2024, which is not a good sign for case numbers for the rest of the year.

Some important things to know are that, of the 338 measles cases, two out of three patients (68%) were unvaccinated for measles. Another 29% of these cases did not know if they had been vaccinated or not, showing how important it is to know our own medical history and advocate for ourselves. Unfortunately, the numbers given here reflect the general population’s prevention, as measles vaccinations have been steadily decreasing for several years.

The Double-Edged Sword of Successful Disease Prevention

This is what I tend to think of as a double-edged sword in the amazing job that public health and medicine have done in eliminating measles in the U.S. It is remarkable that, in the present day, the risk of measles is so low that most people have gone their whole lives without experiencing or even seeing the life-threatening effects of measles. While that is a huge achievement, it tends to lower the population’s guard for protecting against the disease. People are less likely to understand how severe measles can be. And because people do not feel as threatened by measles, they are less likely to take preventive actions like vaccination. When something seems less “real,” or like it doesn’t apply to us, we are not motivated to take action, and this applies far beyond health. For example, I am probably not actively thinking about what kind of maintenance I could or should be doing for my car on a daily basis. I am triggered to action when a “change oil” light comes on. It’s not that I don’t like my car or am just lazy; it is more that, as a society, we have so many things going on at once, that many things do not get our attention until they become a problem or we feel threatened.

So what is critical, is that we don’t fall into the trap of false security just because things seem stable. We cannot treat our health, and the health of others, as a guarantee until it’s not. Because one day, it is possible, and even likely, that there could be a resurgence, change, or unexpected happening in health as we know it, and we want to be protected and to protect others if and when that happens. We should never pass up opportunities to prevent diseases when they are easily available. We should always hope and strive for the best, but prepare for anything we can.

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For More Information

To read more about polio and the development of its life-saving vaccine, check out the World Health Organization’s page: History of the Polio Vaccine

https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-polio-vaccination#:~:text=By%201994%2C%20polio%20had%20been,in%20less%20than%202%20decades.

To read about the crusade against and successful defeat of smallpox, head to the Centers for Disease Control and Prevention site and take a look at their History of Smallpox page. It is pretty incredible to see what humans were able to accomplish with the world working together!

https://www.google.com/search?q=when+was+smallpox+eradicated&rlz=1C1GCEB_enUS1070US1070&oq=when+was+small&gs_lcrp=EgZjaHJvbWUqBwgAEAAYgAQyBwgAEAAYgAQyBggBEEUYOTIHCAIQABiABDIHCAMQABiABDIHCAQQABiABDIHCAUQABiABDIHCAYQABiABDIHCAcQABiABDIHCAgQABiABDIHCAkQABiABNIBCDI3NTRqMGo3qAIAsAIA&sourceid=chrome&ie=UTF-8

To read a lot more information about measles and vaccination and see where I found some of my information for this post, visit the “Measles (Rubeola)” page on the CDC website:

https://www.cdc.gov/measles/index.html

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About Dr. Casey

Dr. Casey, PhD, MPH, is Director of Epidemiology and Public Health and associate professor of family medicine at the University of South Alabama Whiddon College of Medicine with a concurrent appointment in USA Health Mitchell Cancer Institute’s Division of Cancer Control and Prevention; she is also Director of the Masters of Public Health Program at Spring Hill College. Dr. Casey holds a masters and doctoral degrees in Public Health from the University of Alabama at Birmingham and a postdoctoral fellowship at Harvard T.H. Chan School of Public Health.

Her research interests include behavioral epidemiology, childhood/adolescent vaccination, cancer prevention, health communication, and reducing health disparities, emphasizing rural settings. Dr. Casey is a staunch advocate for increasing vaccination to lower rates of preventable diseases; she has led several studies to improve vaccine uptake.

Dr. Casey has held top leadership roles with non-profit organizations such as VAX2STOP CANCER, was elected Chair of Alabama’s Cancer Control Coalition, and is on the executive committee of Alabama’s vaccination task force. She is active in many prominent organizations, including the American Public Health Association and Society of Behavioral Medicine. With over 50 scientific publications and numerous national presentations, and invited talks, Dr. Casey is a widely respected expert in the field of vaccination.

How to Determine Your Measles Vaccination Status

In the maze of childhood memories and medical records, it’s not uncommon to forget whether you’ve had specific vaccinations, especially ones administered in early childhood. The measles, mumps, and rubella (MMR) vaccine is no exception. If you find yourself uncertain about whether you received the measles vaccination, don’t worry — you’re not alone. Fortunately, there are steps you can take to determine your vaccination status and ensure you’re protected against this highly contagious disease.

Understanding the Importance of Measles Vaccination

Measles is a viral infection that can lead to serious complications, particularly in young children and adults. Symptoms include high fever, cough, runny nose, and a characteristic red rash. While measles was once a common childhood illness, widespread vaccination efforts have significantly reduced its prevalence. However, outbreaks still occur, emphasizing the importance of vaccination to prevent the spread of this disease.

Steps to Determine Your Vaccination Status

1. Check Your Immunization Records:

  • Start by reviewing any available immunization records, such as those from your healthcare provider, school, or previous employers. These records may include documentation of the measles vaccination.

2. Contact Your Healthcare Provider:

  • If you’re unable to locate your immunization records or if they’re incomplete, reach out to your healthcare provider. They can access your medical history and vaccination records to determine whether you’ve received the measles vaccine.

3. Consider Your Age:

  • If you were born before 1957, you’re likely considered immune to measles because the disease was prevalent before the introduction of the measles vaccine. However, if you were born after 1957 and are unsure whether you received the vaccine, it’s essential to confirm your vaccination status.

4. Assess Your Risk Factors:

  • Consider factors that may increase your risk of exposure to measles, such as travel to areas where measles is endemic or outbreaks are occurring, occupation (e.g., healthcare workers), or contact with individuals who have measles. If you believe you’re at increased risk, it’s crucial to confirm your vaccination status and, if necessary, receive the vaccine.

5. Serologic Testing:

  • In some cases, your healthcare provider may recommend serologic testing to check for immunity to measles. This involves a blood test to measure the presence of measles antibodies, which can indicate whether you’ve been vaccinated or have had the disease in the past.

The Importance of Measles Vaccination

Measles vaccination is not only essential for individual protection but also for community immunity. By ensuring that you’re vaccinated against measles, you not only safeguard your health but also contribute to the prevention of outbreaks and the protection of those who are unable to be vaccinated, such as individuals with compromised immune systems.

Conclusion

If you’re unsure whether you’ve had the measles vaccination, don’t hesitate to take steps to confirm your vaccination status. Checking your immunization records, consulting with your healthcare provider, and considering your risk factors are all important in ensuring you’re protected against this potentially serious disease. By taking proactive measures to confirm your vaccination status, you’re not only protecting yourself but also contributing to the collective effort to prevent the spread of measles. Your health and the health of your community depend on it.

The Surprising Impact of Measles Virus on Your Immunity to Other Infections

Explore the lesser-known consequences of the measles virus, which extends far beyond its immediate symptoms. Research reveals that measles can significantly weaken our immune system’s memory, reducing preexisting antibodies that protect us against other infections. This insight into the measles virus’s impact on our immunity to different pathogens underscores the critical need to comprehend the extensive repercussions of this viral infection. Read on to understand the vital connection between measles and reduced immunity to other diseases, emphasizing the urgency of taking measures to protect your health.

Unveiling the Dark Side of Measles

How Measles Attacks Your Immunity

Measles is not just a childhood disease with a rash and fever; it has a more insidious side. The virus directly targets immune cells, particularly those responsible for memory. Imagine the immune system as a library of past infections. Measles acts like a fire, burning down sections of this library. The result is “immune amnesia,” where the body forgets how to fight off illnesses it once knew how to defeat. This leaves individuals vulnerable to infections they had previously conquered or had been vaccinated against, ranging from the flu to more severe diseases. By undermining the immune system’s memory, measles can erase the protection gained over years, or even decades, in just a matter of days following infection.

The Disastrous Aftermath of a Measles Infection

The consequences of measles extend far beyond the initial illness. After a measles infection, individuals are at a heightened risk for other diseases. This period of increased vulnerability can last for several years. Studies have shown that measles can lead to a spike in hospitalizations for other infections, which can strain healthcare systems. This is particularly troubling for communities with low vaccination rates, where measles can spread rapidly, potentially leading to outbreaks of other diseases. The impact is not limited to the individual; it ripples through families, schools, and workplaces. The economic burden is also significant, with increased medical costs and lost productivity. The aftermath of measles, therefore, poses a serious public health challenge that requires attention and resources to ensure the protection and resilience of our communities.

The Unseen Damage

Measles and Your Body’s Defense Mechanisms

Measles has a profound effect on the body’s defense mechanisms. The virus explicitly targets two cell types critical to the immune response: memory B and T cells. These cells are the custodians of immunological memory, the aspect of the immune system that recognizes and mounts a swift attack against previously encountered pathogens. When measles infects these cells, it reduces their population, weakening the body’s ability to remember and respond to past threats. Furthermore, the virus can also impair the production of new antibodies. This means that the immune system’s memory is disrupted, and its ability to learn from new infections is compromised. As a result, the body becomes more susceptible to various illnesses, turning an individual who was once immune into a blank slate regarding infectious disease defense.

Understanding the Role of Preexisting Antibodies

Preexisting antibodies are the immune system’s first line of defense against pathogens. They are produced by B cells as a response to infections or vaccinations and provide a form of “memory” that helps the body to recognize and neutralize invaders it has encountered before quickly. When the measles virus invades, it can deplete these crucial antibodies, erasing this memory. The loss of preexisting antibodies leaves individuals susceptible to diseases they might have been protected against, such as influenza, pneumonia, and even some gastrointestinal infections. It’s not just about losing a battle against measles; it’s about losing the war against numerous other pathogens that the body once knew how to fight. This knowledge underscores the importance of preventing measles infections, maintaining the integrity of our immune defenses, and safeguarding our long-term health.

Taking Precautionary Measures

The Need for Prompt Action

Prompt action is essential given the severe implications of measles on the immune system. The window for effective intervention is small, as the virus can spread quickly and covertly. Vaccination is the most powerful tool in our arsenal, offering a safe and effective means of preventing measles and its cascade of adverse effects. It’s imperative that individuals, especially in areas with low immunization rates, recognize the urgency to vaccinate. Health authorities should intensify their efforts to inform the public about the risks of measles and the benefits of vaccination. Collaborative community initiatives can play a crucial role in increasing vaccine coverage. The goal is to preempt outbreaks and sustain herd immunity, protecting those who are most vulnerable, including infants and individuals with compromised immune systems. Immediate action is not just a personal health measure; it’s a communal responsibility.

Safeguarding Your Immunity from Measles

Protecting your immunity from measles is crucial, and vaccination is the best way to do this. The measles, mumps, and rubella (MMR) vaccine is effective and has a long-standing safety track record. By getting vaccinated, you protect yourself and contribute to the broader community’s health by preventing the spread of the virus. In addition to vaccination, good hygiene practices, like regular handwashing and using sanitizers, can reduce the risk of transmission. It’s also important to stay informed about measles’s signs and symptoms and seek medical attention promptly if infection is suspected. Health education campaigns can be instrumental in dispelling myths and encouraging proactive health behaviors. By taking these steps, we can fortify our individual and collective health defenses against the measles virus and its extensive impact on our immunity.

Combating Myths: The Critical Fight Against Vaccine Hesitancy and Measles Outbreaks

Vaccine hesitancy has become a growing concern worldwide, with a noticeable impact on public health. As more parents succumb to misinformation and baseless claims about the dangers of childhood vaccines, we are witnessing a distressing rise in preventable diseases, particularly measles outbreaks.

The Rise of Vaccine Hesitancy

Vaccine hesitancy refers to the delay in acceptance or refusal of vaccines despite the availability of vaccination services. This phenomenon is not new, but it has gained momentum in recent years, fueled by misinformation spread through social media and specific groups claiming vaccines cause more harm than good. Despite overwhelming scientific evidence to the contrary, these claims have led too many parents to make decisions that endanger not only their children’s health but also public health at large.

The Impact on Measles Outbreaks

Measles is a highly contagious disease that can lead to severe health complications, including pneumonia, encephalitis, and death. The disease had been primarily controlled in many parts of the world thanks to widespread vaccination efforts. However, the growing vaccine hesitancy has led to declining vaccination rates, falling below the threshold needed to maintain herd immunity. As a result, we have seen a resurgence of measles outbreaks in various countries, affecting populations that were once protected.

The Dangers of Misinformation

The heart of the vaccine hesitancy problem lies in the spread of misinformation. Bogus claims, such as the debunked theory linking vaccines to autism, continue to circulate and find new audiences. This misinformation not only undermines the efforts of health professionals but also erodes public trust in one of the most effective tools we have for preventing disease. It is crucial to address and correct this misinformation, ensuring that parents and guardians have access to reliable, evidence-based information about the safety and efficacy of vaccines.

The Role of Public Health Initiatives

Combating vaccine hesitancy requires a concerted effort from public health officials, healthcare providers, and the media. Public health campaigns must actively reach out to hesitant parents, using clear, accessible, and persuasive messaging. Healthcare providers also play a critical role in this effort, as they are often the most trusted source of information for parents. By engaging in open, empathetic conversations with parents about their concerns, healthcare providers can help dispel myths and encourage vaccination.

The rise in vaccine hesitancy and the consequent measles outbreaks represent a significant public health challenge. It is a reminder of the importance of vaccination and the need to combat misinformation vigorously. As a society, we must prioritize the health and well-being of all individuals, particularly the most vulnerable among us. By doing so, we can ensure that diseases like measles remain a thing of the past rather than a recurring threat.

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  • Vaccine hesitancy: The WHO describes vaccine hesitancy as a growing challenge for immunization programs worldwide, highlighting its complex nature and the variety of factors that contribute to it, such as misinformation, complacency, convenience, and confidence. Effective communication and tailored strategies are emphasized as key to improving vaccine acceptance​.
  • Vaccines and immunization: This section provides an overview of immunization’s role as a global health success story, noting that vaccines prevent 3.5–5 million deaths every year from diseases such as diphtheria, tetanus, pertussis, influenza, and measles. It also mentions the Immunization Agenda 2030, which aims to improve global vaccination coverage and ensure that everyone benefits from vaccines for good health and well-being​.

The Significance of the Measles Vaccination for Children in Times of Resurgence

In the United States, there continue to be small outbreaks of the measles virus dispute the vaccine being readily available. Once on the brink of elimination, measles has made a comeback, posing a significant threat to children.

Measles is a highly contagious viral infection with symptoms resembling a common cold — fever, cough, runny nose, and red, watery eyes. A rash can occur that starts on the face and spreads across the body. Contracting measles in the U.S. results in hospitalization for approximately 1 in 5 individuals, and 1 to 3 out of 1,000 people with measles may die of the disease, even with the best medical attention.

According to the latest data from the Centers for Disease Control and Prevention, 48 cases of measles were reported by 20 jurisdictions. This number is lower than in previous years, but it’s concerning to see outbreaks occurring considering in the 2000s the disease was declared eliminated. Several factors contribute to this reintroduction, including international travel and reduced childhood vaccinations.

Vaccination remains the most effective way to combat the measles. Children should receive two doses of MMR (measles-mumps-rubella) vaccine, with the first dose starting between 12 and 15 months. The second dose should be administered to those 4 to 6 years old. The second dose can be given earlier just if it is 28 days after the first dose.

A single dose of the MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella. Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps. People receiving their MMR vaccinations are usually considered protected for life against measles and rubella.

One of the most significant challenges with this disease is a delay in accepting the vaccine. The controversy surrounding the link between the MMR vaccine and autism has been thoroughly investigated and debunked by extensive reports from the American Academy of Pediatrics, the National Academy of Medicine, and the CDC. These organizations have found that autism is often identified in those between 18 and 30 months of age, which is around the same time children are given their first MMR vaccine.

The recent resurgence of measles in the United States is a stark reminder of the importance of vaccination. This disease remains one of the leading causes of death among young children globally. While the risk of measles in the U.S. is low, if vaccination rates continue to decline the country could see larger pockets of outbreaks across different jurisdictions. By prioritizing vaccination, we can prevent this disease from spreading further and return to the conditions of the early 2000s when measles was successfully eradicated in the U.S.

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Sources

Centers for Disease Control and Prevention: Measles (Rubeola)

Mayo Clinic: Measles

American Academy of Pediatrics: Vaccines — Autism Toolkit

National Academy of Medicine: Vaccines do not cause Autism

World Health Organization: Measles

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