Measles is surging. Last week the U.S. recorded 90 cases, making this year's outbreak the second largest in more than two decades.
So far this year, the U.S. has confirmed 555 measles cases, the Centers for Disease Control and Prevention announced Monday. That's 50 percent higher than the total number recorded last year, even though we're only about a quarter of the way through 2019.
And the virus isn't slowing down.
"The number of cases is accelerating," says Dr. Amanda Cohn, a senior adviser for vaccines at the CDC. "We are on track to have one of the highest numbers of cases of measles reported since we eliminated the disease in the year 2000."
The majority of the cases are connected to outbreaks in New York, Cohn says.
"This is a very significant outbreak," she says. "These cases were imported from other countries, but because of low vaccination coverage in these communities, measles is spreading widely throughout these communities."
Last week, New York City declared a public health emergency in an ultra-Orthodox community in the Williamsburg neighborhood of Brooklyn. The city's Health Department is mandating that parents vaccinate their children, or they may face a $1,000 fine.
Health officials say there are two main reasons for the virus's surge: more international travel and lower vaccination rates.
Several countries around the world are currently experiencing massive measles outbreaks. Madagascar has recorded more than 100,000 cases since the fall, with more than 1,200 deaths. Ukraine has recorded about 37,000 cases this year. And the European Union is tallying about 1,000 cases a month.
Globally, the World Health Organization reports that measles cases in the first quarter of 2019 nearly quadrupled compared with what was reported at this time last year.
More American families are bringing measles home with them after traveling abroad, Cohn says. And once the disease lands stateside, it has a better chance of gaining a foothold because vaccination rates in some places have dropped below 93 to 95 percent, the threshold required to protect the entire community.
"When you make the decision not to vaccinate your child, please understand you're also making that decision for the people around your child," New York City's deputy mayor of health and human services, Herminia Palacio, told NPR on Wednesday.
Measles can be an extremely serious disease. About 25 percent of infected children are hospitalized. About 10 percent of children develop ear infections, which can cause permanent hearing damage. In about 1 in 1,000 cases, the infection becomes life-threatening. In these cases, the virus moves to the brain, causing encephalitis and convulsions. Children can be left deaf, blind or with intellectual disabilities — if they recover.
Before the development of the measles vaccine in the 1960s, the U.S. recorded nearly a half-million cases each year, the CDC says. About 48,000 kids were hospitalized and about 500 people died per year.
"We eliminated measles from this country in 2000, and ... I think we eliminated the memory of that virus," Dr. Paul Offit of Children's Hospital of Philadelphia told NPR's Weekend Edition Sunday. "People don't remember how sick it could make you."
AILSA CHANG, HOST:
Measles is surging throughout the world. The World Health Organization is reporting that cases have nearly quadrupled in the first few months of this year. And U.S. public health officials say 555 cases have been confirmed nationwide. NPR's Patti Neighmond reports.
PATTI NEIGHMOND, BYLINE: So far, measles has been confirmed in 20 states. Pediatrician Amanda Cohn, adviser on vaccines with the Centers for Disease Control and Prevention, says cases of the disease are accelerating fast.
AMANDA COHN: We are on track to have one of the highest numbers of cases of measles reported since we eliminated measles in the year 2000.
NEIGHMOND: But more and more parents are opting out of vaccinating their child for religious or personal reasons, and more people are traveling to countries where measles is common.
COHN: Countries such as Israel, the Ukraine, Philippines. When people go to those countries and are exposed to measles and they weren't vaccinated, they then travel back from that country to the United States...
NEIGHMOND: Bringing with them the extremely contagious virus.
COHN: If there's a hundred people in the room who have not been vaccinated, 90 people who were just exposed in a room will develop measles.
NEIGHMOND: Measles spreads when people cough or sneeze. Droplets of the virus can survive in the air for a couple of hours. Dr. William Schaffner, an infectious disease specialist at the Vanderbilt Medical Center in Nashville, calls measles an extremely vile infection that can pose great danger for children who are not vaccinated and come down with the disease. They become miserably ill for a week and a half, he says, and many can suffer severe complications.
WILLIAM SCHAFFNER: You can get middle ear infection - otitis media - pneumonia, which can be life-threatening. And worst of all, one in every thousand children will develop encephalitis.
NEIGHMOND: Where the virus travels to the brain and can inflame brain tissue.
SCHAFFNER: This can lead, obviously, to deaths. And some children who recover are left with permanent disabilities.
NEIGHMOND: The best protection, says CDC pediatrician Dr. Amanda Cohn - vaccination.
COHN: If your child has gotten vaccinated with two doses of measles vaccine, your child is highly protected, and you do not need to be worried about measles in your community.
NEIGHMOND: Public health authorities in the U.S. and around the world want to make sure that accurate information about the safety and effectiveness of the vaccine is readily available to parents and that parents get their children vaccinated. Patti Neighmond, NPR News. Transcript provided by NPR, Copyright NPR.