Losing the crown
It was a proud moment for US health officials in 2000 when the World Health Organization declared that measles had been eliminated from the nation. The achievement — meaning the US had seen no continuous spread of the disease for more than 12 months — followed a 1989 change in recommendations that students be given a second dose of the measles, mumps and rubella vaccine.
Now both the US and Canada face losing this status.
The Pan American Health Organization’s Regional Verification Commission, a body of the WHO, will meet Tuesday in Mexico City to hear data from each country in the region on measles outbreaks, genetic links, vaccinations, laboratory testing and surveillance efforts from the past year.
Canada, which achieved measles elimination in 1998, had an outbreak begin last October that has reached more than 5,000 infections. Canada is expected to lose its status after this meeting, which would also mean the entire Americas region will lose its status, too.
The US’s status is also in question. The Centers for Disease Control and Prevention has reported 1,648 measles cases this year, a three-decade record. The US could hold onto its elimination status for a bit longer, as an outbreak in Texas was declared over in August.
But there are other outbreaks in Utah, Arizona and South Carolina. Utah officials say its cluster has not been traced back to Texas through genetic testing, but a South Carolina official said the state has not yet gotten its genetic testing results. If South Carolina cases are genetically linked to Texas, the US’s elimination designation is at risk.
Elimination status is more about prestige and doesn’t change policies, said William Schaffner, a professor of medicine and infectious disease expert at the Vanderbilt University School of Medicine. But measles’ grip on the US could take years to unravel.
The nation’s infection rate is slowly ticking up and the vaccination rate continues to decline. The CDC reported less than 92.5% of kindergarteners – below the herd immunity threshold – got the MMR shot for the 2024-2025 school year. And vaccination exemptions are rising.
In addition, the combination shot MMR and chickenpox vaccine is no longer recommended for children under 4, a change made after members of an influential vaccine panel were fired by Health and Human Services Secretary Robert F. Kennedy Jr. and replaced with people who have expressed doubt in the Covid vaccine.
Less than 15% of kids take the MMRV vaccine, but removing access limits options and could increase costs for some patients, the American Academy of Family Physicians said in a statement.
If measles becomes endemic again, the consequences could be far-reaching, Schaffner said. Hospitalizations and medical costs will rise in an already strained system. Complications, like measles-related pneumonia and measles encephalitis, or brain swelling in children, will become more common.
The US has already recorded three measles deaths this year, including in two unvaccinated Texas children. But the toll could rise sharply — in the period before vaccines were made available, 400 to 500 died from measles each year. — Jessica Nix
| |
|
Enjoyed this article? Sign up for our newsletter to receive regular insights and stay connected.