Nine states have reported 64 cases of the measles to the Centers for Disease Control between January 1 and April 25 – it doesn’t sounds like a lot, but that’s more than in any year since 2001. The CDC is expressing concern that we could be on the verge of a larger outbreak, partly because of three key issues:

• European travel. Many of the cases originated from travel to Israel and Switzerland, where current measles outbreaks number in the thousands. “The principle difference this year is the extent of outbreaks in Europe, in places where … travelers don’t necessarily take the same kind of precautions they do when they’re traveling to other locations,” said Dr. Anne Schuchat of the CDC. 
• Healthcare settings. Some of these cases were acquired in doctor’s waiting rooms and in hospital settings. Twenty or 30 years ago, doctors and health care workers were more aware of measles and its symptoms, said Dr. Schuchat. “We are in a very different era right now where many doctors, nurses and parents are not familiar with measles, where people can seek medical care for something and transmission can occur because we don’t take all the precautions that we would have.”
• Unimmunized children. In the outbreaks so far, two-thirds of children who are old enough to be immunized but were not turned out to not be immunized because of personal belief or religious exemption. ”We are concerned about the populations of people who are choosing not to be vaccinated,” said Dr. Schuchat, “and whether we may be on the verge of facing larger-scale outbreaks in the United States. We want to make sure that parents who are making decisions about immunizing their children are aware of the measles risk …”

Here’s a breakdown of the 59 U.S. residents afflicted with the disease (the other five were visitors to this country).

The children: 

• Thirteen were too young to have received the vaccination (12 months old or less)
• Fourteen hadn’t been vaccinated yet or “missed the opportunity” (ages 12 months to 5 years)
• Fourteen had parents claiming vaccine “exemptions” because of personal or religious beliefs

The adults:

• Fourteen didn’t know their vaccination status
• Two claimed “exemption” because of personal or religious beliefs
• One had evidence of immunity through birth before 1957
• One had evidence of having received the vaccination

WHAT YOU CAN DO:

• Make sure your immunizations are up to date before you travel, even if you’re just traveling to Europe.
• If you suspect measles, alert the doctor’s waiting room attendants so they can take precautions and prevent others from becoming infected. Here are the signs and symptoms of measles.
• If you’re consciously not immunizing, understand the risks – including those for a disease like the measles that, in essence, has been eradicated from the United States – and protect others from exposure. Beyond your own children, those with compromised immune systems and children under 12 months are also at risk.
• If you haven’t immunized your children because you’ve simply overlooked it, here’s a schedule of immunizations from the CDC, including a catch-up schedule if you’ve fallen behind. The measles vaccine is 99 percent effective, according to the CDC.

A full transcript of a call the CDC conducted with the media yesterday to discuss the situation has been posted online.

[Photo: Centers for Disease Control: reported measles cases January through April 25]