U.S. measles cases in 2019 passed the 1,000 mark on Wednesday, the Department of Health and Human Services announced. There are now 1,001 measles cases in the U.S., the HHS statement said, citing CDC data. This is an increase of 20 cases from the CDC's last official update of 981 confirmed cases in 26 states on Monday, June 3. "The 1,000th case of a preventable disease like measles is a troubling reminder of how important that work is to the public health of the nation," said HHS Secretary Alex Azar in a statement. "The Centers for Disease Control and Prevention, alongside others across HHS, will continue our efforts to support local health departments and healthcare providers in responding to this situation, with the ultimate goal of stopping the outbreak and the spread of misinformation about vaccines, and increasing the public's confidence in vaccines." Peter Hotez, MD, PhD, dean of Baylor’s National School of Tropical Medicine in Houston, expressed his own disappointment in a tweet on Wednesday: “America’s 2019 tragedy, over what? A deliberate misinformation campaign led by a handful of [antivax] bandits who monetize the internet, peddle phony [autism] therapies or books … and run unopposed, except for a few academics who tried to stand up.” It's unclear whether the 2019 outbreak will reach the mark set in 1992, when there were 2,126 cases of measles reported in the U.S., according to historical CDC data. The World Health Organization notes that, in temperate regions, measles cases tend to peak in the winter and early spring, which would suggest that the accumulation of new cases will now fall off from the levels seen earlier this year. Despite these growing numbers, Stephen Morse, PhD, of the Columbia University Mailman School of Public Health in New York City, provided an epidemiologist’s perspective on the current U.S. outbreak. He told MedPage Today that there will be a “limiting factor” to the current outbreak, as most of the U.S. population is immunized. “The number of cases are going up, but the numbers [of new cases per week] are varying a lot,” Morse said. “There will be pockets of unimmunized and susceptible people, but it will flatten out. At some point, we’re going to run out of susceptibles.” Nevertheless, Morse characterized this outbreak as a “remarkable setback” for the U.S. in terms of measles elimination. The HHS statement enumerated several steps the CDC has taken to respond to the current situation, including implementing Incident Management Structure (IMS) within the National Center for Immunization and Respiratory Diseases, reinforced guidelines for the recognition and prevention of measles to healthcare providers, and developing strategies to address vaccine hesitancy. "Measles is an incredibly contagious and dangerous disease," Azar said. "We cannot say this enough: Vaccines are a safe and highly effective public health tool that can prevent this disease and end the current outbreak." Morse reiterated that high rates of vaccination coverage are essential for measles, and that while vaccination rates are declining, “the decline has been slow” and the U.S. is still over the 90% coverage line. “The more transmissible the infection is, the higher number of non-susceptibles that are needed,” he said. The U.S. has yet to see a measles death, and Morse said that hospitalizing sicker children should help keep it that way. But he emphasized the burden on the healthcare system from measles complications, such as children who may develop pneumonia and need intensive care. “The cost of hospitalization and psychological effects on the parents are staggering compared to the cost of the vaccine. [A death] is not out of the question, but I hope not [to have any]” Morse said. Source
