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What is the History of Measles in America and Other Countries?

History of measles in America

Measles outbreaks occur in cycles in the U.S. and globally, usually every two to three years.1,2,3 Prior to 1912, measles was not a reportable disease in the U.S., so accurate numbers of cases are not available prior to that time. In 1941, there were 894,134 cases reported.4  In 1920, the United States had 469,924 recorded cases of measles and 7,575 deaths associated with measles. From 1958 to 1962, the U.S. averaged 503,282 cases and 432 death associated with measles each year.5 

Before measles vaccine was licensed in 1963, the CDC admits there was massive underreporting of measles cases and that “because virtually all children acquired measles, the number of measles cases probably approached 3.5 million per year (.i.e., an entire birth cohort).”,6,7 Other doctors say it was more like 5 million cases of measles occurring every year. 22 In 1960, three years before the first measles vaccine was put on the market in the U.S., there were about 442,000 reported measles cases and 380 related deaths,8,9 among 3.5 to 5 million Americans.

There was a huge resurgence of measles in the U.S. between 1989 and 1991, when reported measles cases increased 6- to 9-fold over a previous period studied between 1985 and 1988. During the1989-91 time period, more than 53,000 cases occurred in 815 separate outbreaks.10 Also during that time period, 120 deaths were attributed to measles in the U.S.11

In an eight-year period between 1993 and 2001, there were 1804 cases of measles reported in 120 outbreaks. After only 15 measles cases were reported between 1999 and 2001 and with more than 90 percent of school children having received two doses of MMR vaccine, public health officials declared that measles was no longer endemic in the United States in 2000.12,13

In the years 2000-2007, the U.S. recorded an average of 63 cases of measles a year before an increase in measles cases was reported beginning in 2008.14

Increases in reported measles cases in the U.S. can be observed by looking at the CDC’s Notifiable Diseases and Mortality Tables:15

  • In 2007 there were 43 cases
  • In 2008 there were 140 cases
  • In 2009 there were 71 cases
  • In 2010 there were 63 cases
  • In 2011 there were 220 cases
  • In 2012 there were 55 cases
  • In 2013 there were 187 cases
  • In 2014 there were 634 cases
  • In 2015 through January 28 there were 68 cases

According to the CDC, most cases of measles in 2011 were among, or linked to, travelers returning from, or visiting, other countries, including those in Europe and Southeast Asia.16 In April 2014, the CDC stated there had been 58 confirmed cases of measles reported in the U.S. during the first few months of 2014 and many were associated with a genotype of measles prevalent in a large outbreak in the Phillippines.17 By the end of 2014, 644 measles cases spanning 27 states had been reported in the U.S.18

In mid-January 2015, the California state health department and CDC officials began reporting a “measles outbreak” they said could be traced back to a visitor who was at Disneyland in Orange County, California between Dec. 17 to Dec. 20, 2014. In a Jan. 23, 2015 Health Advisory, the CDC stated “no source case of the outbreak has been identified.”19

Out of 52 confirmed measles cases reported in 7 states, including California, the CDC said that 51 were epidemiologically linked to visitors or contacts of visitors to the popular Disneyland entertainment park. Of the 52 measles cases identified by Jan. 21, 2015 in people aged from 10 months to 57 years, eight (15%) were hospitalized; 28 (55%) were unvaccinated; 6 (12%) were vaccinated and four had received two or more MMR shots; 5 (9%) were too young to receive MMR vaccine and 17 (33%) had an unknown vaccination status.20

On Jan. 30, 2015, the CDC updated their webpage on measles outbreaks in the U.S. and reported that 84 cases of measles had been reported in 14 states, with 64% (or 53) of the measles cases linked to the Disneyland outbreak.21

Public health officials estimate that every year in countries around the world there are about 20 million cases of measles.22

The CDC attributes the drop in reported measles cases and deaths in the U.S. to use of the measles vaccine beginning in the mid-1960’s23 But, published measles morbidity and mortality data give evidence that death rates for measles had dropped significantly in the U.S. before the measles vaccine was introduced in 1963.24,25

“Modified” measles can also occur in persons with some degree of immunity, as well as in previously vaccinated persons, who get a milder form of measles. “Atypical” measles can occur in a person, who was previously vaccinated with a killed-virus vaccine used from 1963 to 1967, and who is exposed to wild-type measles. The course of atypical measles is generally longer than natural measles.26

IMPORTANT NOTE: NVIC encourages you to become fully informed about Measles and the Measles vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

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References

1 Kasper D, Fauci A, Longo D, et al. Measles. Harrison’s Principles of Internal Medicine 16th Edition. 2005.

2 Bjornstad ON, Finkenstadt BF, Grenfell BT. Dynamics of Measles Epidemics: Estimating Scaling of Transmission Rates Using a Time Series SIR Model. Ecological Monographs. 72(2), 2002. Pp 169-184.    

3 CDC.gov. Vaccines. Measles. The Pink Book. No date.

4 Grabenstein JD. ImmunoFacts: Vaccines and Immunologic Drugs 2011. Wolters & Kluwer. p 293.  

5 National Institutes of Health. Emerging & Re-emerging Infectious Disease—Student Activities 5—Making Hard Decisions Measles. No date.  

6 National Institutes of Health. Emerging & Re-emerging Infectious Disease—Student Activities 5—Making Hard Decisions Measles. No date.  

7 CDC.gov. Measles, Mumps, and Rubella—Vaccine Use and Strategies for Elimination  of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. May 22, 1997/ 47(RR-8);1-57. 

8 Wood DJ, Brunell PA. Measles Control in the United States: Problems of the Past and Challenges for the Future. Clin Microbiol Rev 1995; 8(2): 260-267.

9 CDC.gov. Summary of Notifiable Diseases, United States, 1993. MMWR Oct. 21, 1994; 42(53): 1-73.

10 National Center for Health Statistics. U.S. Vital Statistics Mortality Data. National Vital Statistics System.

11 Hutchins S, Markowitz L, Atkinson W, et al. Measles Outbreaks in the United States, 1987 through 1990. Pediatr Infect Dis J 1996; 15:31-38

12 National Institutes of Health. Emerging & Re-emerging Infectious Disease—Student Activities 5—Making Hard Decisions Measles.

13 Yip FY, Papania MJ, Redd SB. Measles Outbreak Epidemiology in the United States, 1993-2001. J Infect Dis May 1, 2004; 189 Suppl 1:S54-60.

14 Cherry JD, Harriman KH. Why Do Vaccine-Preventable Disease Outbreaks Occur in the U.S.?. Measles. Medscape 2012.

15 CDC.gov. Update: Measles—United States, January-July 2008. MMWR. Aug. 22, 2008; 57(33);893-896.

16 CDC.gov. MMWR. Notifiable Diseases and Mortality Tables. Jan. 23, 2015.

17 CDC.gov. Measles Cases and Outbreaks. Jan. 30, 2015.

18 CDC. Notes from the Field: Measles, California, January 1 – April 18, 2014. MMWR April 25, 2014; 63(16): 362-363.

19 CDC.gov. Measles Cases and Outbreaks. Jan. 30, 2015.

20 CDC.gov. CDC Health Advisory: U.S. Multi-state Measles Outbreak. December 2014 – January 2015. Jan. 23, 2015.

21 CDC.gov. CDC Health Advisory: U.S. Multi-state Measles Outbreak. December 2014 – January 2015. Jan. 23, 2015.

22 CDC.gov. Measles Cases and Outbreaks. Jan. 30, 2015.

23 CDC. Measles – United States, January 1 – May 23, 2014. MMWR June 6, 2014; 63(22): 496-499.

24 CDC.gov. Measles, Mumps, and Rubella—Vaccine Use and Strategies for Elimination  of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. May 22, 1997/ 47(RR-8);1-57.

25 Grove RD, Hetzel AM. Vital Statistics Rates in the United States 1940-1960. U.S. U.S. Public Health Service National Center for Health Statistics 1968.

26McKinlay JB, McKinlay SM. The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century. Health and Society. MMFQ. Summer 1977. P 421.

27 Sabella C. Measles: Not Just a Childhood Rash. Cleveland Clinic Journal of Medicine. March 2010. Vol. 77 3 207-213.


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