page_title: Epidemiology of measles
section_title: United States
hierarchical_section_title: Epidemiology of measles / Americas / United States
caption_attribution_description: English: measles cases in the USA between 1938 and 2019 1938-1943: https://www.census.gov/library/publications/1945/compendia/statab/66ed.html Part 2 page 89; 1944-1993: https://www.cdc.gov/mmwr/preview/index93.html MMVR October 21, 1994 / Vol. 42 / No. 53 page 67-72; https://www.cdc.gov/mmwr/preview/mmwrhtml/00035381.htm 1950-2016: CDC (file); 2017: https://wonder.cdc.gov/nndss/nndss_annual_tables_menu.asp?mmwr_year=2017; 2018: https://stacks.cdc.gov/view/cdc/82383 2010-2019: https://www.cdc.gov/measles/cases-outbreaks.html coverage rate: https://www.cdc.gov/vaccines/pubs/pinkbook/appendix/appdx-e.html
context_page_description: Measles is extremely contagious, but surviving the infection results in lifelong immunity, so its continued circulation in a community depends on the generation of susceptible hosts by birth of children. In communities which generate insufficient new hosts the disease will die out. This concept was first recognized by Bartlett in 1957, who referred to the minimum number supporting measles as the critical community size. Analysis of outbreaks in island communities suggested that the CCS for measles is c. 250,000.
context_section_description: Indigenous measles has been declared eliminated in North, Central, and South America; the last endemic case in the region was reported on November 12, 2002. Though measles is considered “eliminated,” outbreaks are still occurring following importations of measles viruses from other world regions. In June 2006, an outbreak in Boston resulted after a resident became infected in India, and in October 2007, a Michigan girl who had been vaccinated contracted the disease overseas. 
  In 1991 in the Philadelphia region, thousands of children were sick with measles. The center of this outbreak was traced to the Faith Tabernacle Congregation, a Faith Healing church that actively discouraged parishioners from vaccinating their children. A judge issued a Court Order to forcibly treat children whose parents refused to seek medical care, and nine children were forcibly vaccinated. Nine children eventually died as a result of this outbreak.
  Between January 1 and April 25, 2008, a total of 64 confirmed measles cases were preliminarily reported in the United States to the Centers for Disease Control and Prevention, the most reported by this date since 2001, and the highest total number in six years. Of the 64 cases, 54 were associated with importation of measles from other countries into the United States, and 63 of the 64 patients were unvaccinated or had unknown or undocumented vaccination status. By July 9, 2008, a total of 127 cases were reported in 15 states, making it the largest US outbreak since 1997 (when 138 cases were reported).  Most of the cases were acquired outside of the United States and afflicted individuals who had not been vaccinated.
  In early 2008 there was an outbreak of measles in San Diego, California. The outbreak is traced to an unvaccinated 7-year-old child who went on a family trip to Europe.  The CDC refers to this as an "import-associated outbreak". The final diagnosis included 11 additional cases of measles in unvaccinated children in San Diego.  All of the confirmed patients were not vaccinated because they were younger than 1, the minimum age for measles inoculation, or because their parents declined to have them vaccinated.  The typical vaccine would be the MMR vaccine. The incident drew attention to the controversy over MMR vaccination.  This was San Diego County's first measles outbreak since 1991.
  In February 2008 there was an outbreak of measles in Pima County, Arizona.  There were 13 laboratory confirmed and 4 probable measles cases, though 22 cases were previously reported.  The outbreak started with a visitor from Switzerland and resulted in a public health emergency declaration by Pima County. The last confirmed Pima County case occurred in 1994, and the last outbreak occurred in 1991.
  By July 9, 2008, a total of 127 cases were reported in 15 states (including 22 in Arizona), making it the largest U.S. outbreak since 1997 (when 138 cases were reported).  Most of the cases were acquired outside of the United States and afflicted individuals who had not been vaccinated. By July 30, 2008, the number of cases had grown to 131. Of these, about half involved children whose parents rejected vaccination. The 131 cases occurred in seven different outbreaks. There were no deaths, and 15 hospitalizations. Eleven of the cases had received at least one dose of measles vaccine.  Children who were unvaccinated or whose vaccination status was unknown accounted for 122 cases. Some of these were under the age when vaccination is recommended, but in 63 cases, the vaccinations had been refused for religious or philosophical reasons.
  On May 24, 2011, the Centers for Disease Control and Prevention reported that the United States has had 118 measles cases so far this year. The 118 cases were reported by 23 states and New York City between Jan 1 and May 20. Of the 118 cases, 105 (89%) were associated with cases abroad and 105 (89%) of the 118 patients had not been vaccinated.
  In 2013, at least 20 members of the Eagle Mountain International Church in North Texas were diagnosed with measles after a few members of the congr
caption: Measles US 1938-2019, showing the effect of vaccination
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