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 Press Release 
 
 Embargoed until: Thursday, December 5, 2013 at 12:00 noon ET 
 
 Contact: Media Relations 
 
 (404) 639-3286 
 
 Measles Still Threatens Health Security 
 
 On 50th Anniversary of Measles Vaccine, Spike in Imported Measles Cases 
 
 Fifty years after the approval of an extremely effective vaccine against measles, one of the world’s most contagious diseases, the virus still poses a threat to domestic and global health security. 
 
 On an average day, 430 children – 18 every hour – die of measles worldwide. In 2011, there were an estimated 158,000 measles deaths. 
 
 In an article published on December 5 by JAMA Pediatrics, CDC’s Mark J. Papania, M.D., M.P.H., and colleagues report that United States measles elimination, announced in 2000, has been sustained through 2011. Elimination is defined as absence of continuous disease transmission for greater than 12 months. Dr. Papania and colleagues warn, however, that international importation continues, and that American doctors should suspect measles in children with high fever and rash, “especially when associated with international travel or international visitors,” and should report suspected cases to the local health department. Before the U.S. vaccination program started in 1963, measles was a year-round threat in this country. Nearly every child became infected; each year 450 to 500 people died each year, 48,000 were hospitalized, 7,000 had seizures, and about 1,000 suffered permanent brain damage or deafness. 
 
 People infected abroad continue to spark outbreaks among pockets of unvaccinated people, including infants and young children. It is still a serious illness: 1 in 5 children with measles is hospitalized. Usually there are about 60 cases per year, but 2013 saw a spike in American communities – some 175 cases and counting – virtually all linked to people who brought the infection home after foreign travel. 
 
 “A measles outbreak anywhere is a risk everywhere,” said CDC Director Tom Frieden, M.D., M.P.H. “The steady arrival of measles in the United States is a constant reminder that deadly diseases are testing our health security every day. Someday, it won’t be only measles at the international arrival gate; so, detecting diseases before they arrive is a wise investment in U.S. health security. 
 
 Eliminating measles worldwide has benefits beyond the lives saved each year. Actions taken to stop measles can also help us stop other diseases in their tracks. CDC and its partners are building a global health security infrastructure that can be scaled up to deal with multiple emerging health threats. 
 
 Currently, only 1 in 5 countries can rapidly detect, respond to, or prevent global health threats caused by emerging infections. Improvements overseas, such as strengthening surveillance and lab systems, training disease detectives, and building facilities to investigate disease outbreaks make the world -- and the United States -- more secure. 
 
 “There may be a misconception that infectious diseases are over in the industrialized world. But in fact, infectious diseases continue to be, and will always be, with us. Global health and protecting our country go hand in hand,” Dr. Frieden said. 
 
 Today’s health security threats come from at least five sources: 
 
 The emergence and spread of new microbes 
 
 The globalization of travel and food supply 
 
 The rise of drug-resistant pathogens 
 
 The acceleration of biological science capabilities and the risk that these capabilities may cause the inadvertent or intentional release of pathogens 
 
 Continued concerns about terrorist acquisition, development, and use of biological agents. 
 
 “With patterns of global travel and trade, disease can spread nearly anywhere within 24 hours,” Dr. Frieden said. “That’s why the ability to detect, fight, and prevent these diseases must be developed and strengthened overseas, and not just here in the United States.” 
 
 The threat from measles would be far greater were it not for the vaccine and the man who played a major role in creating it, Samuel L. Katz, M.D., emeritus professor of medicine at Duke University. Today, CDC is honoring Dr. Katz 50 years after his historic achievement. During the ceremony, global leaders in public health are highlighting the domestic importance of global health security, how far we have come in reducing the burden of measles, and the prospects for eliminating the disease worldwide. 
 
 Measles, like smallpox, can be eliminated. However, measles is so contagious that the vast majority of a population must be vaccinated to prevent sustained outbreaks. Major strides already have been made. Since 2001, a global partnership that includes the CDC has vaccinated 1.1 billion children. Over the last decade, these vaccinations averted 10 million deaths – one fifth of all deaths prevented by modern medicine. 
 
 “The challenge is not whether we shall see a world without measles, but when,” Dr. Katz said. 
 
 “No vaccine is the work of a single person, but no single person had more to do with the creation of the measles vaccine than Dr. Katz,” said Alan Hinman, M.D., M.P.H., Director for Programs, Center for Vaccine Equity, Task Force for Global Health. “Although the measles virus had been isolated by others, it was Dr. Katz’s painstaking work passing the virus from one culture to another that finally resulted in a safe form of the virus that could be used as a vaccine.” 
 
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 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ||||| The Centers for Disease Control and Prevention is warning about a rise in the number of measles cases in the USA. 
 
 There have been 175 confirmed cases of measles this year, and 98% have been in unvaccinated patients. (Photo: Joe Raedle, Getty Images) Story Highlights More than 98% of measles patients unvaccinated, CDC says 
 
 Doctors recommend first measles shot at age 1, a second at 4 to 6 
 
 There were nearly 21,000 measles cases in Europe in the first six months of the year 
 
 The USA is experiencing a spike in measles, with 175 confirmed cases and 20 hospitalizations so far this year, according to the Centers for Disease Control and Prevention. 
 
 That's about three times the usual number of cases of measles, CDC Director Thomas Frieden said Thursday. The USA has seen nine outbreaks this year, with the largest in New York, North Carolina and Texas. 
 
 More than 98% of measles patients were unvaccinated, Frieden said. 
 
 "This isn't the failure of a vaccine; it's the failure to vaccinate," Frieden said. 
 
 The USA's overall measles vaccination rate remains high. 
 
 In fact, measles has been officially eliminated throughout the Western Hemisphere. That means that measles, unlike the flu, no longer circulates among the general population. 
 
 The USA has still had about 60 "imported" measles cases a year, however, largely diagnosed in travelers who come from abroad. Those cases mostly haven't spread beyond a couple of people, however, because nearly everyone those travelers encountered was vaccinated. 
 
 The country's safety net has become more porous in recent years, as like-minded parents who refuse vaccines have clustered in the same communities. 
 
 In August, for example, a visitor who had traveled abroad infected 15 people at a Texas megachurch. One of those infected was a 4-month-old baby, too young to have received a first measles shot. 
 
 Doctors recommend that children receive their first measles shot at age 1, followed by a second between 4 to 6 years old. 
 
 Babies traveling abroad, however, can receive a first measles shot at 6 months, Frieden said. 
 
 Many travelers are surprised to learn that some of the most popular destinations have the highest rates of measles, said William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine in Nashville. 
 
 There were nearly 21,000 cases of measles in Europe in just the first six months of the year, according to the World Health Organization. Measles continues to circulate in Europe, Schaffner said, because countries there have much weaker school vaccination requirements than in the USA. 
 
 "This is an eminently controllable, eminently eliminatable childhood viral infection," said Schaffner, who notes that up to 500 Americans a year died of measles before a vaccine was introduced 50 years ago. The fact that measles continues to spread "is an ongoing tragedy." 
 
 Read or Share this story: http://usat.ly/1d1M1hX ||||| Measles may seem like a distant threat in the United States, but the Centers for Disease Control and Prevention are warning the disease still poses a danger to U.S. residents. 
 
 The CDC fears that because measles is so prevalent overseas, people who travel are bringing the virus back to U.S. shores. Almost all of the 175 cases of measles reported thus far in 2013 were linked to people who had contracted the disease after traveling outside the country. 
 
 
 
 “A measles outbreak anywhere is a risk everywhere,” CDC director Dr. Tom Frieden said in a press release. “The steady arrival of measles in the United States is a constant reminder that deadly diseases are testing our health security every day. Someday, it won’t be only measles at the international arrival gate; so, detecting diseases before they arrive is a wise investment in U.S. health security.” 
 
 Measles is a respiratory viral illness that grows in the cells that line the back of the throat or lungs. It can cause a fever, runny nose, cough and a rash all over the body. It can lead to ear infections in 10 percent of cases in kids, and 5 percent will develop pneumonia. 
 
 Other complications include encephalitis and death. About 18 children every hour around the world die due to measles, the CDC reported. There were 158,000 measles deaths across the globe in 2011 alone. 
 
 
 
 A new research paper published in JAMA Pediatrics on Dec. 5 shows that measles was "eliminated" in the U.S. from 2000 through at least through 2011. For a disease to be eliminated, there must be no continuous disease transmission for more than 12 months. 
 
 
 
 However, in 2013, there at least 175 cases and counting -- significantly more than the typical 60 who contract the disease each year. 
 
 The new report was released on the 50th anniversary of the measles vaccine. The CDC also published the latest figures on the global progress against measles in its journal Morbidity and Mortality Weekly Report. 
 
 
 
 Dr. William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine in Nashville, told USA Today that people might be surprised to learn that popular travel destinations in Europe are often where people contract measles. 
 
 The CDC added that doctors should consider a person has contracted measles if they are displaying high fever and rashes “especially when associated with international travel or international visitors,” and report the cases to their local health department. 
 
 
 
 Before the measles vaccination program was started in the U.S. in 1963, almost every child was infected by the disease, the CDC said. About 450 to 500 people died from it each year, 48,000 were hospitalized, 7,000 had seizures, and around 1,000 suffered permanent brain damage or deafness before the vaccine was distributed regularly. 
 
 
 
 About 2.6 million deaths worldwide were attributed to measles until vaccination was available around the globe in the 1980s, the report's authors noted. 
 
 
 
 The CDC has and continues to push for more vaccinations against measles, especially because the virus is so contagious that the majority of people have to receive protection to prevent an outbreak. The CDC has vaccinated 1.1. billion children globally since 2001 against the disease. They estimate they have prevented 10 million deaths, about one-fifth of all the deaths prevented by modern treatments. 
 
 "This is an eminently controllable, eminently eliminatable childhood viral infection," said Schaffner. 
 
 
 
 But, increasing anti-vaccination beliefs may also be behind growing measles rates in the States. A recent CDC study showed that 82 percent of people who had contracted measles as of September 2013 were not vaccinated, and 9 percent were not sure if they had been vaccinated. 
 
 Only one out of five countries have the ability to quickly detect, respond to or prevent global health threats started by infectious diseases, the CDC said. Because people are so mobile, a disease can spread globally in just 24 hours, Frieden pointed out. 
 
 “There may be a misconception that infectious diseases are over in the industrialized world. But in fact, infectious diseases continue to be, and will always be, with us. Global health and protecting our country go hand in hand,” he said. ||||| Importance To verify the elimination of endemic measles, rubella, and congenital rubella syndrome (CRS) from the Western hemisphere, the Pan American Health Organization requested each member country to compile a national elimination report. The United States documented the elimination of endemic measles in 2000 and of endemic rubella and CRS in 2004. In December 2011, the Centers for Disease Control and Prevention convened an external expert panel to review the evidence and determine whether elimination of endemic measles, rubella, and CRS had been sustained. 
 
 Objective To review the evidence for sustained elimination of endemic measles, rubella, and CRS from the United States through 2011. 
 
 Design, Setting, and Participants Review of data for measles from 2001 to 2011 and for rubella and CRS from 2004 to 2011 covering the US resident population and international visitors, including disease epidemiology, importation status of cases, molecular epidemiology, adequacy of surveillance, and population immunity as estimated by national vaccination coverage and serologic surveys. 
 
 Main Outcomes and Measures Annual numbers of measles, rubella, and CRS cases, by importation status, outbreak size, and distribution; proportions of US population seropositive for measles and rubella; and measles-mumps-rubella vaccination coverage levels. 
 
 Results Since 2001, US reported measles incidence has remained below 1 case per 1 000 000 population. Since 2004, rubella incidence has been below 1 case per 10 000 000 population, and CRS incidence has been below 1 case per 5 000 000 births. Eighty-eight percent of measles cases and 54% of rubella cases were internationally imported or epidemiologically or virologically linked to importation. The few cases not linked to importation were insufficient to represent endemic transmission. Molecular epidemiology indicated no endemic genotypes. The US surveillance system is adequate to detect endemic measles or rubella. Seroprevalence and vaccination coverage data indicate high levels of population immunity to measles and rubella. 
 
 Conclusions and Relevance The external expert panel concluded that the elimination of endemic measles, rubella, and CRS from the United States was sustained through 2011. However, international importation continues, and health care providers should suspect measles or rubella in patients with febrile rash illness, especially when associated with international travel or international visitors, and should report suspected cases to the local health department.
– Measles was indeed "eliminated" in the US from 2000 through 2011, per a review of data through that year published in JAMA Pediatrics yesterday. But there's a "but": As CBS News reports, America isn't actually measles-free. Elimination is defined as the "absence of continuous disease transmission for greater than 12 months" (USA Today translates: That means it's not circulating among the general population), but the US still sees about 60 cases a year. This year, however, we've logged at least 175, reports the CDC, and they're almost all tied to people who picked up the infection abroad and brought it home. And according to CDC director Dr. Tom Frieden, all but about 2% of the patients were unvaccinated, reports USA Today. "This isn't the failure of a vaccine; it's the failure to vaccinate," he says. This could end up being the worst year for measles since 1996.