Stanford researcher: U.S. at a ‘tipping point on' measles resurgence
Blood sample positive with Measles virus. (iStock / Getty Images Plus)
A new report from the Centers for Disease Control and Prevention notes that the current measles outbreak marks the second highest annual case count in 25 years, and more than 80% of the nearly 900 current cases are associated with the 'ongoing outbreak in close-knit communities with low vaccination coverage' in New Mexico, Oklahoma and Texas.
Overall, 96% of the cases have been among people confirmed as unvaccinated, or with unknown vaccination records.
As of Tuesday, New Mexico had 66 cases, with no new ones reported yet this week. Most of the state's cases are in Lea County, just across the state line from Gaines County, Texas, where the outbreak began in mid-February.
Measles, one of the most contagious diseases known to science, is a respiratory virus which is spread through contact with droplets from an infected person's speech, coughs or sneezes. Symptoms, such as fever, headache, red eyes, runny nose, and a spotty red rash, can take weeks to develop. People can spread measles days before they show symptoms.
Heath officials say the best prevention from measles infection is two doses of vaccination.
From Feb. 1 to April 25, 20,304 New Mexicans received a dose of the measles vaccine statewide, nearly double the 10,860 people over the same time last year, according to the New Mexico Department of Health. The national vaccination rate has slipped from 90.8% for one dose of measles, mumps and rubella, below the 95% threshold to prevent outbreaks from spreading.
In 2000, after decades of vaccination, the CDC declared measles eliminated in the U.S., but if current vaccination rates continue, or decline further, measles may become commonplace again, according to research co-authored by Dr. Nathan Lo, an infectious diseases physician-scientist at Stanford University.
'It was striking for us, just seeing how much the U.S. was at this tipping point for measles, where small declines in vaccination can put us very certainly on the path for measles returning,' Lo told Source NM in a phone call. 'But also, small increases in vaccines can push us back into safe territory.'
In research published in the academic journal JAMA last week, Lo and other researchers at Stanford used mathematical models to estimate how four serious diseases eliminated by vaccines in the U.S. (measles, rubella, polio and diphtheria) might reemerge based on vaccination rates. The models run thousands of simulations, projecting what the changes look like in the next 25 years.
A 10% decrease in people choosing to vaccinate could spur an estimated 11 million measles cases over 25 years in the U.S.
Even at the current levels of vaccination, measles could reestablish itself in the U.S. with hundreds of thousands of cases over 25 years.
'We're still very likely on the path toward measles return, but it won't happen for sometime,' Lo said, estimating that reemergence is about 20 years away.
The state with the highest risk of measles: Texas. This is in part due to declines in vaccination rates, but also due to its large cities with international travel and demographic features, such as the age of the population.
As for New Mexico, Lo said: 'One of the risks is being next to Texas, I think that's been made clear.'
Prevalent measles infections would mean preventable illness-related deaths, often in children, and long-term injuries such as brain damage, he said.
'There's a number of rare but real neurologic complications that happen from measles; some of which are universally fatal and many of which lead to lifelong-disability,' he said. 'Those are the really unfathomable types of outcomes we hope don't come to pass.'
For the other childhood diseases to reemerge, there would need to be a significant drop in vaccination rates, such as a 30% to 40% decline, he said.
That's unlikely to happen without big policy shifts from the federal government, Lo said, such as changes to the childhood vaccine schedule, reducing potency of vaccines or revoking vaccines' uses.
'Suddenly, those scenarios of vaccine decline suggest that even rubella, polio and their really awful clinical complications such as babies born with birth defects and people living with lifelong paralysis or even dying, becomes much more of a risk,' Lo said.
Lo said he hopes that not just policy makers, but parents and people considering getting a vaccine hear about the research.
'A small fraction of the population can really make a difference here,' he said.
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