The True Cost of Measles Outbreaks During the Postelimination Era
A large measles outbreak in Washington State has prompted officials to declare a state of emergency. As of March 4, 2019, the Washington State Health Department reported 71 confirmed cases, with the majority of cases among individuals who were not vaccinated or who had an unverified vaccination status. The outbreak is centered in a geographic cluster of persistently high vaccine exemption rates among young children. This cluster has persisted despite the overall reduction in vaccine exemptions in the state of Washington, subsequent to the introduction of legally mandated health care practitioner counseling of parents seeking vaccine exemptions.
During the past 5 years, a series of similar measles outbreaks have occurred across the United States. In 2014, a large outbreak of 383 cases, occurring primarily among unvaccinated Amish communities in Ohio, was associated with a large measles outbreak in the Philippines. In 2014-2015, a large measles outbreak first reported at Disneyland in California resulted in 147 cases of measles. In 2017, a 75-case outbreak was reported in Minnesota in a Somali-American community with poor vaccination coverage. This community was the focus of some antivaccination advocates…
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