The number of measles cases in the United States continues to rise, fueled by large numbers of unvaccinated people.

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Measles outbreaks have popped up across the United States. Getty Images.

As of last week, 228 U.S. measles cases were confirmed this year, according to the Centers for Disease Control and Prevention (CDC).

So far, 12 states have reported cases: California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington.

The latest weekly update includes measles cases reported to the CDC by state health departments through March 7.

This means that this year’s total is inching closer to the entire number of 2017 measles cases: 372. But that number is for the entire year and we’re only hitting mid-March.

At this speed, it’s possible the number of measles cases this year could rival or even surpass the 667 cases seen in 2014 — currently the worst year in a decade.

Whether or not this year sets a new record for measles cases depends on two factors:

  • How many travelers bring new cases into the United States.
  • How many unvaccinated people in the country are exposed to someone with measles.

Dr. Len Horovitz, an internist and pulmonary specialist at Lenox Hill Hospital in New York City, said, “I think we’re going to see a continuing upward trend, unless there’s a bigger push for people to be vaccinated.”

Measles is highly contagious and infected people can spread measles to others even before symptoms appear.

People can be infectious up to four days before and four days after the tell-tale measles rash appears.

The measles vaccine, which is given as part of the measles, mumps, rubella (MMR) vaccine, is the best protection against measles. It is highly effective at preventing measles — 93 percent for one dose and 97 percent for two doses.

The CDC recommends that children receive the first dose of the MMR vaccine at 12 to 15 months of age, and the second dose at ages 4 to 6.

In 2017, just over 91 percent of children ages 19 to 35 months received at least one dose of the MMR vaccine, according to CDC data.

But vaccination rates vary from state to state — from a low of 85.8 percent in Missouri to a high of 98.3 percent in Massachusetts.

It’s in areas with a high number of unvaccinated people that measles has taken off.

In Washington state, only 88.5 percent of eligible children were vaccinated against measles in 2017, according to the CDC.

The state has an ongoing measles outbreak with 75 cases so far this year (4 cases in Oregon are linked to this outbreak).

In New York City, most of the 158 cases in Brooklyn and Queens have involved unvaccinated members of the Orthodox Jewish community.

This outbreak began when an unvaccinated child became infected while visiting Israel, where a large outbreak of measles is occurring.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on the Diane Rehm show last month that even a slight drop in immunization rates — down to 90 or 85 percent — can mean a significant loss in herd immunity protection, and that if someone from abroad brings in measles it can lead to an outbreak.

“Well the outbreaks are absolutely directly related to the lack of vaccination among a certain percentage of the population,” Fauci said of the ongoing outbreaks in Washington and New York.

Fauci pointed out that since measles remains a problem globally, if a traveler visits an area with unvaccinated people or if an unvaccinated person goes abroad, they can bring the disease back to the United States.

“Those in the community who are not vaccinated, namely the children of parents who are anti-vaxxers — those [are the] ones that are vulnerable,” said Fauci.

The CDC reports that 82 people brought measles to the United States from other countries in 2018.

According to the World Health Organization, measles is still common in many developing countries.

But even developed countries like the United States continue to see cases. Japan has had at least 221 cases this year. Europe had 881 cases in 19 countries as of January of this year.

Part of the rise in measles cases around the world is due to people refusing vaccination because of concerns about the safety of vaccines or doubts about how well they work.

One study found that in the Philippines, confidence in the effectiveness of vaccines dropped from 82 percent in 2015 to 21 percent in 2018.

The WHO reports that the Philippines has seen 12,700 measles cases since the beginning of this year, with at least 203 deaths.

But even the United States isn’t immune to the rise in resistance to being vaccinated.

The Pacific Northwest is a stronghold for the anti-vaccination movement — and also a “hotspot” for measles.

Part of this is fueled by misinformation about vaccines spread on social media and anti-vaxxing websites, and by certain celebrities.

Horovitz pointed out that serious reactions to the measles vaccine are “extremely rare.”

But complications of measles are more common, especially among children. These include:

  • pneumonia
  • swelling of the brain
  • death

“There is no autism risk of the MMR vaccine,” he added. This is backed up by several studies, including one published this month.

Given that, he said the best way to protect yourself is to get vaccinated.

“It’s not worth taking the risk that you’re going to get a rare complication,” said Horovitz, “when you are more likely to get measles, especially if you have any contact with people who have measles.”