The outbreaks reflect worldwide misinformation that has helped drive down child immunizations.
The number of people sickened by measles in the first three months of this year is more than for all of 2018 — and the second-highest number reported since U.S. health officials declared the highly contagious and sometimes deadly disease "eliminated" in 2000.
The outbreaks — and the increasingly aggressive public health response to them — have also prompted a spike in activity among anti-vaccine activists. Across the nation and around the world, a global movement that spreads misinformation about vaccines has helped drive down child immunizations, lowering the community immunity that is critical for protection against one of the world's most contagious diseases.
After Rockland County, N.Y., banned unvaccinated children from all public spaces last week as it battles a growing measles outbreak that originated in the Orthodox Jewish community, anti-vaccination activists likened the public health measures to the Nazi persecution of Jews that included forcing them to wear yellow stars.
Texas has one of the most organized and politically active anti-vaccine groups. Texans for Vaccine Choice, which organized the rally last week, receives support from tea party Republicans and some of the state's most influential conservative organizations, state lawmakers have said.
The rise in measles cases was both predicted and predictable, Hotez said. In a study last year, he and colleagues from several Texas academic centers identified pockets of vulnerability where the risk of measles and other vaccine-preventable childhood diseases are higher because parents hesitate or refuse to get their children immunized.
Of 15 counties with the most nonmedical vaccine exemptions across the country, about half are now reporting measles outbreaks, including communities in Washington, Texas and Michigan, he said.
The researchers characterized many of these areas as "hot spots" because their high exemption rates put them at risk for epidemics, not just of measles but also of other vaccine-preventable pediatric infectious diseases such as whooping cough.
The growing measles counts come as state legislatures weigh measures to tighten vaccine requirements. In Washington state, where the worst measles outbreak in more than two decades has sickened 74 people and cost over $1 million, the legislature is deciding whether to eliminate personal or philosophical exemptions that allow parents to avoid immunizing their children against measles, mumps and rubella. In Maine, a measure to eliminate nonmedical exemptions for all communicable diseases is also pending.
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