CDC issues alert as measles cases pop up in Georgia and other states

The Centers for Disease Control and Prevention is urging clinicians to be alert for measles cases after 23 cases of the extremely contagious disease were recently confirmed in the U.S., including two in Georgia.

Most people in Georgia and the rest of the U.S. are vaccinated for measles but the rate has been slipping since the pandemic began. The rising number of unvaccinated Americans is making the country more vulnerable to the disease, which was declared eliminated in the U.S. in 2000, according to the CDC.

In Georgia, an estimated 88% of young children have received at least one dose of the recommended "MMR" vaccination for measles, mumps and rubella, according to the American Academy of Pediatrics. That coverage rate is down from 94% in 2019. The CDC estimates 91% of young children in the U.S. have gotten at least one dose of the vaccine.

Back in 2019, 3% of kindergartners had an exemption in Georgia from at least one vaccine, which was the same overall percentage for the U.S. During the 2021-222 year, exemptions rose to 5%, falling to 4% during the 2022-2023 year, the most recent school year available. The national rate was 3%.

Measles is so contagious that herd immunity against measles requires about 95% of the population to be vaccinated. At that level of immunity, the whole community is protected—not just those who are vaccinated or immune.

Dr. Joanna Dolgoff, a Paulding County pediatrician said she is not seeing much pushback to the MMR vaccine. Parents are generally as open to this vaccine as for other routine childhood vaccines, such as a vaccine for polio.

Dolgoff said she takes the time to reassure parents who may be reluctant that there have been multiple studies on the MMR vaccine's safety and effectiveness. Studies have shown it does not lead to an increased risk for autism, as some have charged in the past.

After the conversation, "Most parents are open to the vaccine at that time," she said.

Even so, vaccination rates for the MMR vaccine falling below 90% is "very concerning," she said.

"This can lead to a reemergence of diseases such as what we are seeing with measles," she said.

The CDC said the agency has been notified of 23 confirmed cases since Dec. 1 through last week, and most of the cases were among children who had not been vaccinated. A state-by-state breakdown is not available but the Georgia Department of Public Health has confirmed two cases in a metro Atlanta family.

Two weeks ago, DPH announced the first confirmed case of measles in an unvaccinated person who was exposed while traveling out of the country. DPH worked to identify anyone who may have had contact with the person while he or she was infectious. DPH then confirmed a second case in the same family.

There are no additional exposures related to this second case because the person was quarantining at home with the other family member with measles, according to DPH spokeswoman Nancy Nydam.

Measles symptoms typically appear seven to 14 days after being infected but it can take as long as 21 days. It is possible but not likely that there could be additional cases related to the first confirmed measles case, Nydam said.

These are the first measles cases in the state since 2020.

Since 2020, there have been anywhere between 13 and 121 measles cases in the U.S., according to the CDC. But in 2019, the U.S. saw nearly 1,300 measles cases across 31 states, making the highest number since 1992 and a record since being considered eliminated in the country. The 2019 outbreak in the U.S. included 11 cases in Cobb county which was contained.

According to the CDC, most measles cases in the U.S. occur when unvaccinated or partially vaccinated Americans travel internationally, contract the disease, and then spread it to those who are unvaccinated upon their return.

Due to the recent cases, the CDC said health care providers should be on alert for symptoms of measles which include a rash among patients who have recently traveled abroad, especially to countries with ongoing measles outbreaks which include Yemen, India and Ethiopia. Health officials in England have also recently warned about an outbreak of measles there.

The first symptoms of the virus typically include high fever, cough, runny nose, and watery eyes. Then a rash of tiny, red spots breaks out. It starts at the head and spreads to the rest of the body.

Measles can cause serious health complications, such as pneumonia and brain inflammation, especially in children younger than five years of age, according to the CDC. About one in every five people in the U.S. will be hospitalized. One to three of every 1,000 people with measles will die even with medical care, according to the CDC.

The CDC also recommends patients with suspected measles cases be isolated from other patients and be tested to confirm the case of measles. Other recommended steps include making sure patients are up-to-date on measles vaccines, especially before international travel.

Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected, according to the CDC. Measles spreads through the air when an infected person coughs or sneezes. The virus can stay in the air or on surfaces for up to two hours after an infected person has left the room.

Infected people can spread measles to others from four days before through four days after the rash appears, according to the Centers for Disease Control and Prevention.

However, the vaccine is very effective in preventing a measles infection. About 95% of the people who receive a single dose of MMR will develop immunity to all three viruses. A second dose boosts immunity, typically enhancing protection to 98%.

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