U.S. loses measles elimination status, according to reports, as Pa. battles largest outbreak in 3 decades

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The United States has lost its global measles elimination status, according to multiple news outlets, as Pennsylvania continues to tackle one of the nation’s largest measles outbreaks of the past three decades.

Citing officials close to the decision making process, outlets such as The Washington Post and The Wall Street Journal wrote that the Pan America Health Organization, a branch of the World Health Organization, has revoked the country’s measles elimination status, which it achieved in 2000 after mass vaccination campaigns.

The decision comes as Pennsylvania has seen more than 1,500 residents infected with the highly contagious measles virus so far this year, with nearly all cases occurring in unvaccinated adults and children, according to state data. State officials have reported seven measles-related deaths, including two infants, as of Nov. 13.

“I think measles is endemic in this country,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “I think it has gained a foothold. I think we’re going to be seeing measles again, not only this year, but next year and the year after and until we get on top of this with vaccination,” he said.

In Pennsylvania, many infections are linked to an outbreak that began in Lancaster County in April. In total, 46 of the state’s 67 counties have reported measles cases this year.

Public health teams across the state have ramped up vaccination efforts by offering the combination measles, mumps and rubella shots at people’s homes, community pop-up clinics and inside recreational vehicles.

Meanwhile, doctors, nurses, community health workers, epidemiologists, virologists and others have been working nonstop to test symptomatic people, perform contact tracing, treat hospitalized residents, increase public awareness of measles symptoms and investigate deaths, said Lisa McHugh, state epidemiologist at the Pennsylvania Department of Health.

“The investments that we have made in this measles response will ultimately help us in the future,” she said. “But that is part of the challenge, that public health has been underfunded for many, many years. And we need to maintain this strong public health workforce to be able to continue to contain measles as we move forward.”

Eliminating measles in the U.S. and the lost ‘memory’ of disease

Measles vaccines first became available in the U.S. in 1963. Since then, the vaccine has been modified, improved and combined with vaccines for the mumps and rubella viruses to form today’s MMR vaccine.

By 2000, U.S. cases of measles dropped dramatically, and the few cases reported nationally each year were mostly related to international travel and isolated incidents.

“This was the most, is the most, contagious infectious disease of humans, and we eliminated it. Amazing,” Offit said during a recent panel hosted by the Association of Health Care Journalists.

But the elimination of the disease had unintended consequences, Offit said.

“We largely eliminated the memory of measles,” he said. “I think people don’t remember how sick or dead that virus can make you.”

Because of that, some adults who grew up in recent decades never got vaccinated, he said.

“What you’re seeing now are people in their 20s, 30s and 40s who grew up at a time when this virus wasn’t circulating,” Offit said. “So, they’re not naturally infected. They’ve also, for whatever reason, not been vaccinated. So, you now have a fairly large population of susceptible adults.”