A Comparison of Post-elimination Measles Epidemiology in the United States, 2009−2014 versus 2001−2008

Details

• Alternative Title:
  J Pediatric Infect Dis Soc
• Personal Author:
  Fiebelkorn, Amy Parker ; Redd, Susan B. ; Gastañaduy, Paul A. ; Clemmons, Nakia ; Rota, Paul A. ; Rota, Jennifer S. ; Bellini, William J. ; Wallace, Gregory S.
• Description:
  Background
  
  Measles, a vaccine-preventable disease that can cause severe complications, was declared eliminated from the U.S. in 2000. The last published summary of U.S. measles epidemiology was during 2001−2008. We summarized U.S. measles epidemiology during 2009−2014.
  
  Methods
  
  We compared demographic, vaccination, and virologic data on confirmed measles cases reported to the Centers for Disease Control and Prevention during 1/1/2009—12/31/2014 and 1/1/2001—12/31/2008.
  
  Results
  
  During 2009−2014, 1264 confirmed measles cases were reported in the U.S., including 275 importations from 58 countries and 66 outbreaks. The annual median number of cases and outbreaks during this period was 130 (range: 55–667 cases) and 10 (range: 4–23 outbreaks), respectively, compared with an annual median of 56 cases (p=0.08) and 4 outbreaks during 2001−2008 (p=0.04). Among U.S.-resident case-patients during 2009−2014, children aged 12–15 months had the highest measles incidence (65 cases; 8.3 cases/million person-years), and infants aged 6–11 months had the second highest incidence (86 cases; 7.3 cases/million person-years). During 2009−2014, 865 (74%) of 1173 U.S.-resident case-patients were unvaccinated and 188 (16%) had unknown vaccination status; of 917 vaccine-eligible U.S.-resident case-patients, 600 (65%) were reported as having philosophical or religious objections to vaccination.
  
  Conclusions
  
  Although the U.S. has maintained measles elimination since 2000, measles outbreaks continue to occur globally resulting in imported cases and potential spread. The annual median number of cases and outbreaks more than doubled during 2009−2014 compared to the earlier post-elimination years. To maintain elimination, it will be necessary to maintain high two-dose vaccination coverage, continue case-based surveillance, and monitor the patterns and rates of vaccine exemption.
  
  
• Subjects:
  Age Factors Cross-Sectional Studies Disease Eradication Disease Outbreaks Female Humans Immunization Programs Immunization Schedule Incidence Infant Male Measles Measles Vaccine Population Surveillance Vaccination Coverage

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• Source:
  J Pediatric Infect Dis Soc. 6(1):40-48.
• Pubmed ID:
  26666559
• Pubmed Central ID:
  PMC4905815
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Volume:
  6
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c8d3e059bffb61bb88c642afe954aa3401603225f926c772d0aa6d4957ce1dd5
• Download URL:
  https://stacks.cdc.gov/view/cdc/39933/cdc_39933_DS1.pdf
• File Type:
  [PDF - 1.40 MB ]