First Posted: 5/24/2012

In 2000, the United Statess achieved measles elimination. So that’s the end of it, right? Nope, not so fast. Last year there were 222 measles cases in the country. How can that be if it had been eliminated?

The long and short of it is importation (no, not payback for NAFTA). That is, unvaccinated individuals are exposed to measles outside the country. For example, France, Italy, Romania, Spain and Germany make up 90 percent of the cases identified in Europe. So unvaccinated or under vaccinated individuals who contacted residents of these areas stand at risk.

Measles is clinically defined by a generalized rash lasting three or more days, a temperature of 101 degrees or greater, a cough, coryza (inflamed nasal membranes) or conjunctivitis. It can also be confirmed by laboratory results. The elimination efforts have been maintained by the high population immunity via the MMR vaccination. Coverage for one dose is greater than 90 percent for children 19 to 35 months, which assists in the “herd Immunity” theory. Generally MMR is recommended for all children 12 to 15 months old, with a second dose at age 4 to 6. Unvaccinated adults should receive one dose.

People should be reminded that if they plan to travel internationally that there is an increased risk of measles during bus, train or air travel and at large international events, such as the Summer Olympics. If traveling, children 6 months or older should get one dose while children 12 months or greater should get two doses separated by 28 days.

For 2011, the median measles patient age was 14, with a range from 3 months to 84 years old. Nearly 40 percent were over age 20. The greatest reason for not being vaccinated was philosophic, religious or personal objection, which places those individuals at a much higher risk. Thirty-six percent of the people with measles acquired it overseas; the rest acquired it from them.

So the message is: Seek medical attention if the above symptoms appear; ensure children receive routine immunizations on schedule; unvaccinated adults need to be vaccinated; and, if going overseas, get prepared properly. But remember, the vast majority got the disease without having to travel anywhere — it was brought to them.