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Measles Are On The Rise: Vaccines Are Encouraged
Submitted by Becky Johnson, BSN-RN
Administrator/SEK Local Health Officer
Increase in Global and Domestic Measles Cases and Outbreaks: Ensure Children in the United States and Those Traveling Internationally 6 Months and Older are Current on MMR Vaccination
Distributed via the CDC Health Alert Network
March 18, 2024, 12:30 PM ET
CDCHAN-00504
Summary
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform clinicians and public health officials of an increase in global and U.S. measles cases and to provide guidance on measles prevention for all international travelers aged ≥6 months and all children aged ≥12 months who do not plan to travel internationally. Measles (rubeola) is highly contagious; one person infected with measles can infect 9 out of 10 unvaccinated individuals with whom they come in close contact. From January 1 to March 14, 2024, CDC has been notified of 58 confirmed U.S. cases of measles across 17 jurisdictions, including seven outbreaks in seven jurisdictions compared to 58 total cases and four outbreaks reported the entire year in 2023. Among the 58 cases reported in 2024, 54 (93%) were linked to international travel. Most cases reported in 2024 have been among children aged 12 months and older who had not received measles-mumps-rubella (MMR) vaccine. Many countries, including travel destinations such as Austria, the Philippines, Romania, and the United Kingdom, are experiencing measles outbreaks. To prevent measles infection and reduce the risk of community transmission from importation, all U.S. residents traveling internationally, regardless of destination, should be current on their MMR vaccinations. Healthcare providers should ensure children are current on routine immunizations, including MMR. Given currently high population immunity against measles in most U.S. communities, the risk of widescale spread is low. However, pockets of low coverage leave some communities at higher risk for outbreaks.
Background
Measles is a highly contagious viral illness and can cause severe health complications, including pneumonia, encephalitis (inflammation of the brain), and death, especially in unvaccinated persons. Measles typically begins with a prodrome of fever, cough, coryza (runny nose), and conjunctivitis (pink eye), lasting 2 to 4 days before rash onset. The incubation period for measles from exposure to fever is usually about 10 days (range 7 to 12 days), while rash onset is typically visible around 14 days (range 7 to 21 days) after initial exposure. The virus is transmitted through direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes, and can remain infectious in the air and on surfaces for up to 2 hours after an infected person leaves an area. Individuals infected with measles are contagious from 4 days before the rash starts through 4 days afterward.
Declines in measles vaccination rates globally have increased the risk of measles outbreaks worldwide, including in the United States. Measles cases continue to be brought into the United States by travelers who are infected while in other countries. As a result, domestic measles outbreaks have been reported in most years, even following the declaration of U.S. measles elimination in 2000. Most importations come from unvaccinated U.S. residents.
Measles is almost entirely preventable through vaccination. MMR vaccines are safe and highly effective, with two doses being 97% effective against measles (one dose is 93% effective). When more than 95% of people in a community are vaccinated (coverage >95%) most people are protected through community immunity (herd immunity). However, vaccination coverage among U.S. kindergartners has decreased from 95.2% during the 2019–2020 school year to 93.1% in the 2022–2023 school year, leaving approximately 250,000 kindergartners susceptible to measles each year over the last three years. Thirty-six states plus the District of Columbia (DC) had less than 95% MMR coverage among kindergartners during the 2022–2023 school year. Of states with less than 95% MMR coverage, ten reported more than 5% of kindergartners had medical and nonmedical exemptions, highlighting the importance of targeted efforts at increasing vaccine confidence and access.
Recommendations for Healthcare Providers
- Schools, early childhood education providers, and healthcare providers should work to ensure students are current with MMR vaccine.
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- Children who are not traveling internationally should receive their first dose of MMR at age 12 to 15 months and their second dose at 4 to 6 years.
- All U.S. residents older than age 6 months without evidence of immunity who are planning to travel internationally should receive MMR vaccine prior to departure.
- Infants aged 6 through 11 months should receive one dose of MMR vaccine before departure. Infants who receive a dose of MMR vaccine before their first birthday should receive two more doses of MMR vaccine, the first of which should be administered when the child is age 12 through 15 months and the second at least 28 days later.
- Children aged 12 months or older should receive two doses of MMR vaccine, separated by at least 28 days.
- Teenagers and adults without evidence of measles immunity should receive two doses of MMR vaccine separated by at least 28 days.
- At least one of the following is considered evidence of measles immunity for international travelers: 1) birth before 1957, 2) documented administration of two doses of live measles virus vaccine (MMR, MMRV, or other measles-containing vaccine), or 3) laboratory (serologic) proof of immunity or laboratory confirmation of disease.
- Consider measles as a diagnosis in anyone with fever (≥101°F or 38.3°C) and a generalized maculopapular rash with cough, coryza, or conjunctivitis who has recently been abroad, especially in countries with ongoing outbreaks. When considering measles, then:
- Isolate: Do not allow patients with suspected measles to remain in the waiting room or other common areas of a healthcare facility; isolate patients with suspected measles immediately, ideally in a single-patient airborne infection isolation room (AIIR) if available, or in a private room with a closed door until an AIIR is available. Healthcare providers should be adequately protected against measles and should adhere to standard and airborne precautions when evaluating suspect cases, regardless of their vaccination status. Healthcare providers without evidence of immunity should be excluded from work from day 5 after the first exposure until day 21 following their last exposure. Offer testing outside of facilities to avoid transmission in healthcare settings. Call ahead to ensure immediate isolation for patients referred to hospitals for a higher level of care.
- Notify: Immediately notify state, tribal, local, or territorial health departments (24-hour Epi On Call contact list) about any suspected case of measles to ensure rapid testing and investigation. States report measles cases to CDC.
- Test: Follow CDC’s testing recommendations and collect either a nasopharyngeal swab, throat swab, and/or urine for reverse transcription polymerase chain reaction (RT-PCR) and a blood specimen for serology from all patients with clinical features compatible with measles. RT-PCR is available at many state public health laboratories, through the APHL Vaccine Preventable Disease Reference Centers, and at CDC. Given potential shortages in IgM test kits, providers should be vigilant in contacting their state or local health department for guidance on testing.
- Manage: In coordination with local or state health departments, provide appropriate measles post-exposure prophylaxis (PEP) as soon as possible after exposure to close contacts without evidence of immunity, either with MMR (within 72 hours) or immunoglobulin (within 6 days). The choice of PEP is based on elapsed time from exposure or medical contraindications to vaccination.
Recommendations for Health Departments
Measles is an immediately notifiable disease. State, tribal, local, and territorial health departments have the lead in disease investigations and should report measles cases and outbreaks within 24 hours through the state health department to CDC ([email protected]) and through NNDSS.
- Establish measles case reporting from healthcare facilities, providers, and laboratories to public health authorities.
- If measles is identified, conduct active surveillance for additional (secondary) cases and facilitate transportation of specimens immediately to confirm diagnosis.
- Record and report details about cases of measles, including adherence to recommended precautions and facility location(s) of index and secondary cases.
- Enhance outreach and communications to under-vaccinated communities through trusted messengers.
Recommendations for Parents and International Travelers
- Even if not traveling, ensure that children receive all recommended doses of MMR vaccine. Two doses of MMR vaccine provide better protection (97%) against measles than one dose (93%). Getting MMR vaccine is much safer than getting measles, mumps, or rubella.
- Anyone who is not protected against measles is at risk of getting infected when they travel internationally. Before international travel, check your destination and CDC’s Global Measles Travel Health Notice for more travel health advice, including where measles outbreaks have been reported.
- Parents traveling internationally with children should consult with their child’s healthcare provider to ensure that they are current with their MMR vaccinations at least 2 weeks before travel. Infants aged 6 to 11 months should have one documented dose and children aged 12 months and older should have two documented doses of MMR vaccine before international travel. Depending on where you are going and what activities you plan, other vaccines may be recommended too.
- After international travel, watch for signs and symptoms of measles for 3 weeks after returning to the United States. If you or your child gets sick with a rash and a high fever, call your healthcare provider. Tell them you traveled to another country and whether you or your child have received MMR vaccine.
For More Information
- Parents and International Travelers
- Health Departments and Public Health Professionals
- Healthcare Providers
- Measles One-Pager for Healthcare Providers | Project Firstline and AAP
- Immunization Schedules | CDC
- Safety Information for Measles, Mumps, Rubella (MMR) Vaccines | CDC
- For Healthcare Professionals – Diagnosing and Treating Measles | CDC
- Interim Measles Infection Prevention Recommendations in Healthcare Settings | CDC
- Measles – Vaccine Preventable Diseases Surveillance Manual | CDC
- Rubeola / Measles | CDC Yellow Book 2024
- Measles Lab Tools | CDC
- Measles Serology | CDC
- Measles Specimen Collection, Storage, and Shipment | CDC
- Test Directory | Submitting Specimens to CDC | Infectious Diseases Laboratories | CDC
- Webinar Thursday, August 17, 2023 – We Must Maintain Measles Elimination in the United States: Measles Clinical Presentation, Diagnosis, and Prevention (cdc.gov) (Free CE)
The Centers for Disease Control and Prevention (CDC) protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations.
Department of Health and Human Services
HAN Message Types
- Health Alert: Conveys the highest level of importance about a public health incident.
- Health Advisory: Provides important information about a public health incident.
- Health Update: Provides updated information about a public health incident.
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This message was distributed to state and local health officers, state and local epidemiologists, state and local laboratory directors, public information officers, HAN coordinators, and clinician organizations.
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Obituary of Shirley Custodio Spaulding
Shirley Custodio Spaulding, age 63, resident of Austin, AR, and more recently of Fort Scott, KS passed away Sunday, March 17, 2024. She was born in Siruma Camarines Sur, Philippines.
She was married but divorced shortly after she moved to the United States. She then raised her 6 children by herself in a country where she barely understood English. So, she was a very strong woman.
She was a survivor of trauma in the Philippines and many more here in the United States. But she did it because of her faith in God and Jesus Christ. She prayed often.
She loved her family dearly and would do anything for them. She was proud of her children and grandchildren, bragging about them often.
Her spouse for 35 years was James Spradlin.
She had breast cancer 2 years ago. A month later she needed brain surgery. Then last year in October 2023, cancer returned in her back, brain, lungs, and bone. Shirley then decided to move to Fort Scott, KS in February 2024, to be closer to her family. She was establishing care and treatment at KU Cancer Center in Overland Park, KS. But she lost her battle with cancer and passed away at Freeman Hospital in Joplin MO Sunday morning.
She loved spending time in nature, gardening, landscaping, cooking, karaoke, dancing, fishing, playing bingo, lottery scratch-offs, collecting antiques, and so much more. She was always active doing something. She was always making sure everyone around her was taken care of and happy. She sacrificed so much for her children.
Survivors include James Spradlin of the home; her children and grandchildren, Anthony Spaulding- 5 children, Chrystaleah Doherty & Shane Doherty (son in law) – 5 children, Lyzl Spaulding- 2 children, Angela Collet, Casey Spaulding & Marsha Walker (daughter in law) – 5 children, and Shane Spaulding & Elizabeth Underwood (daughter in law) – 4 children.
Private family services are under the direction of the Cheney Witt Chapel, 201 S. Main St., Fort Scott, KS. Words of remembrance may be submitted to the online guestbook at cheneywitt.com.
St. Mary’s Catholic School Dinner and Auction is April 13
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HBCAT Receives Sunflower Foundation Capacity Building Grant
Fort Scott, Kan. – The Healthy Bourbon County Action Team recently received a $23,212 capacity building grant from Sunflower Foundation through an initiative to support the core operating capacities of nonprofit organizations across the state that are working to meet the critical health needs of their communities. This Request for Proposals (RFP) process was one of the most competitive in the foundation’s history, attracting almost 300 applications.
The Healthy Bourbon County Action Team was one of 65 organizations to receive a Sunflower Foundation capacity-building grant. These grants are designed to provide nonprofits’ needed flexibility and the necessary time to determine how they might strengthen their internal capacity to realize their missions, better serve their communities, and bolster their impact. The grant program also provides The Healthy Bourbon County Action Team with opportunities to attend high-caliber learning collaboratives and skill-building workshops supported by Sunflower.
“This grant will allow us to hire accounting and grant administration assistance to expand both HBCAT efforts locally and Rural Community Partners regionally.” States HBCAT’s President and CEO, Jody Love.
This grant funding opportunity focused specifically on organizations serving diverse populations and those that provide a wide range of services, including health care, housing supports, community safety, economic development, education, food security, social cohesion, social justice, and transportation. Applicant organizations were prioritized to receive funds based on need, the organization’s focus on underserved communities, and those organizations with more limited access to resources.
“Nonprofits are the lifeline of our communities,” said Sunflower Foundation President and CEO Billie Hall. “We are honored to call these organizations partners in our mission to improve the health and wellbeing of all Kansans and look forward to working with them in the future.”
A diverse team of experts representing the fields of public health, mental health, economic and rural development, health care, health equity, and aging, among others, provided in-depth reviews of each application. To learn more about the capacity building program and see a full list of this year’s grantees, go to the Capacity Building Grants web page.
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ABOUT The Healthy Bourbon County Action Team
The Healthy Bourbon County Action Team’s mission is to increase access to healthy food and physical activity, promote commercial tobacco cessation, enhance quality of life and encourage economic growth. The problems of health inequity and social injustice are complex in nature and inextricably linked to key economic indicators. A healthy workforce is a prerequisite for economic success in any industry and in all cities. Our solution to building healthy communities is by transforming power, building trust, and encouraging community participation. Comprehensive strategy for change includes local organizing, strategic communication, community research, creating systems, and environmental changes.
Spark Wheel Receives Kansas Dept. For Children and Families Grant
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Are You A Friend of The Fort?
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Harley Race World League Wrestling returns to Memorial Hall in Fort Scott on April 13
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The Bourbon County Sheriff’s Office Daily Reports March 19
There were no releases.
City of Uniontown Council Special Meeting Agenda for March 19
CALL TO ORDER AT _________ by __________________________________________
ROLL CALL:
____ Jess Ervin ____ Danea Esslinger ____ Amber Kelly ____ Mary Pemberton ____ Bradley Stewart
Motion by _____________, Second by __________, Approved ______, to enter into executive session pursuant to non-elected personnel exception, KSA 75-4319(b)(1), in order to interview applicants of non-elected personnel, the open meeting to resume at ____________.
Obituary of Richard Riley
Richard Jack Riley, age 85, a resident of Ft. Scott, Kansas, passed away Saturday, March 16, 2024, at the Guest Home Estates in Ft. Scott. He was born March 10, 1939, in Ft. Scott, the son of Wallace Riley and Dorothy Brotherton Riley. Richard graduated from the Ft. Scott High School.
He married Phyllis Darlene Totman on August 31, 1957, at Miami, Oklahoma. Following their marriage, Richard enlisted with the United States Air Force. He served for six years and was stationed primarily at Richards-Gebaur Air Force Base near Kansas City.
Following his military service, Richard returned to Ft. Scott. He worked in the printing department of the Western Insurance Company which later became American States Insurance Company. He also did printing work for Lincoln National Insurance Company and Sekan Printing.
During this time, Richard obtained his minister’s license from the Nazarene Church. He was a long-time member of the Ft. Scott Church of the Nazarene. After his retirement, he served as pastor of the Nazarene Church in Humboldt, Kansas for nearly ten years.
Richard was a man of many talents. He enjoyed drawing and painting and was an accomplished cartoon artist. He published a book of his cartoon series, The Lil’ Wrangler. These cartoons were featured in a variety of periodicals including the Western Horseman.
Richard also worked as a sign painter. He designed and painted numerous area signs including the Ruddick’s warehouse on the 69 Bypass in Ft. Scott and the Chicken Mary’s sign near Pittsburg.
Some of his favorite times were spent on the water. He enjoyed deep sea fishing and going out on his sailboat. He was fortunate enough to take a father and son cruise onboard the aircraft carrier John F. Kennedy while his son, Nathan, was serving with the United States Navy.
Following the death of his first wife, Phyllis, on June 13, 2012, Richard married Linda June Hurd on April 6, 2013. Richard and Linda enjoyed five years of married life until her death on May 30, 2018. Richard left behind a legacy of faith and love and will be dearly missed by his family and friends.
Survivors include his three daughters, Belinda Yockey (Don) of Joplin, Missouri, Christine Bosley (Gary) of Ft. Scott and Carol Johnson (Michael) of Lawrence, Kansas. Also surviving are eleven grandchildren, and numerous great and great-great-grandchildren.
In addition to his wives, Richard was also preceded in death by his son, Nathan Riley; two brothers, Ronnie and Paul Riley and a sister, Mary Ann Brenner.
Rev. Virgil Peck will conduct funeral services at 1:30 P.M. Friday, March 22nd at the Cheney Witt Chapel.
Burial will follow in the Evergreen Cemetery.
Memorials are suggested to the Ft. Scott Church of the Nazarene Mission Department and may be left in care of the Cheney Witt Chapel, 201 S. Main, P.O. Box 347, Ft. Scott, KS 66701. Words of remembrance may be submitted to the online guestbook at cheneywitt.com.
Live Jazz Performance at Gordon Parks Museum on March 21
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