Preventable diseasesAs measles cases crack 1,000, a look at what to do

Measles was declared eliminated in the U.S. in 2000, but by early June, the U.S. Centers for Disease Control and Prevention reported 1,022 cases in 28 states, the most since 1992.

The disease is occurring in clusters of unvaccinated people who, for religious, personal, or medical reasons, have refused to be vaccinated or to have their children vaccinated.

Though global measles deaths are down significantly from more than half a million in 2000, the disease still killed 110,00 in 2017, according to the World Health Organization.

Barry Bloom, former dean of the Harvard T. H. Chan School of Public Health, and Juliette Kayyem, Belfer Senior Lecturer in International Security at the Harvard Kennedy School and a former Department of Homeland Security official, agree that additional steps are needed to address the crisis, but Bloom comes at the problem from the public-health viewpoint, and Kayyem from that of public safety.

They sat down with the Harvard Gazette’s Alvin Powell to share their thoughts on the outbreak and likely ways forward.

Alvin Powell: The Centers for Disease Control and Prevention says that there are seven ongoing measles outbreaks in the U.S. What’s the difference between an outbreak and an epidemic? And is a measles epidemic possible in a population with the level of vaccination that we have?
Barry Bloom: Technically, anything over three cases is an outbreak for these reportable diseases. And because over 90 percent of Americans are vaccinated, it is unlikely we’ll see an epidemic.

But there are still big pockets in districts that have very poor vaccine coverage. So that leads to bigger outbreaks than three people: several hundred in New York state, for example, and prior to that in California, Minnesota, and Washington. But it’s unlikely there will be an epidemic in the sense of spreading both within those states and across the country.