PUBLIC HEALTH The Threat of More, Expanded Measles Outbreaks Looms with Start of School
A combination of dropping vaccination rates and skepticism – if not hostility – toward vaccination at the highest levels of HHS, resulting in conflicting federal messaging on vaccination, have created an opening for measles, widely considered the most contagious infectious disease known to humans.
School starts soon in north-central Colorado and pediatrician Shen Nagel, MD, is bracing for the possibility of a measles outbreak.
In some ways this is par for the course. After major holidays and summer breaks, kids bring viruses back to their classrooms, and Nagel sees spikes of flu, respiratory syncytial virus and other respiratory illnesses, among his patients at Pediatrics West, a practice in suburban Denver.
Measles might soon be added to that list, though it wasn’t a disease that pediatricians worried about much when Nagel started practicing 25 years ago. But post-COVID-19, dropping vaccination rates and conflicting federal messaging have created an opening for measles, widely considered the most contagious infectious disease known to humans.
The good news is that most parents do get their kids the measles, mumps, and rubella (MMR) vaccine, which is 97% effective after two doses. Experts who spoke to CIDRAP News for this story say that if a fully vaccinated child has a normal immune system, parents shouldn’t worry about their child catching measles at school—especially if that school has a relatively high vaccination rate. Outbreaks are extremely unlikely in communities where overall MMR coverage is 95%.
But uptake is uneven. For example, the country’s largest active measles outbreak is in Lancaster County, Pennsylvania, where more than a dozen schools have MMR rates below 70%. In these buildings, a single exposure can set off a cascade of hospitalizations, mandatory quarantines, children missing school, and parents missing work.
“All we need is one case to start something,” said Nagel.
Schools Are Higher-Risk Settings
Schools are higher-risk settings for measles, said Zach Moore, MD, MPH, North Carolina’s state epidemiologist and president-elect of the Council of State and Territorial Epidemiologists.
Kids tend to have more physical contact with each other than adults do, and classrooms are confined spaces. Also, particles of the measles virus can remain in the air up to two hours after an infected person leaves an area, so as students move from room to room throughout the day, they can become infected, even if everyone in their own class is healthy.
