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Measles “Eliminated” in Americas: WHO; But Designation Doesn’t Mean Disease Gone

November 17, 2016

By Mendy Hecht, Hamaspik Gazette

Milestone Announcement Comes on Heels of 2014 Disneyland Case, Tennessee Outbreak

According a September 27 announcement by the World Health Organization (WHO), the highly contagious disease of measles has now been officially “eliminated” from the Americas.

“Today we say bye-bye to the indigenous transmission of measles,” said Pan American Health Organization (PAHO) director Carissa Etienne at a PAHO meeting in Washington Sept. 27.  “We celebrate the historic day in which the scourge has been eliminated.”  The PAHO is the Americas arms of the WHO, the United Nations’ global health apparatus. 

However, in the jargon of public health, “eliminated” here has a specific definition: No more local or regional outbreaks of a disease, but the possibility of outbreaks due to “imports” of the disease.

By contrast, “eradicated” in public-health terminology specifically refers to a disease no longer exists.

The only disease so far to earn the public health status of “eradicated” is smallpox, which was declared officially eradicated in 1972.

The declaration means that the viral disease is no longer endemic, or constantly present in a geographic area, which in this case is Chile to Canada.  Measles is still common in Africa, Asia, the Pacific and some European countries.

However, there have been at least three local outbreaks of measles across the United States in recent years—despite the fact that the government declared measles officially “eliminated” in the U.S. back in 2000.

All were caused by infected foreigners inadvertently spreading the virus in the U.S. to unvaccinated Americans, or by unvaccinated Americans catching the virus abroad and “importing” it back home.

A small outbreak in 2013, confined largely to members of an extended family in Brooklyn that was mostly unprotected due to anti-vaccine misinformation, was quickly contained by city health officials. That outbreak was caused by an infected family member visiting from England.

In 2014, an infected tourist visiting Disneyland in Southern California triggered an outbreak that infected at least 147 people by the time it was brought under control in 2015.  Also in 2014, two unvaccinated Amish relief workers caught the virus in the Philippines and “imported” it back to Ohio’s sizable Amish community, where 383 mostly unvaccinated people in the state ultimately got the virus.

And this past April, a measles outbreak of unknown origin struck Shelby County, Tennessee, with three people—an 18-month-old boy, a 50-year-old man, and a seven-month old girl—initially testing positive for the virus.  That number eventually rose to seven.

An effective and rapid response by local, state and federal health authorities ultimately tracked down 985 contacts of the seven patients, six of whom were unvaccinated.  The response, which also quarantined 41 contacts and administered 400 MMR vaccines at public clinics and community events, eventually found that “a lack of international travel and absence of recent measles cases in the community can provide false reassurance,” according to a CDC report.

No common source was ever identified for the outbreak—which, the CDC report added, “highlights the importance of high two-dose MMR vaccination coverage among vaccine-eligible persons and the need for ongoing, vigilant surveillance for measles virus in the United States.”