Editing Measles (section)

====United States====
{{see also|Measles resurgence in the United States}}
[[File:Measles US 1938-2019.png|thumb|Measles cases in the U.S. from 1938 to 2019]]
In the United States, measles affected approximately 3,000 people per million in the 1960s before the vaccine was available. With consistent widespread childhood vaccination, this figure fell to 13 cases per million by the 1980s, and to about 1 case per million by 2000.<ref>{{cite journal | vauthors = Orenstein WA, Papania MJ, Wharton ME | title = Measles elimination in the United States | journal = The Journal of Infectious Diseases | volume = 189 | issue = Supplement 1 | pages = S1-3 | date = May 2004 | pmid = 15106120 | doi = 10.1086/377693 | quote = Figure 1: Reported US measles incidence, 1950–2001. | doi-access = free | title-link = doi }}</ref>

In 1991, an [[1990–1991 Philadelphia measles outbreak|outbreak of measles in Philadelphia]] was centered at the Faith Tabernacle Congregation, a faith-healing church that actively discouraged parishioners from vaccinating their children. Over 1400 people were infected with measles and nine children died.<ref>{{cite web|url=https://6abc.com/504818/|title=1991: The Philly measles outbreak that killed 9 children|date=6 February 2015|website=6abc Philadelphia|access-date=7 August 2021|archive-date=25 November 2020|archive-url=https://web.archive.org/web/20201125033257/https://6abc.com/504818/|url-status=live}}</ref>

Before immunization in the United States, between three and four million cases occurred each year.<ref name="Pink Book" /> The United States was declared free of circulating measles in 2000, with 911 cases from 2001 to 2011. In 2014 the CDC said endemic measles, rubella, and [[congenital rubella syndrome]] had not returned to the United States.<ref name=PapaniaSeward2014>{{cite journal | vauthors = Papania MJ, Wallace GS, Rota PA, Icenogle JP, Fiebelkorn AP, Armstrong GL, Reef SE, Redd SB, Abernathy ES, Barskey AE, Hao L, McLean HQ, Rota JS, Bellini WJ, Seward JF | title = Elimination of endemic measles, rubella, and congenital rubella syndrome from the Western hemisphere: the US experience | journal = JAMA Pediatrics | volume = 168 | issue = 2 | pages = 148–55 | date = February 2014 | pmid = 24311021 | doi = 10.1001/jamapediatrics.2013.4342 | doi-access = }}</ref> Occasional measles outbreaks persist, however, because of cases imported from abroad, of which more than half are the result of unvaccinated U.S. residents who are infected abroad and infect others upon return to the United States.<ref name=PapaniaSeward2014/> The CDC continues to recommend measles vaccination throughout the population to prevent outbreaks like these.<ref>{{cite journal | title = Multistate measles outbreak associated with an international youth sporting event--Pennsylvania, Michigan, and Texas, August-September 2007 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 57 | issue = 7 | pages = 169–73 | date = February 2008 | pmid = 18288074 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5707a1.htm | author1 = Centers for Disease Control Prevention (CDC) | access-date = 1 February 2018 | archive-date = 18 October 2020 | archive-url = https://web.archive.org/web/20201018010756/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5707a1.htm | url-status = live }}</ref>

In 2014, an outbreak was initiated in Ohio when two unvaccinated [[Amish]] men harboring asymptomatic measles returned to the United States from missionary work in the Philippines.<ref name="Gastanaduy2016">{{cite journal | vauthors = Gastañaduy PA, Budd J, Fisher N, Redd SB, Fletcher J, Miller J, McFadden DJ, Rota J, Rota PA, Hickman C, Fowler B, Tatham L, Wallace GS, de Fijter S, Parker Fiebelkorn A, DiOrio M | title = A Measles Outbreak in an Underimmunized Amish Community in Ohio | journal = The New England Journal of Medicine | volume = 375 | issue = 14 | pages = 1343–1354 | date = October 2016 | pmid = 27705270 | doi = 10.1056/NEJMoa1602295 | doi-access = free | title-link = doi }}</ref> Their return to a community with low vaccination rates led to an outbreak that rose to include a total of 383 cases across nine counties.<ref name="Gastanaduy2016"/> Of the 383 cases, 340 (89%) occurred in unvaccinated individuals.<ref name="Gastanaduy2016"/>

From 4 January, to 2 April 2015, there were 159 cases of measles reported to the CDC. Of those 159 cases, 111 (70%) were determined to have come from an earlier exposure in late December 2014. This outbreak was believed to have originated from the [[Disneyland]] [[theme park]] in California. The Disneyland outbreak was held responsible for the infection of 147 people in seven U.S. states as well as Mexico and Canada, the majority of which were either unvaccinated or had unknown vaccination status.<ref>{{cite web |url=https://blogs.cdc.gov/publichealthmatters/2015/12/year-in-review-measles-linked-to-disneyland/ |title=Year in Review: Measles Linked to Disneyland |date=2 December 2015 |access-date=26 May 2017 |url-status=live |archive-url=https://web.archive.org/web/20170519211805/https://blogs.cdc.gov/publichealthmatters/2015/12/year-in-review-measles-linked-to-disneyland/ |archive-date=19 May 2017 }}</ref> Of the cases 48% were unvaccinated and 38% were unsure of their vaccination status.<ref>{{cite journal | vauthors = Clemmons NS, Gastanaduy PA, Fiebelkorn AP, Redd SB, Wallace GS | title = Measles - United States, January 4-April 2, 2015 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 64 | issue = 14 | pages = 373–6 | date = April 2015 | pmid = 25879894 | pmc = 5779542 | url = https://www.cdc.gov/mmwr/pdf/wk/mm6414.pdf | access-date = 1 November 2019 | archive-date = 13 July 2020 | archive-url = https://web.archive.org/web/20200713221937/https://www.cdc.gov/mmwr/pdf/wk/mm6414.pdf | url-status = live }}</ref> The initial exposure to the virus was never identified.<ref>{{cite web|title=Measles Outbreak — California, December 2014–February 2015|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm|access-date=8 January 2022|website=U.S. [[Centers for Disease Control and Prevention]] (CDC)|archive-date=10 December 2020|archive-url=https://web.archive.org/web/20201210053113/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm|url-status=live}}</ref>

In 2015, a U.S. woman in Washington state died of [[pneumonia]], as a result of measles. She was the first fatality in the U.S. from measles since 2003.<ref>{{cite news |title=Measles kills first patient in 12 years |url=https://www.usatoday.com/story/news/2015/07/02/measles-death-washington-state/29624385/ |access-date=2 July 2015 |newspaper=[[USA Today]] |date=2 July 2015 |url-status=live |archive-url=https://web.archive.org/web/20150702200945/http://www.usatoday.com/story/news/2015/07/02/measles-death-washington-state/29624385/ |archive-date=2 July 2015}}</ref> The woman had been vaccinated for measles and was taking [[immunosuppressive drug]]s for another condition. The drugs suppressed the woman's immunity to measles, and the woman became infected with measles; she did not develop a rash, but contracted pneumonia, which caused her death.<ref>{{cite web |title= First Measles Death in US Since 2003 Highlights the Unknown Vulnerables – Phenomena: Germination |website= [[National Geographic Society]] |url= https://www.nationalgeographic.com/science/phenomena/2015/07/02/measles-death-us/ |access-date= 13 May 2020 |date= 2 July 2015 |archive-date= 31 May 2020 |archive-url= https://web.archive.org/web/20200531020834/https://www.nationalgeographic.com/science/phenomena/2015/07/02/measles-death-us/ |url-status= dead }}</ref><ref>{{cite web |title=First Measles Death In 12 Years Renews Vaccination Concerns |website=[[NPR]] |date=6 July 2015 |url=https://www.npr.org/2015/07/06/420594973/first-measles-death-in-12-years-renews-vaccination-concerns |access-date=23 April 2019 |archive-url= https://web.archive.org/web/20191224204938/https://www.npr.org/2015/07/06/420594973/first-measles-death-in-12-years-renews-vaccination-concerns |archive-date= 24 December 2019}}</ref>

In June 2017, the Maine Health and Environmental Testing Laboratory confirmed a case of measles in Franklin County. This instance marks the first case of measles in 20 years for the state of Maine.<ref>{{cite web|title=Maine confirms its first case of measles in 20 years |url=https://www.cbsnews.com/news/maine-confirms-first-case-measles-20-years/ |website=CBS News |date=27 June 2017 |access-date=28 June 2017 |url-status=live |archive-url=https://web.archive.org/web/20170628021043/http://www.cbsnews.com/news/maine-confirms-first-case-measles-20-years/|archive-date=28 June 2017 }}</ref> In 2018, one case occurred in Portland, Oregon, with 500 people exposed; 40 of them lacked immunity to the virus and were being monitored by county health officials as of 2 July 2018.<ref>{{Cite news|url=http://katu.com/news/local/measles-case-confirmed-in-portland-about-500-people-exposed|title=Measles case confirmed in Portland, about 500 people possibly exposed|work=KATU|access-date=3 July 2018|archive-date=7 August 2020|archive-url=https://web.archive.org/web/20200807014127/https://katu.com/news/local/measles-case-confirmed-in-portland-about-500-people-exposed|url-status=live}}</ref> There were 273 cases of measles reported throughout the United States in 2018,<ref>{{cite web|url=https://wonder.cdc.gov/nndss/static/2018/52/2018-52-table1.html|title=TABLE 1. Weekly cases* of selected infrequently reported notifiable diseases (|website=wonder.cdc.gov|access-date=12 January 2019|archive-date=22 October 2020|archive-url=https://web.archive.org/web/20201022112034/https://wonder.cdc.gov/nndss/static/2018/52/2018-52-table1.html|url-status=live}}</ref> including an outbreak in [[Brooklyn]] with more than 200 reported cases from October 2018 to February 2019. The outbreak was tied with population density of the [[Orthodox Jewish]] community, with the initial exposure from an unvaccinated child that caught measles while visiting Israel.<ref name="usatoday 2019-02-11"/><ref>{{Cite news|url=https://www.cnn.com/2019/01/08/health/measles-outbreak-ny-bn/index.html|title=New York tackles 'largest measles outbreak' in state's recent history as cases spike globally|last=Howard|first=Jacqueline|date=9 January 2019|work=CNN|access-date=12 January 2019|archive-date=11 January 2019|archive-url=https://web.archive.org/web/20190111093850/https://www.cnn.com/2019/01/08/health/measles-outbreak-ny-bn/index.html|url-status=live}}</ref>

A resurgence of measles occurred during 2019, which has been generally tied to [[Vaccine hesitancy|parents choosing not to have their children vaccinated]] as most of the reported cases occurred in people 19 years old or younger.<ref>{{cite web|url=https://www.nbcnews.com/storyline/measles-outbreak/measles-outbreak-southwestern-washington-rises-50-cases-n966751|title=Washington state is averaging more than one measles case per day in 2019|website=NBC News|date=4 February 2019 |access-date=5 February 2019|archive-date=5 February 2019|archive-url=https://web.archive.org/web/20190205011950/https://www.nbcnews.com/storyline/measles-outbreak/measles-outbreak-southwestern-washington-rises-50-cases-n966751|url-status=live}}</ref><ref>{{cite web|url=https://www.msn.com/en-ph/lifestyle/family/amid-measles-outbreak-anti-vaxx-parents-have-put-others-e2-80-99-babies-at-risk/ar-BBTbIBq|title=Amid Measles Outbreak, Anti-Vaxx Parents Have Put Others' Babies At Risk|website=MSN|access-date=5 February 2019|archive-url=https://web.archive.org/web/20190330170245/https://www.msn.com/en-ph/lifestyle/family/amid-measles-outbreak-anti-vaxx-parents-have-put-others-e2-80-99-babies-at-risk/ar-BBTbIBq|archive-date=30 March 2019|url-status=dead}}</ref><ref>{{cite web|url=https://www.vox.com/2019/1/27/18199514/measles-outbreak-2018-clark-county-washington|title=Washington declared a public health emergency over measles. Thank vaccine-refusing parents.|first=Julia|last=Belluz|date=27 January 2019|website=[[Vox (website)|Vox]]|access-date=5 February 2019|archive-date=5 February 2019|archive-url=https://web.archive.org/web/20190205005311/https://www.vox.com/2019/1/27/18199514/measles-outbreak-2018-clark-county-washington|url-status=live}}</ref><ref>{{cite web|url=https://www.newsweek.com/dangerous-anti-vaxx-warning-issued-washington-officials-cases-measles-1306997|title="Dangerous" anti-vaxx warning issued by Washington officials as cases in measles outbreak continue to rise|first=Kashmira|last=Gander|date=28 January 2019|website=[[Newsweek]]|access-date=5 February 2019|archive-date=4 February 2019|archive-url=https://web.archive.org/web/20190204224837/https://www.newsweek.com/dangerous-anti-vaxx-warning-issued-washington-officials-cases-measles-1306997|url-status=live}}</ref><ref name="cnn190424"/> Cases were first reported in Washington state in January, with an [[2019 Pacific Northwest measles outbreak|outbreak of at least 58 confirmed cases]] most within [[Clark County, Washington|Clark County]], which has a higher rate of vaccination exemptions compared to the rest of the state; nearly one in four kindergartners in Clark did not receive vaccinations, according to state data.<ref name="usatoday 2019-02-11">{{cite news | url = https://www.usatoday.com/story/news/health/2019/02/11/measles-spread-anti-vaccination-communities-new-york-clar-county-washington/2812667002/ | title = A quarter of all kindergartners in Washington county aren't immunized. Now there's a measles crisis | first = Ken | last = Alltucker | date = 11 February 2019 | access-date = 11 February 2019 | work = [[USA Today]] | archive-date = 11 February 2019 | archive-url = https://web.archive.org/web/20190211160944/https://www.usatoday.com/story/news/health/2019/02/11/measles-spread-anti-vaccination-communities-new-york-clar-county-washington/2812667002/ | url-status = live }}</ref> This led Washington state governor [[Jay Inslee]] to declare a state of emergency, and the state's congress to introduce legislation to disallow vaccination exemption for personal or philosophical reasons.<ref>{{cite web | url = https://www.seattletimes.com/seattle-news/amid-measles-outbreak-legislation-proposed-to-ban-vaccine-exemptions/ | title = Amid measles outbreak, legislation proposed to ban vaccine exemptions | first = Jake | last = Goldstein-Street | date = 28 January 2019 | access-date = 28 January 2019 | work = [[The Seattle Times]] | archive-date = 29 January 2019 | archive-url = https://web.archive.org/web/20190129011001/https://www.seattletimes.com/seattle-news/amid-measles-outbreak-legislation-proposed-to-ban-vaccine-exemptions/ | url-status = live }}</ref> In April 2019, New York Mayor [[Bill de Blasio]] declared a public health emergency because of "a huge spike" in [[2019 New York measles outbreak|cases of measles]] where there were 285 cases centred on the Orthodox Jewish areas of Brooklyn in 2018, while there were only two cases in 2017. There were 168 more in neighboring [[Rockland County, New York|Rockland County]].<ref>{{cite journal |vauthors=Tanne JH |title=New York City mayor declares measles public health emergency |journal=BMJ |volume=365 |pages=l1724 |date=April 2019 |pmid=30971409 |doi=10.1136/bmj.l1724 |s2cid=145979493 }}</ref> Other outbreaks occurred in Santa Cruz County and Butte County in California, and the states of New Jersey and Michigan.<ref name="cnn190424">{{cite web | url = https://www.cnn.com/2019/04/24/health/measles-outbreak-record-us-bn/index.html | title = US measles outbreak is largest since disease was declared eliminated in 2000 | first1 = Jacqueline | last1 = Howard | first2 = Debra | last2 = Goldschmidt | date = 24 April 2019 | access-date = 24 April 2019 | website = [[CNN]] | archive-date = 24 April 2019 | archive-url = https://web.archive.org/web/20190424160923/https://www.cnn.com/2019/04/24/health/measles-outbreak-record-us-bn/index.html | url-status = live }}</ref> {{As of|April 2019}}, there have been 695 cases of measles reported in 22 states.<ref name="CDC2019"/> {{As of|2019|04}}, this is the highest number of measles cases since measles was declared eliminated in 2000.<ref name="CDC2019">{{cite press release |title=CDC Media Statement: Measles cases in the U.S. are highest since measles was eliminated in 2000 |url=https://archive.cdc.gov/#/details?url=https://www.cdc.gov/media/releases/2019/s0424-highest-measles-cases-since-elimination.html |website=U.S. [[Centers for Disease Control and Prevention]] (CDC) |date=26 April 2019 |access-date=2 May 2019 |archive-date=15 July 2020 |archive-url=https://web.archive.org/web/20200715061619/https://www.cdc.gov/media/releases/2019/s0424-highest-measles-cases-since-elimination.html |url-status=live }}</ref> From January, to December 2019, 1,282 individual cases of measles were confirmed in 31 states.<ref name="CDC Outbreaks">{{cite web | title=Measles Cases and Outbreaks |website=U.S. [[Centers for Disease Control and Prevention]] (CDC) | date=6 January 2020 | url=https://www.cdc.gov/measles/cases-outbreaks.html | archive-url=https://web.archive.org/web/20191101062347/https://www.cdc.gov/measles/cases-outbreaks.html | archive-date=1 November 2019 | url-status=live | access-date=6 January 2020}} {{PD-notice}}</ref> This is the greatest number of cases reported in the US since 1992.<ref name="CDC Outbreaks"/> Of the 1,282 cases, 128 of the people who got measles were hospitalized, and 61 reported having complications, including pneumonia and encephalitis.<ref name="CDC Outbreaks"/> Following the end of the 2019 outbreak, reported cases fell to pre-outbreak levels: 13 cases in 2020, 49 cases in 2021, and 121 cases in 2022.<ref>{{Cite web |date=29 September 2023 |title=Measles Cases and Outbreaks |url=https://www.cdc.gov/measles/data-research/ |access-date=6 October 2023 |website=U.S. [[Centers for Disease Control and Prevention]] (CDC) |archive-date=15 May 2024 |archive-url=https://web.archive.org/web/20240515235451/https://www.cdc.gov/measles/data-research/ |url-status=live }}</ref>

{{As of|2025|02}}, an [[2025 Southwest United States measles outbreak|outbreak of measles]] is ongoing amongst unvaccinated communities in Texas and New Mexico. On 26 February, the first measles death since 2015 was reported to be that of an unvaccinated school-aged child in West Texas. The confirmed number of measles cases in this outbreak is 124 {{as of|2025|02|26|lc=yes}}, according to the Texas Department of Health Services. Most are in children ages 5–17.<ref>{{Cite web |last=Mukherjee |first=Neha |date=26 February 2025 |title=Child in West Texas is first US measles death in a decade |url=https://www.cnn.com/2025/02/26/health/texas-measles-death/index.html |access-date=26 February 2025 |website=CNN }}</ref> As of March 2025, the CDC has recorded 483 confirmed cases across 20 states, 2 deaths and 70 hospitalized. This exceeds the entire 2024 total that was only 285.<ref>{{Cite web |last=IANS |date=29 March 2025 |title=Measles outbreak 2025: US cases surge past 2024 total |url=https://gulfnews.com/world/americas/measles-outbreak-2025-us-cases-surge-past-2024-total-1.500076568 |access-date=30 March 2025 |website=Gulf News }}</ref>