DefinitionNumber of reported confirmed cases of measles infections in Utah per 100,000 population per year.
NumeratorNumber of confirmed indigenous measles cases reported in Utah.
DenominatorTotal Utah population per year.
Why Is This Important?Measles is a highly contagious viral disease that can be particularly serious in infants and adults. Although measles usually lasts only one to two weeks, it can cause serious complications such as pneumonia, ear infections, and encephalitis (inflammation of the brain). In very young or malnourished patients, blindness can occur.
Measles is a common and often fatal disease in developing countries. The World Health Organization (WHO) reports that in 2015 there were 251,342 reported cases of measles worldwide, with 134,200 deaths.
Before the measles vaccine was introduced in 1963, more than a half million cases of measles were reported annually in the United States. Due to intensive efforts to vaccinate preschool aged children, reported cases of measles have declined rapidly over time.
The United States has established the goal of eliminating the transmission of endemic measles strains. Surveillance data indicates this goal was reached in 2000.
Healthy People Objective IID-1.4:Reduce measles cases (U.S.-acquired cases)
U.S. Target: 30 cases
State Target: 0 cases per year
How Are We Doing?In 1996, Utah's childhood immunization rate was the lowest in the country. Since that time, Utah's immunization rate has improved. The recent low rates of measles infection in Utah can be attributed both to improved immunization rates, as well as the natural cycle of the disease.
However, despite higher immunization rates in Utah than in previous years, there is still more work to be done in this regard. For example, in 2011, Utah experienced an outbreak of measles with 13 cases reported. Measles was introduced into Utah through foreign travel by an unvaccinated adolescent. Two of the 13 cases were known to be vaccinated, and the remaining 11 were either unvaccinated, partially vaccinated, or documentation was not found. Two more measles outbreaks were subsequently identified in 2014 (3 cases) and 2017 (3 cases) in Utah; the majority of cases in these outbreaks were unvaccinated.
In 2014, the Center for Disease Control and Prevention (CDC) reported that a total of 668 cases of measles were reported in the United States resulting from 23 outbreaks. This is the highest number of cases documented in the U.S. since 2000. In 2016, 86 cases of measles were reported in the United States.
How Do We Compare With the U.S.?Measles prevalence was virtually non-existent in both Utah and U.S. during 2006-2010. After the 2011 measles outbreak, Utah's case count decreased to one case in 2012 and zero cases in 2013.
In December of 2014, Utah experienced an outbreak of measles in which 3 cases were identified and associated with a national outbreak out of Orange County, California. Due to the 2014 measles outbreak, Utah's rate of measles was 0.10 cases per 100,000 persons, compared to the U.S. rate of 0.21 cases per 100,000 persons in 2014; the U.S. rate reflects the impact of other outbreaks in the U.S. during that time.
In February 2017, Utah experienced another outbreak of measles in which 3 cases were identified. The index case was appropriately immunized for age but had traveled to an area where measles is endemic without receiving a second MMR dose as recommended by the CDC. Upon returning to Utah, the index case had extensive contacts during the infectious period related to church, family events, and multiple medical visits. Two unvaccinated contacts of the index case were subsequently confirmed as measles cases.
In the U.S., 23 measles outbreaks were reported in 2014 resulting in 667 cases. There were 383 cases attributed to one outbreak in Ohio that primarily affected unvaccinated Amish communities in Ohio. On average there are four measles outbreaks in the U.S. reported annually, with a median of 62 cases reported nationwide. The majority of outbreaks are related to importation of measles, meaning that unvaccinated U.S. citizens traveled abroad and returned to the U.S. while infectious, spreading the highly contagious disease to other unvaccinated people.
According to an October 7, 2017 CDC surveillance report, there was a decrease in cases from 667 (0.21 cases per 100,000 population) in 2014 to a total of 120 (0.04 cases per 100,000 population) cases of measles reported in the U.S. in 2017.
Following the national trend, measles cases in Utah decreased from 0.10 cases per 100,000 population in 2014 to 0.0 cases per 100,000 population in 2016.
What Is Being Done?Travelers to foreign endemic countries frequently import the highly contagious measles virus into the U.S. Each imported measles case could start an outbreak, especially if under-vaccinated groups are exposed. Surveillance and prompt investigation of cases and contacts are critical to halt the spread of disease. Surveillance data are used to characterize persons, groups, or areas in which additional efforts are required to reduce disease incidence.
Childhood immunization is the most effective weapon against measles infection. The UDOH Immunization Program works with parents, physicians, and local health departments to provide immunization histories for all children under age two and remind parents when vaccinations are due. Since 1996, Utah's immunization rate has improved.
The Bureau of Epidemiology conducts ongoing statewide surveillance of measles cases. Per Communicable Disease Rule R386-702-3, health care providers and laboratories are required to report suspected cases of measles immediately by telephone to the Bureau of Epidemiology or the local health department. When measles is reported the Bureau of Epidemiology assists local health departments with the investigation of cases and implementation of control measures to prevent further cases.
Control measures were implemented by public health during the 2014 and 2017 measles outbreaks, limiting the spread of the disease. The control methods used to for these responses resulted in the post exposure treatment of over 200 persons, over 800 MMR containing vaccines administered by the local health departments, and the voluntary quarantine of 443 susceptible community members.