Measles just hit a major milestone as it spreads across the country, infecting the most people since the year 2000, when public health officials declared the virus eliminated in the US. Thanks to the anti-vaccination movement, the virus has come roaring back. The case count has climbed to 695 people infected across 22 different states, driven in part by outbreaks that have lingered in New York and Washington, according to a statement from the Centers for Disease Control and Prevention. Stopping these ongoing outbreaks as soon as possible will be critical, the CDC says. “The longer these outbreaks continue, the greater the chance measles will again get a sustained foothold in the United States,” the CDC said in a statement. “The longer these outbreaks continue, the greater the chance measles will again get a sustained foothold” Measles, recognized for its rash, can also cause pneumonia, brain swelling, and death. The Measles, Mumps, and Rubella — or MMR — vaccine is safe and can ward off measles infections. But some people, like children under one year old and those who can’t be vaccinated for medical reasons, rely on the rest of us being vaccinated to keep the notoriously contagious virus from spreading. If everyone who can get vaccinated does, outbreaks are small to non-existent, the CDC says. But when someone with measles visits a community that isn’t adequately vaccinated, the outbreak can metastasize. That’s because a sneeze can squirt the virus into the air, where it can stick around for up to two hours. And 90 percent of unvaccinated people who are exposed to someone with the infection will catch it. The CDC points to inadequate vaccination and the rise of vaccine misinformation as a driver of the New York outbreaks, in particular. “Some organizations are deliberately targeting these communities with inaccurate and misleading information about vaccines,” the CDC says. Vox reported earlier this month that anti-vaxx organizations have directed fear-mongering misinformation about the health risks of vaccines at orthodox Jewish communities in New York. Alex Azar, secretary of the U.S. Department of Health & Human Services, tried to calm the fearful in a statement today. “The measles vaccines are among the most extensively studied medical products we have, and their safety has been firmly established over many years in some of the largest vaccine studies ever undertaken,” he said. “With a safe and effective vaccine that protects against measles, the suffering we are seeing is avoidable.”<doc-sep>Rand Paul says he doesn't need to be vaccinated. Doctor says he's wrong A mural of George Floyd is shown in the intersection of 38th St & Chicago Ave on March 31, 2021 in Minneapolis, Minnesota. Community members continue preparations during the third day in the trial of former Minneapolis police officer Derek Chauvin, who is charged with multiple counts of murder in the death of George Floyd. (Photo by Brandon Bell/Getty Images) WASHINGTON, DC - JULY 01: President Donald Trump's lawyer and former New York City Mayor Rudy Giuliani talks to journalists outside the White House West Wing July 01, 2020 in Washington, DC. Giuliani did an on-camera interview with One America News Network's Chanel Rion before talking to other journalists about Vice President Joe Biden and the news that Russian intelligence may have paid Taliban operatives to kill U.S. troops in Afghanistan. (Photo by Chip Somodevilla/Getty Images) ORLANDO, FLORIDA - FEBRUARY 28: Former President Donald Trump addresses the Conservative Political Action Conference held in the Hyatt Regency on February 28, 2021 in Orlando, Florida. Begun in 1974, CPAC brings together conservative organizations, activists, and world leaders to discuss issues important to them. (Photo by Joe Raedle/Getty Images) Here's what reported grand jury in Trump case may look like NEW YORK, NY - FEBRUARY 09: People walk past the Trump Tower as the impeachment trial of Donald Trump begins in Washington on February 09, 2021 in New York City. After listening to nearly four hours of legal arguments, the Senate has voted on Tuesday to move ahead with the impeachment trial of former President Trump. (Photo by Spencer Platt/Getty Images) Report: US companies may have benefited from forced labor of Uyghurs WASHINGTON, DC - MAY 20: U.S. President Joe Biden delivers remarks on the conflict in the Middle East from Cross- Hall of the White House on May 20, 2021 in Washington, DC. Israel and Hamas announced that they would agree to a cease-fire, which will take into effect on Friday, following days of fighting that claimed more than 200 lives. (Photo by Anna Moneymaker/Getty Images) SAN JOSE, CA - MAY 26: A view of the Valley Transportation Authority (VTA) light-rail yard where a mass shooting occurred on May 26, 2021 in San Jose, California. A VTA employee opened fire at the yard, with preliminary reports indicating nine people dead including the gunman. (Photo by Philip Pacheco/Getty Images) A healthcare worker prepares to administer a Pfizer/BioNTEch coronavirus disease (Covid-19) vaccine at The Michener Institute, in Toronto, Ontario on December 14, 2020. - Ontario, Canada's most populous province and one of the hardest hit by the pandemic, had 1,940 new cases and 23 deaths on Monday. The province is expected to give its next doses to nursing home workers as a priority, according to media reports. (Photo by CARLOS OSORIO / POOL / AFP) (Photo by CARLOS OSORIO/POOL/AFP via Getty Images) 'Never seen levels like this': Union president on airline passenger misconduct NEW YORK, NEW YORK - APRIL 19: A sign warns people of measles in the ultra-Orthodox Jewish community in Williamsburg on April 19, 2019 in New York City. As a measles epidemic continues to spread, New York City Mayor Bill de Blasio recently announced a state of emergency and mandated residents of the ultra-Orthodox Jewish community in Williamsburg at the center of the outbreak to get vaccinated for the viral disease. Those who choose not to will risk a $1,000 fine. (Photo by Spencer Platt/Getty Images) (CNN) — Measles cases in the United States have surpassed the highest number on record since the disease was declared eliminated nationwide in 2000. Overall, there have been 681 measles cases across 22 states this year, according to CNN’s analysis of data from state and local health departments. Previously, the highest number of reported cases since elimination was 667 in 2014. The states reporting measles cases are Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Tennessee, Texas and Washington. As of Monday, the US Centers for Disease Control and Prevention reported 626 individual cases of measles confirmed in those 22 states. This includes illnesses reported by state health departments to the CDC through April 19 and therefore does not include cases reported since then. Wednesday evening, the CDC confirmed the milestone. In a statement the agency said that as of 3 p.m., it counted 695 cases of the illness this year. This is a break from the CDC practice of updating measles numbers weekly on Mondays. The CDC said it will not update its website with this new number until Monday, as scheduled. As the number of measles cases has soared this year federal health officials have remained mostly silent. That changed Wednesday evening when Health and Human Services Secretary Alex Azar released a statement. “The United States is seeing a resurgence of measles, a disease that had once been effectively eliminated from our country,” he said and acknowledged the significance of the number of cases. ’Most of the cases that we’re seeing are in unvaccinated communities’ Measles is a highly contagious disease caused by a virus that can spread through the air when an infected person coughs or sneezes or if someone comes into direct contact or shares germs by touching the same objects or surfaces. Measles symptoms may include fever, cough, runny nose, watery eyes and a rash of red spots. Most cases in the United States have emerged in communities with low rates of vaccination against the virus, according to public health officials. “I do believe that parents’ concerns about vaccines leads to undervaccination, and most of the cases that we’re seeing are in unvaccinated communities,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the CDC, said in February at a congressional hearing about measles outbreaks. Nationally, the United States has high measles vaccination coverage. The CDC says 91.5% of US children aged 19 months to 35 months received at least one dose of the measles, mumps and rubella vaccine in 2017, the most recent year available. “However, there are pockets of people who are vaccine-hesitant,” Messonnier said. “Outbreaks of measles occur when measles gets into these communities of unvaccinated people,” she said. “The only way to protect against measles is to get vaccinated.” A source familiar with the measles situation in the United States previously told CNN that of the 626 cases of measles that federal officials counted as of last week, 72% are unvaccinated, and 18% have an unknown vaccination status. Among those who are unvaccinated, it may be because of personal beliefs and medical reasons. The other 10% were vaccinated with either one or two doses. Of those 626 cases, 487 were in people 19 and younger. Measles outbreaks – defined as three or more cases – have been ongoing this year in Rockland County, New York; New York City; Washington state; New Jersey; Butte County, California; and Michigan. The CDC has noted that those outbreaks are linked to travelers who were infected and brought measles back from other countries, including Israel, Ukraine and the Philippines. For instance, the outbreak in New York, which was declared a public health emergency this month, began when an unvaccinated child became infected while visiting Israel, according to health officials. A person from New York who was unknowingly contagious with the measles then visited Southeast Michigan, spreading the illness to at least 38 people there, according to Lynn Sutfin, public information officer for the Michigan Department of Health and Human Services. The CDC referenced the ongoing outbreak in New York Wednesday. “The longer these outbreaks continue, the greater the chance measles will again get a sustained foothold in the United States.” The history of measles in America In 1912, measles became a nationally notifiable disease in the United States, meaning it was required that health care providers and laboratories report diagnosed cases. In that first decade of reporting, an average of about 6,000 measles-related deaths were reported annually. In the 1950s, researchers isolated the measles virus in a patient’s blood, and in the 1960s, they were able to transform that virus into a vaccine. The vaccine was licensed and then used as part of a vaccination program. Before the measles vaccination program was introduced in the United States in 1963, an estimated 3 million to 4 million people got the disease each year nationwide, according to the CDC. Afterward, cases and deaths from measles in the United States and other developed countries plummeted. There were 963 cases reported in the United States in 1994 and 508 in 1996. By 2000, when there were only 86 cases, measles was declared eliminated from the United States, meaning there was no continuous transmission of the disease for more than 12 months. Since 2000, the annual number of reported measles cases has ranged from 37 people in 2004 to 667 in 2014. The measles, mumps and rubella vaccine – known as the MMR vaccine – is very effective. One dose is about 93% effective at preventing measles if you come into contact with the virus. Two doses are about 97% effective. Get CNN Health's weekly newsletter Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team. Experts recommend that children receive the vaccine in two doses: first between 12 months and 15 months of age and a second between 4 and 6 years old. With any medicine, including vaccines, there is a chance of reactions, according to the CDC. These are usually mild and go away on their own, but there is a “remote chance” of side effects and even serious injuries. Experts say the benefits outweigh the risks when it comes to the measles vaccine. In his statement, Azar emphasized the safety and effectiveness of the vaccine that protects against measles. The CDC said it is working around the clock to protect Americans from measles. CNN’s Susan Scutti and Elizabeth Cohen contributed to this report. Correction: A previous version of this story incorrectly stated when New York declared a public health emergency and incorrectly included Santa Cruz County as a place where there have been measles outbreaks this year.<doc-sep>
Measles was eliminated in the US in 2000. And yet progress against the disease unraveled to a startling degree. According to the latest measles numbers from the Centers for Disease Control and Prevention, health officials recorded 971 cases in the first five months of this year. That’s the largest number since 1992. It’s also a huge uptick compared to 2018, when 372 cases were reported. Given that it’s only May, and the virus has already been confirmed in 26 states, we’re well on track to set an even more dramatic record this year. So what’s driving the big increase in cases? The outbreaks here have been concentrated in just four states: New York, New Jersey, Washington, and California. And among those, the vast majority of cases (more than 600) has occurred in Orthodox Jewish communities in New York City and the suburb of Rockland. There, a minority of people who are vaccine skeptics have been opting out of the shots on behalf of their children, driving vaccine rates down and creating the space for the highly contagious virus to spread. “Measles is preventable and the way to end this outbreak is to ensure that all children and adults who can get vaccinated, do get vaccinated,” said CDC Director Robert Redfield in a statement Thursday. To really understand what’s going on with measles in the US, though, you have to take a step back and look at the global picture. All the major outbreaks here are linked to travelers who brought the virus back to the US from countries with ongoing outbreaks, including Ukraine, the Philippines, and Israel. It’s a reminder of how tightly dependent our health can be to that of people in even far-away countries — particularly when we don’t take advantage of tools that can prevent diseases from spreading, like vaccines. A worldwide surge in measles Over the past two years, measles cases have been edging up in several countries around the world, with a 300 percent rise in measles cases globally over the same period in 2018, according to the World Health Organization. Ukraine, Madagascar, India, Pakistan, Philippines, Yemen, and Brazil are among the countries most affected, according to WHO. As of April 2019, Madagascar’s health officials recorded more than 69,000 measles cases and 1,200 related deaths in the largest-ever measles outbreak on the island nation. Ukraine has experienced 72,000 cases, and the Philippines 19,000 cases. The reasons for outbreaks differ in each country — from vaccine refusal to problems with health care access or access to vaccines, to civil unrest and low awareness about the need to vaccinate. But what all these causes have in common: These factors are driving down the rate of vaccine coverage. And in places that used to see very little measles previously, like the US, vaccine skepticism seems to be a common contributor, said Amanda Cohn, the CDC’s senior adviser for vaccines. “There’s vaccine hesitancy in a world where people don’t see measles anymore. We have to continue to remind people how serious measles is.” How measles spreads in places with high rates of vaccine coverage The measles virus is indeed one of the most infectious diseases known to man. A person with measles can cough in a room and leave, and hours later, if you’re unvaccinated, you could catch the virus from the droplets in the air the infected person left behind. No other virus can do that. The good news is that the measles-mumps-rubella, or MMR, vaccine is incredibly effective at stopping measles from spreading. The CDC usually recommends that children get two doses: Immunity from the vaccine lasts for decades, but you should ask your health provider about booster shots if you’re an adult. (People born before 1957, when measles was widespread, are assumed to be immune since they probably suffered through an infection. Those born in the years 1957 to 1989 may not be fully immunized, since they likely got an older vaccine. And anyone who is unsure about their vaccine status can ask for the shot now or get a blood test to check their immunity.) But nearly everybody in a community needs to be fully vaccinated to achieve what’s known as “herd immunity.” In order for any vaccine to be effective, you need to have a certain percentage of people in a population immunized. This prevents diseases from spreading through populations, and it protects even those who aren’t or can’t be vaccinated, like newborns and people with vaccine allergies.