The website for the Centers for Disease Control and Prevention currently leads its homepage with information about measles, a disease considered eliminated in the U.S. in 2000.
Now, outbreaks have become such a concern that the New York City suburb of Rockland County just barred minors not vaccinated for measles from public places for 30 days, and Gov. Jay Inslee declared a state of emergency in Washington two months ago because of the disease.
Washington’s 74 incidents of measles rank second behind New York among the 15 states where cases have been confirmed this year, according to the CDC, which lists 314 such instances nationwide as of March 21. That’s more than in any full year this decade except for 2014 (667) and 2018 (372).
“The reason measles is coming back is that a critical number of parents have chosen not to vaccinate their children,’’ said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “If you get to a few thousand cases, you’ll start to see children die of measles again.’’
The highly contagious illness, whose early symptoms may include a high fever, cough, runny nose and red, watery eyes, is not the only old-time disease making an unwanted comeback.
Child with a classic measles rash after four days.
Mumps and pertussis (whooping cough) have been on the rise in recent years, and the previously devastating tuberculosis is still causing trouble, though not at the rate it once did.
“Recently, we’ve been seeing an uptick in a whole different variety of infectious diseases, and that includes diseases we previously thought we had beat. Measles is probably the No. 1 example,’’ said Judd Hultquist, assistant professor of infectious diseases at Northwestern University’s Feinberg School of Medicine.
“It’s pretty incredible because even in the late 1960s, early 1970s, we were having so much success in coming up with new vaccines, new drug treatments, that we really felt like infectious diseases were going to be something we had beaten. And yet, here we are 50 years later and they’re making a comeback.’’
Here’s a look at some troubling illnesses that won’t go away:
Measles
Symptoms may take a week or two to appear, and shortly after that the patient may develop little white spots inside the mouth. That’s often followed by a facial rash that starts at the hairline and spreads to other parts of the body. At that point, the fever may surge to dangerous levels, above 104 degrees.
What to know: Measles outbreak is affecting over 150 in New York county
Pneumonia and even death – often because of severe dehydration – may follow, and there’s no cure for measles, although some medications may alleviate the symptoms.
Measles crisis: A quarter of all kindergartners in this county in Washington aren’t immunized
A much better alternative, public health experts say, is prevention through the MMR (measles, mumps, rubella) vaccine, which also protects against chicken pox and has a 97 percent rate of effectiveness after a second dose (93 percent after one).
Hultquist is among many who point out the spread of misinformation has led to more people opting out of vaccinating their children, allowing for measles to make a comeback. Last year’s 372 cases were the second-highest total in more than two decades, and this year’s pace would yield well over 1,000 cases.
In an analysis published in October, the CDC said vaccination rates for polio, MMR, hepatitis B and varicella remain steady and above 90 percent for U.S. children 19-35 months. However, the CDC also noted an increase in the number of minors 2 years old and under who received no vaccines from 0.9 percent in 2011 to 1.3 percent in 2015, consistent with the rise in the anti-vax movement.
“More and more we’re seeing people opting out of vaccinations out of a feeling they’re in some way dangerous, which is absolutely and completely untrue,’’ Hultquist said.
Mumps
Besides the tell-tale puffy cheeks, the viral disease can also produce fever, headaches and muscle aches. It’s most common among people who have extended close contact with each other, such as sports teams or college students.
“You are seeing more mumps,’’ Offit said. “I’m living in a city where at Temple University there are a hundred cases of mumps right now, and it spread to Drexel University and West Chester University.’’
Offit said the mumps outbreaks are likely related to its vaccine’s immunity diminishing after 10 years, even with a booster shot. Health officials are now seeing more cases among people in late adolescence and early adulthood, so they’re recommending a third dose for those in outbreak settings. That third shot may eventually become standard practice around age 16-18, especially considering mumps can affect fertility.
Mumps has never been eradicated in the United States, but from an average of 186,000 yearly reported cases when the vaccine was introduced in 1967, the numbers went down to a few hundred in the 1990s. However, the figures spiked to the 6,000 range in 2016 and 2017 before dropping to below 3,000 last year.
Pertussis
The contagious respiratory disease leads to violent coughing that impairs breathing and can be particularly dangerous, even fatal, for babies under a year of age.
Before the pertussis vaccine began to get widely administered in the mid-1940s, the annual number of cases nationally sometimes topped 200,000, with thousands of the kids dying.
The vaccine was extremely effective – reducing whopping-cough diagnoses to 1,000-2,000 through most of the 1970s and early ’80s – but concerns about side effects like high fever and occasional seizures led to a reformulation in 1997.
Administered with immunization for diphtheria and tetanus, the vaccine is now known as DTaP. However, the protection for pertussis wears off, and this decade the yearly instances have averaged in the 25,000 range.
“You’re seeing more pertussis now because we switched to that vaccine,’’ Offit said. “We ended up trading efficacy for safety, and I don’t think we realized at the time, frankly, how big that trade was going to be.’’
Tuberculosis
This bacterial disease, spread through the air when infected people cough, sneeze or speak, was the leading cause of death in this country in the early 1900s and remains the world’s leading infectious-disease killer. TB typically affects the lungs but can also harm the brain, spine and kidneys.
The incidence of tuberculosis in the U.S. has been decreasing for years, to a low of 9,029 new cases in 2018, down 0.7 percent from 2017. Despite advances in treatment, tuberculosis hasn’t been wiped out, and likely won’t be for a while.
More: Almost 40 at Mankato State infected with tuberculosis
The CDC said a recent model predicted that reaching the goal of eliminating TB – which would mean an incidence of less than one case per million people – won’t be achieved in this century without significantly increasing funding for detection and treatment.
Offit said the U.S. is among the few countries that doesn’t regularly administer a TB vaccine. The disease is especially dangerous for people with a compromised immune system, such as those who are HIV-positive.
“Ever since AIDS came into the U.S., tuberculosis increased,’’ Offit said. “Those two things are related.’’
This article originally appeared on USA TODAY: Anti-vaxxers open door for measles, mumps, other old-time diseases back from near extinction