• CDC has had reports of 704 cases of measles in the United States between January 1st and April 26th of 2019. This is the greatest number of cases reported in the United State since 1994 and also since measles was declared eliminated in 2000.
• Based on the cases we received during this time period, this is what we know about the age ranges of those that were affected:
• The median age of the patients reported was 5 years.
• About 1 out of every 4 cases was a child between 16 months and 4 years old.
• 71% of the individuals with measles were unvaccinated, and another 18% had an unknown vaccination status. 11% were vaccinated.
• Overall, 66 (9%) patients were hospitalized and 24 (3%) had pneumonia. No deaths or cases of encephalitis were reported to CDC.
• There have been 13 outbreaks reported in 2019. Six outbreaks occurred in under immunized close-knit communities and account for almost 90% of all cases.
• New York and New York City have accounted for 67% of all of the reported measles cases this year so far.
• The vast majority (98%) of the cases were U.S. residents. Forty-four of the cases were the result of an international traveler (usually a U.S. resident) becoming infected in another country and returning to the United States.
• 9 out of 10 of those individuals who became infected during international travel were either unvaccinated or had an unknown vaccination status, although all were eligible to get vaccinated according to their ages.
• The top three countries where travelers became infected so far in 2019 include the Philippines, Ukraine, and Israel.

• Individuals may not be vaccinated for many reasons. Some adults may not be aware they need the vaccine. Some children may not be up to date either because the child is unable to be vaccinated or because the caregiver refuses or delays vaccination.
• In New York, parents may refuse or delay MMR vaccine because of concerns based on the misinformation being spread by some organization about the vaccine safety and effectiveness, as well as disease severity.
• Measles can be serious. There is no way to predict how bad a case will be. There is no treatment or cure for measles. Some children may have very mild symptoms but others may face more serious complications, like pneumonia and encephalitis. We have seen a variety of cases in this outbreak, from mild to severe.
• Parents all want to protect and what is best for their children. The best and safest protection we have against measles is the MMR vaccine.

• Children 12 months of age or older should have 2 doses, the first dose at age 12 to 15 month and the second dose between 4 to 6 years.
• Adults who do not have evidence of immunity should get at least one dose of MMR vaccine.
• Certain persons should receive two doses of MMR. This includes healthcare personnel (not just clinical staff), students at post-secondary institutions (such as colleges or vocational schools), and international travelers.

CDC’s MMR vaccine travel recommendations for international travel:

• Infants 6 months through 11 months of age should have 1 dose of MMR vaccine.
• Children 12 months of age and older should receive two doses of MMR vaccine, separated by at least 28 days.
• Adults with documentation of one dose of MMR vaccine should get a second dose. 
• Adults who do not have evidence of immunity against measles should get two doses of MMR vaccine, separated by at least 28 days.

• Where outbreaks with sustained transmission are occurring, health departments are best poised to make outbreak recommendations for their communities.
• If the outbreak affects preschool children or adults with community wide transmission: A second dose should be considered for children aged 1 through 4 years or adults who have received 1 dose (with the 2nd dose given at least 28 days after the first).
• If the outbreak involves infants aged <12 months with ongoing transmission and continued risk for exposure to infants, infants 6 months through 11 months can be vaccinated.

• Do not use self-report of MMR vaccination as proof of immunity. If there is no record of vaccination or proof of immunity, the patient should be vaccinated.
• Health care providers, don’t miss any opportunity to vaccinate patients who are behind on MMR vaccine, especially those who are traveling internationally and/or living in or near communities with measles outbreaks.

Additional resources for immunization partners and professionals

• CDC Measles Webpages
• PHF Immunization Center and Upcoming Webinar(s)
• Measles training on the TRAIN Learning Network
• Epidemiology and Prevention of Vaccine-Preventable Diseases (“The Pink Book”)