2005 - Measles

Measles is an acute viral infectious disease normally resulting in rash and fever, with cough, conjunctivitis, and coryza. Other symptoms of measles include anorexia, diarrhea, and generalized lymphadenopathy. Measles transmission is primarily person to person via large respiratory droplets.

Reported cases of measles have declined rapidly after the resurgence in 1989-1991. In recent years, almost all cases of measles reported in the U.S. can be traced directly or indirectly to foreign travel or contact with foreign visitors. All confirmed cases of measles in Indiana since 1994 have been the result of importation from a foreign country.

In 2005, Indiana had a measles outbreak with 33 measles cases reported. A 17-year-old unvaccinated child became infected with the measles virus while on a mission trip to Romania. She attended a church gathering soon after her return where she exposed the virus to unvaccinated children whose parents object to vaccination. This was the largest outbreak of measles in Indiana since 1990 and the largest national outbreak since 1996. Figure 1 shows reported measles cases by year for 2001-2005. The outbreak occurred in mid-May and continued until the end of June (Figure 2). As shown in Figure 3, age-specific rates were greatest for children aged 10-19 years (2.09), followed by children aged 5-9 years (1.83). The outbreak involved residents from three counties: Clinton (17), Tippecanoe (15), and White (1) (Figure 4). High vaccination levels in the surrounding community and low rates of vaccine failure averted a larger outbreak. Maintenance of high rates of vaccination coverage, including improving strategies of communication with persons who refuse vaccination, is necessary to prevent future outbreaks and sustain the elimination of measles in the U.S. This reinforces the need for all international travelers to be immune to measles prior to leaving the United States.

Because of the low incidence of measles, an IgM measles-specific serologic analysis must be conducted on all reported cases. The specimen should be drawn at least three days following onset of rash. Although incidence of measles disease is low, health care providers should consider measles diagnosis and serologic analysis when patients have a generalized rash, with a fever of 101 degrees Fahrenheit or greater, and at least one of the prodromal symptoms of cough, conjunctivitis, or coryza.

You can learn more about measles by visiting the following Web site:
CDC Measles homepage