Ongoing Outbreaks Put Measles Elimination Status at Risk in the United States


The CDC has indicated that many recent measles cases reported in the United States in 2018 have been the result of international travel to areas of the world where the virus is active, and individuals who are not vaccinated against the virus.

The United States is at risk of losing its measles elimination status, according to CDC officials.1

The agency announced Thursday there were 971 reported cases of measles in the United States in the first 5 months of 2019. The number is the highest annual total since 1994, when 963 cases of measles were reported for that entire year.1

“That [status] loss would be a huge blow for the nation and erase the hard work done by all levels of public health,” CDC officials said, in a press release.1 “The measles elimination goal, first announced in 1963 and accomplished in 2000, was a monumental task.”

Earlier this year, the CDC indicated that many measles cases reported in the United States in 2018 were the result of international travel to areas of the world where the virus is active. The majority of individuals who got measles were not vaccinated for the virus, according to the agency.2

“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. Again, I want to reassure parents that vaccines are safe, they do not cause autism. The greater danger is the disease that vaccination prevents,” said CDC Director Robert Redfield, MD, in a prepared statement.1

“Your decision to vaccinate will protect your family’s health and your community’s well-being. CDC will continue working with public health responders across our nation to bring this outbreak to an end,” Redfield continued.1

Before widespread use of the measles vaccine, an estimated 3 to 4 million people got measles each year in the United States, along with an estimated 400 to 500 deaths and 48,000 hospitalizations. In eliminating measles in the United States the CDC credited availability and widespread use of measles vaccine; a public health infrastructure that detects and contains the virus; and ongoing work with affected state and local health departments to bring ongoing outbreaks under control.1

However, outbreaks in New York City and Rockland County, New York have continued for nearly 7 months.1

Concerns based on misinformation about the vaccine safety and effectiveness, as well as disease severity, may lead parents to delay or refuse vaccines for their children, according to the CDC.1

Mary Koslap‐Petraco DNP, PNPPC‐BC, CPNP, FAANP of Stony Brook University School of Nursing and Pediatric Nurse Practitioner House Calls, advised health care providers to listen to concerned parents and assure them they want the best for their children, in an interview at the 2019 National Association of Pediatric Nurse Practitioners annual meeting in New Orleans.

According to Koslap-Petraco, vaccination providers should respond to questions and concerns with honest answers. Although vaccinations rely on science, she said, many parents make decision on an emotional level, and that’s where health care professionals may be able to reach parents who are "on the fence" about whether to immunize their children.

“Find something that you can agree about with parents, say something right up front, 'I know you want the best for your children, and I only want the same,' and then continue the discussion from there,” said Koslap-Petraco.

Everyone 6 months and older should be protected against measles before traveling internationally, the agency recommended. Babies age 6 to 11 months old need 1 dose of measles vaccine before traveling. Everyone age 12 months and older needs 2 doses.1

International travelers unsure of their vaccination status should consult with their health care provider before traveling.1


  • Immunizations: Active Versus Passive
  • Vaccines for Babies Traveling Abroad


  • U.S. measles cases in first five months of 2019 surpass total cases for any year since 1994 [news release]. May 30, 2019: CDC website. Accessed May 30, 2019.
  • Coppock K. 2019 Begins with 79 Measles Cases Reported in the US. Contemporary Clinic. Published February 4, 2019. Accessed May 30, 2019.
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