Measles Still an Issue in the US

Environment, Energy, and Related News from the week ending May 3rd.

– by R. J. Sigmund

Measles

Texas measles total grows to 663 as Arkansas reports local spread, CIDRAP 

The Texas Department of State Health Services today reported 17 more measles cases from the West Texas outbreak, bringing the state’s total to 663. Along with more cases in the West Texas outbreak, the state reported 23 more hospitalizations from earlier in the outbreak, putting that total at 87. The number of deaths remain at 2.

So far, 26 Texas counties have measles cases linked to the outbreak, which began in Gaines County in January. Ten are still experiencing active transmission. The state also reported 1 more measles case that doesn’t have any known link to the West Texas outbreak, raising that total to 30. No new cases were reported in New Mexico and Oklahoma, where illnesses have been linked to the West Texas outbreak.

The Arkansas Department of Health today reported its fourth case, which involves a Faulkner County resident who had no travel history, signifying the state’s first case of the year involving community spread. The patient, like the previous three, is younger than 18 years old. Officials also noted that the child wasn’t fully vaccinated and visited a medical clinic and a dance studio while infectious. Based on community spread in Faulkner County, the health department updated its vaccine recommendations for anyone living in or traveling to the county and six neighboring counties. All children ages 6 to 11 months old can receive a “zero dose” measles, mumps, and rubella (MMR) vaccine, meaning it doesn’t count as one of the two recommended doses for kids ages 12 months and older.

Mexico’s government on April 25 issued a yellow (medium) health notice about travel to Canada and the United States because of measles outbreaks in both countries. Officials noted that, as of April 17, Canada has reported 880 cases this year in six provinces, though 804 of them (91%) are in Ontario. They also said that, as of the same date, the United States has reported 800 cases in 25 states, though mostly in Texas, New Mexico, Kansas, and Ohio. They urged travelers to ensure that they are up to date with MMR vaccination and to avoid travel and limit contact with others if symptomatic.

Mexico is also experiencing a measles outbreak, with 421 cases in eight states, but with 96% of them (403) in Chihuahua, according to an update yesterday from the World Health Organization on measles activity in the Americas.

US measles total passes 900 as CDC responds to alternative treatment push 

The US Centers for Disease Control and Prevention (CDC) today in its weekly update reported 51 more measles cases, bringing the national total to 935 from 30 states, though most are part of a large outbreak with an epicenter in West Texas. The nation is now experiencing 12 outbreaks, one more than the previous week, and 93% of illnesses reported are connected to outbreaks.

The Texas Department of State Health Services (TDSHS) today reported 20 more cases since its last update on April 29, lifting the state’s total at 683. Three more counties reported cases linked to the outbreak, putting the total at 29. Of the 683 cases reported from Texas, 396 are from the Gaines County hot spot. Of the state’s total, 653 patients were unvaccinated or have an unknown vaccination status. So far, 89 people have been hospitalized since the start of the outbreak, and the number of deaths remains at 2.

In related developments, CBS News reported yesterday that Health and Human Services Secretary Robert F. Kennedy Jr. would ask the CDC to develop new guidance for treating measles with drugs and vitamins. Today, the CDC posted new resources for public health departments and parents, along with a fact sheet for clinicians that covers two alternative treatments that Kennedy has pushed, including vitamin A, antibiotics, and inhaled steroids. The vitamin A treatments that Kennedy has supported in the response to the Texas outbreak have put some kids in the hospital after they were given toxic amounts of the vitamin.

In the fact sheet, the CDC said vitamin A doesn’t prevent measles and isn’t a substitute for vaccination but has been shown to reduce measles mortality in children living in areas with high levels of vitamin A deficiency. “In the U.S., prevalence of vitamin A deficiency is very low,” the group said. It added that vitamin A can be administered to infants and children with measles in the United States under the supervision of a health provider as part of “supportive management,” with age-specific daily dose limits. “Overuse of vitamin A can lead to toxicity and cause damage to the liver, bones, central nervous system, and skin,” the CDC said. “Pregnant women should avoid taking high levels of vitamin A as it has been linked to severe birth defects.”The CDC said there is no evidence for using antibiotics to treat measles, which is a viral disease. It notes that treatment decisions should be based on the clinical assessment of health providers. As for inhaled steroids, the CDC said they are useful for patients who have a history of reactive airway disease and again said use should be based on individual decision-making by health providers.