References to measles can be found as far back as the 7^th century A.D. In fact, the disease was described by Rhazes in the 10th Century A.D. as "more dreaded than smallpox." But all that changed in 1963 when the measles vaccine was first licenced in the U.S.

Impact of the Measles Vaccine
Prior to 1963, almost everyone got measles; it was an expected life event. Each year in the U.S. there were approximately 3 to 4 million cases and an average of 450 deaths, with epidemic cycles every 2 to 3 years. More than half the population had measles by the time they were 6 years old, and 90 % had the disease by the time they were 15. This indicates that many more cases were occurring than were being reported. However, after the vaccine became available, the number of measles cases dropped by 98 % and the epidemic cycles drastically diminished.

Second Measles Vaccine Dose
It was discovered that, between 1985 and 1988, many measles cases had occurred in children who had been vaccinated. While there were far fewer measles cases among vaccinated children than among unvaccinated, the children who received only one dose were not always protected from the disease. This led to the recommendation of a second dose for children between the ages of 5 and 19 years of age to ensure protection for those who had not developed immunity from the first dose.

1989-1990 Measles Epidemic
A dramatic increase in measles cases occurred between 1989 and 1991. During those three years, 55,622 cases were reported Most of the cases occurred in children under 5 years of age, with the number of cases among unvaccinated Hispanic and African American populations being four to seven times higher than among non-Hispanic whites. This also marked the first time the number of measles cases for children under 5 years of age exceeded those for the 5 to 19 years old group.

During this period, 123 people died from measles-related illnesses — almost half were under 5 years old. Ninety percent of those who lost their lives had not been vaccinated. The 64 deaths in 1990 was the largest number that had been seen in almost 20 years.

Measles Outbreaks in Recent Years
Since 1993, the largest outbreaks of measles have occurred in populations that refuse vaccination, including communities in Utah and Nevada, and in Christian Scientist schools in Missouri and Illinois. Smaller outbreaks were reported in unvaccinated preschool populations, vaccinated school populations, among college students, and in adult communities, but these outbreaks were much smaller than those reported during 1989-1991. In recent years, outbreaks of measles have been small (less than 50 cases) and have chiefly involved high school and college students who are unvaccinated or have received only one dose of measles No large preschool-type outbreak has been reported since 1992.

Source of Today’s Measles Cases
In March of 2000, a group of expert consultants convened by the CDC concluded that measles is no longer endemic in the U.S. Rather, all cases in the U.S. appear to be the result of importations, with limited domestic spread. This means that the only measles cases we see in the U.S. today have been brought in from other countries, usually Europe and Asia. Due to an aggressive measles vaccination program by the Pan American Health organization, measles incidence is now very low in Latin America and the Caribbean. Measles elimination from the Americas appears to be an achievable goal.

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Measles Cases Imported into U.S. 1990-1999*
   * 1999 data is provisional

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Reported Measles cases, 1950 -1998*
   *1998 provisional data

• Measles prevalence throughout world
• World measles immunization coverage
• Immunization profiles for specific countries

[CDC Morbidity and Mortality Weekly Report (MMWR)]

• Measles Outbreak in a Boarding School - Pennsylvania, 2003 New!
  Vo. 53, No 14;306-309 04/16/2004
  Summary: This report summarizes the results of the outbreak investigation, which indicated that measles continues to be imported into the U.S. and that high coverage with 2 doses of measles-containing vaccine (MCV) among students was effective in limiting the size of the outbreak. Health-care providers should maintain a high index of suspicion for measles, especially in those who have traveled abroad recently, and recommendations for 2 doses of MCV in all school-aged children should be followed...
     
• Multistate Investigation of Measles Among Adoptees from China -- April 2004 New!
  Vo. 53, No 14;309-310    04/16/2004
  Summary: This report summarizes the preliminary results of an ongoing multistate investigation that has so far identified four confirmed and five suspected cases of measles among adoptees from China, underscoring the need for health-care providers to remain vigilant for measles and other vaccine-preventable communicable diseases in children adopted from international regions... See Also Brief Report: Update: Measles Among Adoptees from China -- April 14, 2004
     
• Brief Report: Imported Measles Case Associated with Nonmedical Vaccine Exemption -- Iowa, March 2004 New!
  Vo. 53, No 11;244-246 03/26/04
  Summary: This report describes the measles case, the public health response to prevent secondary cases, and the impact on the public health system...
     
• Public Health Dispatch: Measles Epidemic -- Majuro Atoll, Republic of the Marshall Islands, July 13-Sept. 13, 2003
  Vo. 52, No 37;888-889 09/19/2003
  Summary: During July 13-September 13, 2003, a total of 647 clinically diagnosed measles cases were reported on Majuro Atoll in the Republic of the Marshall Islands (RMI)... This report describes the clinically diagnosed measles cases and the public health response to stop the epidemic...
     
• Measles Epidemic Attributed to Inadequate Vaccination Coverage -- Campania, Italy, 2002
  Vo. 52, No 43;1044-1047 10/31/2003
  Summary: This report summarizes the preliminary results of the investigation..., which attributed the epidemic to inadequate vaccination coverage. A coordinated effort is needed to interrupt measles transmission in Italy...
     
• Measles Outbreak -- Netherlands, April 1999
  Vol 49, No 14;299 04/14/2000
  Summary: On June 21, 1999, a cluster of five cases of measles was reported among the 390 students attending a religion-affiliated elementary school in the Netherlands. Persons belonging to this religious denomination routinely do not accept vaccination. 
     
• Measles Outbreak -- Romania, 1997
  Vol 46, No 49;115 12/12/1997
  Summary: During December 1, 1996 - September 30, 1997, a total of 20,034 cases of measles were reported to the Ministry of Health (MOH) in Romania; 13 cases were fatal. The outbreak began in December 1996, peaked in May 1997, then declined.
     
• Measles Outbreak -- Southwestern Utah, 1996
  Vol 46, No 33;766 08/22/1997
  Summary: During April 9_July 7, 1996, a total of 107 confirmed measles cases were reported from Washington County, Utah -- one of five counties in the Utah Southwest Health District (USHD).
        
• Measles Outbreak Among School-Aged Children in Juneau, Alaska, 1996
  Vol 45, No 36;777 09/13/1996
  Summary: An outbreak of measles among school-aged children occurred in Juneau, Alaska, from February 16 through April 25, 1996.
       
• Measles Outbreak in Guam, 1994
  Vol 44, No 36;657 09/15/1995
  Summary: One of the largest outbreaks of measles in the United States and its territories since 1992 occurred in Guam during 1994. From February 8 through June 25, 1994, a total of 280 suspected, probable, or confirmed cases of measles were reported to the Guam Department of Public Health and Social Services (GDPH). 
     
• Interstate Measles Transmission from Ski Resort - Colorado, 1994
  Vol 43, No 34;627 09/02/1994
  Summary: During April 1 -May 25, 1994, a chain of measles transmission began in Breckenridge, Colorado, and extended into nine additional states; a total of 247 measles cases were reported, representing 36% of all U.S. measles cases reported to the National Notifiable Diseases Surveillance System. This report summarizes the investigation of this chain of interstate measles transmission.
     
• Outbreak of Measles Among Christian Science Students
  Vol 43, No 25;463 07/01/1994
  Summary: During April 4_May 17, 1994, the largest U.S. measles outbreak since 1992 occurred among students in two communities that do not routinely accept vaccination. This report summarizes the investigation of and control measures for this outbreak.
     
• Measles in Duval County, Florida, 1991-1992
  Vol 42, No 04;81 02/05/1993
  Summary: An outbreak of measles occurred in northeastern Florida (Bradford, Clay, Duval, Nassau, Putnam, and St. Johns counties) in 1991 and early 1992. A total of 193 confirmed cases of measles were reported to the Florida Department of Health and Rehabilitative Services (FDHRS). 
    
• Measles at International Gymnastics Competition in Indiana, 1991
  Vol 41, No 07;109 02/21/1992
  Summary: On September 7, 1991, the Indiana State Department of Health (ISDH) was notified of three suspected measles cases among athletes from New Zealand (NZ) participating in an international gymnastics competition September 6-15 in Indianapolis (Marion County). This report summarizes the epidemiologic investigation of these cases.
     

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This page last modified on April 15, 2004