Public health officials in Orange County Florida are reporting that tourists from Texas, Minnesota and Michigan have been diagnosed with measles after visiting Orlando. A CDC investigation suggests an air show may be a common link between several cases. Since no cases have ben identified in Florida, it is possible a visitor from overseas infected people attending the air show. In Texas, an 11-month old was diagnosed in Houston, while two adult cases in the Fort Worth area are the first in 17 years. The infant and one of the adult cases are believed to have been infected in Orlando. In Minnesota, 15 measles cases have been confirmed: 1 case likely came from Florida, 1 from India, and the others are linked to a case imported from Kenya.
Measles is highly contagious among the unvaccinated. Houston saw large outbreaks in the 1980s and 1990s when the immunization rate was quite low (58%). Many Texas news sources are reporting much higher coverage among kindergartners in surrounding communities. Abilene, for example, reports a 99% coverage rate. High levels of immunity should diminish the risk of an outbreak. In Minneapolis, public health workers are meeting resistance to vaccination by some in the large Somali community. One doctor said in his experience as many as 70% of Somali families are avoiding the vaccines. Overall, Minnesota has seen a decline in vaccination rates. At 76.95%, the state has fallen from 7th to 20th place in the most recent survey of US states.
This week, a CDC report warned “measles importations and transmission from imported cases continue to pose a threat to U.S. residents.” In January and February, 28 import-associated cases were reported. Although measles was eliminated in the US, international travel poses the constant risk of reintroduction and establishment. Where immunization coverage is low, a single introduced case can lead to the return of the disease. For every 1,000 children who get measles, one or two will die.