CONTRA COSTA COUNTY, CA — With the number of measles cases rising nationally and local cases seen recently, health officials from Contra Costa County and neighboring Bay Area counties on Tuesday urged everyone to be up to date on measles vaccinations and to watch for symptoms after travel or exposure.
The best protection against measles is two doses of the measles-mumps-rubella —MMR—vaccine, which protects a person for life. This is particularly important, health officials said, for anyone traveling internationally in the upcoming months.
The U.S. Centers for Disease Control and Prevention — CDC —reported that as of March 28, 97 confirmed cases in 18 states and jurisdictions thus far in 2024. Seven outbreaks —defined as three or more related cases — have been reported in 2024, and 72 percent of cases — 70 of 97 —are outbreak-associated. For comparison, four outbreaks were reported during 2023 and 48 percent of cases —28 of 58 — were outbreak-associated.
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The jurisdictions with cases this year are Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York City, New York State, Ohio, Pennsylvania, Virginia and Washington.
As of March 20, California had five measles cases reported for 2024. No measles cases were reported in California in 2022 and four cases were confirmed in California in 2023.
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Over 90 percent of U.S. cases thus far in 2024 have been linked to international travel. Measles is circulating in many regions of the world, including popular tourist and business destinations. Austria, the Philippines, Romania and the United Kingdom are all experiencing measles outbreaks, the CDC said.
“To prevent measles infection and reduce the risk of community transmission from importation, all U.S. residents traveling internationally, regardless of destination, should be current on their MMR vaccinations,” the CDC said in a March 18 health advisory.
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Most cases in the United States have been among children 12 months and older who had not received the MMR vaccine. Travelers are at risk of measles if they have not been fully vaccinated at least two weeks before departure or have not had measles in the past and travel internationally.
“With three major airports, the Bay Area is a hub for international travel, increasing the potential for exposure to this highly contagious virus,” the Association of Bay Area Health Officers —ABAHO — said in a statement issued Tuesday. “For people or families who plan to travel internationally, anyone not vaccinated against measles is at increased risk of getting infected.”
Health officers from the counties of Alameda, Contra Costa, Marin, Monterey, Napa, Santa Clara, Santa Cruz, San Benito, San Francisco, San Mateo, Solano, Sonoma and the city of Berkeley are all members of ABAHO.
The health officers urged Bay Area residents to plan early before international travel and check their destination and the CDC’s Global Measles Travel Health Notice for more travel health advice, including where measles outbreaks have been reported. Parents should consult with their child’s healthcare provider before traveling. After returning to the United States, watch for signs and symptoms of measles for three weeks, the association said.
While MMR vaccination rates have been high in the Bay Area, the association said it is important to confirm vaccination history. For those exposed, carrying documentation of vaccination status can help avoid being ordered to quarantine. The CDC offers accelerated vaccination guidelines for persons, including children younger than 12 months, who plan to travel internationally.
Measles symptoms include fever, cough, runny nose and conjunctivitis —pink eye — followed two to four days later by a rash. The virus is transmitted through direct contact with infectious droplets or through the air when an infected person breathes, coughs or sneezes. Infectious droplets can linger in indoor air for several hours.
About one in five persons infected with measles requires hospitalization, and nearly one in three of every 1,000 children who become infected with measles will die from respiratory and neurologic complications, according to the CDC. Measles presents the greatest risk to children under 5 years old, adults over 20, pregnant women and people with compromised immune systems.
Vaccination is highly effective at preventing measles, the association said. The MMR vaccine is recommended for children 12-15 months, with a second dose needed at ages 4-6. Infants 6-12 months can start vaccination early if traveling soon to an international destination. Teenagers and adults with no evidence of immunity should be vaccinated right away, health officials said.
“While the risk of exposure to measles in the Bay Area is still low, it’s important to make sure that everyone has the strongest protections against this dangerous disease,” said San Mateo County Health Officer Dr. Kismet Baldwin-Santana.
For questions about the MMR vaccine and immunization records, Bay Area residents should check with their healthcare provider and access their digital vaccine records.
Health officers from the counties of Alameda, Contra Costa, Marin, Monterey, Napa, Santa Clara,
Santa Cruz, San Benito, San Francisco, San Mateo, Solano and Sonoma, and the city of Berkeley
encouraged the public Tuesday to take these easy steps to protect themselves and others.
Measles Outbreaks In California
From December 2014 to April 2015, at least 131 California residents were infected in a large measles outbreak associated with Disneyland; the outbreak also infected residents of six other states, Mexico and Canada.
In 2019, there were 73 confirmed measles cases in California, including 41 cases associated with six outbreaks (three or more cases), according to the CDPH. Of the six outbreaks, five were linked to patients with international travel, while one had an unknown source. The largest outbreak consisted of 21 cases and involved multiple generations of transmission in a healthcare setting. The other five outbreaks involved from three to five cases.
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