Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Mar 1;6(1):40-48.
doi: 10.1093/jpids/piv080.

A Comparison of Postelimination Measles Epidemiology in the United States, 2009-2014 Versus 2001-2008

Amy Parker Fiebelkorn  1 , Susan B Redd  1 , Paul A Gastañaduy  1 , Nakia Clemmons  1 , Paul A Rota  2 , Jennifer S Rota  2 , William J Bellini  2 , Gregory S Wallace  1
Affiliations
Comparative Study

A Comparison of Postelimination Measles Epidemiology in the United States, 2009-2014 Versus 2001-2008

Amy Parker Fiebelkorn et al. J Pediatric Infect Dis Soc. .

Abstract

Background: Measles, a vaccine-preventable disease that can cause severe complications, was declared eliminated from the United States in 2000. The last published summary of US measles epidemiology was during 2001-2008. We summarized US measles epidemiology during 2009-2014.

Methods: We compared demographic, vaccination, and virologic data on confirmed measles cases reported to the Centers for Disease Control and Prevention during January 1, 2009-December 31, 2014 and January 1, 2001-December 31, 2008.

Results: During 2009-2014, 1264 confirmed measles cases were reported in the United States, including 275 importations from 58 countries and 66 outbreaks. The annual median number of cases and outbreaks during this period was 130 (range, 55-667 cases) and 10 (range, 4-23 outbreaks), respectively, compared with an annual median of 56 cases (P = .08) and 4 outbreaks during 2001-2008 (P = .04). Among US-resident case-patients during 2009-2014, children aged 12-15 months had the highest measles incidence (65 cases; 8.3 cases/million person-years), and infants aged 6-11 months had the second highest incidence (86 cases; 7.3 cases/million person-years). During 2009-2014, 865 (74%) of 1173 US-resident case-patients were unvaccinated and 188 (16%) had unknown vaccination status; of 917 vaccine-eligible US-resident case-patients, 600 (65%) were reported as having philosophical or religious objections to vaccination.

Conclusions: Although the United States has maintained measles elimination since 2000, measles outbreaks continue to occur globally, resulting in imported cases and potential spread. The annual median number of cases and outbreaks more than doubled during 2009-2014 compared with the earlier postelimination years. To maintain elimination, it will be necessary to maintain high 2-dose vaccination coverage, continue case-based surveillance, and monitor the patterns and rates of vaccine exemption.

Keywords: epidemiology; measles; measles elimination; measles mumps rubella (MMR) vaccine.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None reported

Figures

Figure 1
Figure 1
Reported measles cases and incidence by year, United States, 1989−2014. Inset: Reported measles cases and incidence by year, United States from 2009−2014. Gray shading: Reported number of measles cases Black line: Measles incidence per million population
Figure 2
Figure 2
Percent of measles case-patients by age group (by year), United States, 2009−2014. Diagonal striped bars: case-patients aged <1 year Gray dotted bars: case-patients aged 1–4 years Striped vertical bars: case-patients aged 5–9 years Dark gray bars: case-patients aged 10–19 years Black bars: case-patients aged 20–29 years White bars: case-patients aged 30–39 years Cross-hatched bars: case-patients aged 40–49 years Horizontal striped bars: case-patients aged ≥50 years *Missing data on 2 case-patients (1 in 2013 and 1 in 2014).
Figure 3
Figure 3
Measles importations to the U.S. by World Health Organization region, 2009−2014 White diagonal stripes on black background: importations of unknown origin Black dots on white background: Western Pacific Region White shading: South-East Asia Region Black shading: European Region Black and white vertical stripes: Eastern Mediterranean Region Dark gray shading: African Region Black and white horizontal stripes: Region of the Americas
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Strebel PM, Papania MJ, Parker Fiebelkorn A, Halsey NA. Measles Vaccine. In: Plotkin SA, Orenstein WA, Offit P, editors. Vaccines. 6 ed. Elsevier Saunders; 2013. pp. 352–387.
    1. McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Recomm Rep. 2013;62(RR-04):1–34. - PubMed
    1. Centers for Disease C. School immunization requirements for measles--United States, 1982. MMWR Morb Mortal Wkly Rep. 1982;31(6):65–67. - PubMed
    1. Katz SL, Hinman AR. Summary and conclusions: measles elimination meeting, 16–17 March 2000. J Infect Dis. 2004;189(Suppl 1):S43–S47. - PubMed
    1. Papania MJ, Wallace GS, Rota PA, et al. Elimination of endemic measles, rubella, and congenital rubella syndrome from the Western hemisphere: the US experience. JAMA pediatrics. 2014;168(2):148–155. - PubMed

Publication types

Substances