One of the major health headlines in 2015 has been a measles outbreak. The current outbreak is believed to have begun in Disneyland and Disney California Adventure Park in late December 2014. Since that time, well over 115 cases of measles have been reported in multiple states. In Florida, 4 cases have been reported at the time of this writing. Based on information from the Florida Department of Health (DOH), the four individuals identified, traveled to Florida, including Tampa and are not state residents. Two of the individuals are U.S. citizens while two are international visitors. None of the four were vaccinated against the disease. The DOH and local health departments has been aggressive about monitoring individuals who were potentially exposed to the four travelers.
This recent identification of measles in the Sunshine state comes after a prior outbreak in the Orlando area. Case information from the Center for Disease Control and Prevention (CDC) identified a 10 year unvaccinated resident of Orange County as the index case last year. Subsequently, her 3 siblings all contracted measles within a week of the diagnosis. The parents of the children claimed religious exception to vaccination. Nasal specimens that were collected from all of the children by the Florida Department of Health and Bureau of Public Health Laboratories, did test positive for the measles virus RNA. An additional case of confirmed measles was identified by the DOH in Miami-Dade County. This case was identified nearly one month after the Orlando cases. A Brazilian citizen, without evidence of vaccination, reported having visited a theme park in the Orlando area. Genomic sequencing of the Brazilian patient was identical to the cases reported in Orange County. It is believed that this exposure likely came from the same Orlando based theme park where the index patient’s family had visited one month prior.
Measles is a highly contagious disease with an estimated incidence of more than 20 million cases worldwide. Complications occur in about 30% of cases in which over 164,000 deaths occur worldwide yearly. Cases in the U.S. tend to be sporadic and commonly occur from unvaccinated international visitors and from U.S. citizens traveling abroad.
The MMR vaccine has been shown to be highly effective at preventing the spread of measles, however, its use is under scrutiny by subsets of the population that contest that vaccines are harmful and can cause autism. Florida State Surgeon General and State Secretary of Health, Dr. John Armstrong has reported that approximately 93% of kindergartners in Florida have received vaccination for measles, mumps, and rubella (MMR vaccine).