(CDC — Updated 3/28/19)


In January, we checked in on Clark County, Washington after Governor Jay Inslee declared a public health emergency because of a measles outbreak. Vaccine hesitancy and refusal were threatening to turn back decades of remarkable progress in Washington, in the rest of the country, and all around the world:

Because immunization rates in most areas of the U.S. have been historically high over the last several decades, cases of measles are rare. So rare, in fact, that the Centers for Disease Control and Prevention declared measles eliminated from the United States in 2000. In 2016, we celebrated the World Health Organization’s announcement that measles had been eradicated from the Americas (North, Central, South, and the Caribbean).


Last week, the CDC announced that there have been a total of 387 individual cases of measles in 15 states so far in 2019. That’s more than all the cases reported to the CDC in 2018 and the second highest number of cases since 2014, which saw 667 cases in 23 separate measles outbreaks. (More than half the cases in 2014 involved unimmunized residents of an Amish community in Ohio.) Four of the 15 states are having ongoing outbreaks, including two separate areas in California, and two in New York, says Susan Scutti:

The CDC says six outbreaks — defined as three or more cases — are ongoing in California (Santa Cruz and Butte County), New Jersey, New York (Rockland County and New York City) and Washington.

These outbreaks are linked to travelers who brought measles back from other countries such as Israel, Ukraine and the Philippines, where large measles outbreaks are occurring.


There have been 71 cases of measles in Washington State so far in 2019, almost all of them in unvaccinated children. In New York State, Rockland County is now experiencing an outbreak that won’t quit: 153 confirmed cases of measles since October 2018. It’s gotten so bad that the county executive recently made an emergency declaration banning unvaccinated residents under the age of 18 from public places like schools, restaurants, stores, public transportation, and places of worship.* The CDC describes how measles — one of the most contagious diseases known — spreads from one person and one community to another:

  • The majority of people who got measles were unvaccinated.
  • Measles is still common in many parts of the world including some countries in Europe, Asia, the Pacific, and Africa.
  • Travelers with measles continue to bring the disease into the U.S.
  • Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated.


Pediatrician Vincent Iannelli keeps a running tab of every reported case of measles in the U.S. on his essential website, Vaxopedia. He reviews the MMR requirements for international travelers, though, with so many areas in the U.S. experiencing measles outbreaks, domestic travelers also might want to double-check their immunization status:

These outbreaks are a great reminder to review the special vaccine travel requirements, including that adults who “plan to travel internationally should receive 2 doses of MMR at least 28 days apart,” that infants traveling abroad can get their first dose of MMR as early as age 6 to 11 months, with a repeat dose at age 12 months, and that “children aged who are greater than or equal to 12 months need 2 doses of MMR vaccine before traveling overseas,” even if they aren’t four to six years old yet.


*Update 4/8/19: On Friday, April 5, a Rockland County, NY judge temporarily blocked a ban on unvaccinated children. According to CNN: “The judge wrote that the small percentage of cases in Rockland County didn’t meet the definition of an epidemic that the law permitting emergency declarations requires.” A hearing is scheduled for April 19 to review the situation.