By Bahar Gholipour, Staff Writer

Published: 09/12/2013 01:25 PM EDT on LiveScience


Despite progress toward eliminating measles in the United States, outbreaks continue to occur, particularly in communities with high percentages of people who are not vaccinated because of religious and philosophical beliefs, according to a new report from the Centers for Disease Control and Prevention (CDC).


Since the beginning of this year, 159 cases of measles have been reported in 16 states.


Eight outbreaks of measles[1] have occurred this year, including one with 58 cases in New York City, the largest U.S. outbreak reported since 1996.


The outbreaks often begin when the virus is brought into the country by travelers. So far this year, 42 people contracted measles while abroad, about half of whom had traveled to Europe, according to the report.


Three of this year's outbreaks occurred after measles was brought into communities with high rates of people who were not vaccinated due to philosophical or religious objection. These three outbreaks have accounted for nearly two-thirds of all 2013 U.S. measles cases. [5 Dangerous Vaccination Myths[2] ]


"The increase in measles cases in the United States in 2013 serves as a reminder that imported measles cases can result in large outbreaks," particularly if the virus is introduced into areas with communities with a high number of unvaccinated persons, the CDC researchers wrote in their report.



"These outbreaks demonstrate that unvaccinated persons place themselves and their communities at risk for measles," the researchers said.


Measles is a highly contagious illness that can lead to complications and death, but can be prevented by the MMR vaccine[3] . An estimated 20 million people get measles each year worldwide, and Europe, a popular destination for U.S. travelers and an area where the virus continues to circulate, is most often the source of imported measles cases, according to the report.


Since 2000, when measles was declared eliminated in the United States in 2000, 60 cases have been reported yearly, on average. The highest numbers of cases[4] reported since then were in 2008 and 2011, with 140 cases and 220 cases, respectively.


The CDC recommends vaccination for all children older than 6 months. Vaccine coverage in the United States is high, with 91 percent of U.S. children having been vaccinated, which limits the size of measles outbreaks, according to the report.


However, some states still have lower coverage levels[5] . Unvaccinated children tend to be clustered in the same communities, increasing the risk for outbreaks.


Because the virus is likely to continue to be brought to the country, increases in the number of persons declining vaccination for themselves or their children might result in large-scale outbreaks, and threaten the elimination of measles in the United States, the researchers said.

[6]


Email Bahar Gholipour[7] or follow her @alterwired . Follow LiveScience @livescience , Facebook & Google+ . Original article on LiveScience .[8] [9] [10] [11] [12]



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  • Bubonic Plague


    Yes, the black plague -- responsible for <a href="http://www.smithsonianmag.com/people-places/mall_aug99.html?c=y&page=2" target="_hplink">killing 56 million people in Europe the 14th century</a> -- is still around, but it isn't as deadly or prevalent as it was in Medieval times. Dr. Robert Gaynes, an infectious disease expert at Emory University and author of the book <a href="http://estore.asm.org/viewItemDetails.asp?ItemID=1036" target="_hplink">Germ Theory: Medical Pioneers in Infectious Diseases</a>, said that people contract the disease when they gain access to previously undistrubed ecosystems, thereby making "these types of diseases become evident as a result of animal contact."

    These days, the disease is most commonly spread by bites from fleas that are infected with Yersinia pestis. When the bacteria enters into a person's skin, it leads to headache, chills, and <a href="http://www.bt.cdc.gov/agent/plague/factsheet.asp" target="_hplink">swollen lymph glands</a>, according to the CDC. Early <a href="http://www.bt.cdc.gov/agent/plague/factsheet.asp" target="_hplink">treatment with antibiotics</a> is essential for survival, as the disease can cause respiratory failure and shock if left untreated.

    Every year, about 1,000 to 3,000 <a href="http://healthland.time.com/2011/05/10/first-case-of-bubonic-plague-in-2011-appears-in-new-mexico/" target="_hplink">bubonic plague cases</a> occur around the world, with 10 to 20 of those cases in the United States, <em>TIME</em> reported. The first 2011 case of bubonic plague was confirmed in May in a New Mexico man.

    The reason is murky for why black plague seems to be less deadly today than in the Medieval times, Weinberg said, but it probably has to do with more rats and unclean living conditions back then, as well as a lack of appropriate medicines. In addition, the bacteria back then may be different from the current form, he added.




  • Scarlet Fever


    <a href="http://www.medicinenet.com/scarlet_fever/article.htm#history" target="_hplink">Scarlet fever</a> was among the rash of diseases that commonly afflicted people in the 19th century (alongside yellow fever, rubella and measles), according to MedicineNet. Scarlet fever most often afflicts children, causing rash and fever.

    Fortunately, scarlet fever is a lot less common today than it was centuries ago, but it still can be deadly. Today, we now know that scarlet fever is just a form of group A streptococcus (strep), Weinberg said. But instead of just turning into a regular case of strep throat, scarlet fever manifests as a red skin rash.

    With antibiotics, the disease is easily treated, though complications can occur that <a href="http://www.medicinenet.com/scarlet_fever/article.htm#history" target="_hplink">can lead to sepsis</a> (bacteria in the blood, tissue or bone), according to MedicineNet. Just this summer, Reuters reported that a Hong Kong kindergarten was closed after tests revealed that a child there may have <a href="http://www.reuters.com/article/2011/06/21/us-scarletfever-china-idUSTRE75K14Q20110621" target="_hplink">died from scarlet fever</a>. Scarlet fever is relatively common in that part of the world, but this year a Hong Kong health department spokesman told Reuters that there seem to be more cases of it this year than in past years.




  • Whooping Cough


    <a href="http://articles.sfgate.com/2011-09-20/bay-area/30178479_1_whooping-cough-booster-shots-childhood-vaccine" target="_hplink">Whooping cough</a>, caused by the Bordetella pertussis bacteria, was a common illness among children in the early 1900s, according to HealthCentral. However, when the vaccine for whooping cough was introduced in the 1940s, cases dropped. But while whooping cough cases are still dramatically lower than 50 years ago, there are still cases that persist today possibly because the vaccine against the disease doesn't provide lasting protection later in life, Weinberg said.

    Another reason is that older people seem to be able to carry whooping cough in their throats without actually getting sick (due to being vaccinated at a younger age), but that whooping cough is then passed on to infants who haven't yet been vaccinated against the disease, Gaynes said.

    "This problem has led to a recent recommendation by [the] CDC to have adults get TDAP once as adults (it contains pertussis in the vaccine) and not just a tetanus booster, which is needed every ten years," Gaynes told HuffPost.

    Recent research presented just last month shows that the <a href="http://articles.sfgate.com/2011-09-20/bay-area/30178479_1_whooping-cough-booster-shots-childhood-vaccine" target="_hplink">protection from the whooping cough vaccine</a> is decreased dramatically once a child reaches age 8 or 9, the <em>San Francisco Chronicle</em> reported.

    <a href="http://www.cdc.gov/features/pertussis/" target="_hplink">Whooping cough is very contagious</a> -- spread by cough and sneezing -- and is so named because of the sound people who have it make when they cough. Last year, 27,550 people had whooping cough in the United States, according to the CDC. The disease is the deadliest for babies, as it can lead to pneumonia, convulsions and even death.




  • Polio


    Polio, the paralysis-causing disease that afflicted former president Franklin D. Roosevelt, isn't completely gone from the world today. However, it has been eliminated from the western world, Weinberg said. The Mayo Clinic reports that the last known <a href="http://www.mayoclinic.com/health/polio/DS00572" target="_hplink">case of polio in the U.S.</a> was in 1979.

    Polio is still present in <a href="http://www.who.int/mediacentre/factsheets/fs114/en/" target="_hplink">Afghanistan, Pakistan, India and Nigeria</a>, where unrest and dangerous conditions can make it more difficult to get everyone vaccinated against the disease, according to the World Health Organization. Recently, the WHO reported that a dangerous strain of polio -- called wild poliovirus type 1 -- had <a href="http://www.huffingtonpost.com/2011/09/20/polio-china-pakistan_n_971787.html" target="_hplink">made its way from Pakistan to China</a>.

    Polio<a href="http://www.mayoclinic.com/health/polio/DS00572" target="_hplink"> causes paralysis</a> and can make it hard to breathe, the Mayo Clinic reported. It can even lead to death.




  • Gout


    Gout has been known throughout history as the "<a href="http://www.bl.uk/learning/langlit/booksforcooks/1700s/1700sfood.html" target="_hplink">disease of kings</a>" and the "rich man's disease," as it was most commonly seem among the gluttonous rich in the 1700 and 1800s, according to the British Library. Gout is considered an ancient form of <a href="http://www.cdc.gov/arthritis/basics/gout.htm" target="_hplink">inflammatory arthritis</a>, and is caused by metabolic disorder that has not been properly controlled. It occurs when uric acid crystals build up in tissues and fluids, thereby leading to a red, swollen joint that is very painful, according to the Centers for Disease Control and Prevention. The condition is most common in overweight men and women who have gone through menopause.

    Gout rates have <a href="http://arthritis.webmd.com/news/20101110/gout-cases-on-the-rise-in-u-s" target="_hplink">been on the rise</a> since the 1960s, with cases doubling between 1960 and 1990 and then continuing to rise through 2008, according to WebMD. More than 8 million Americans currently have gout.

    WebMD reported that the <a href="http://arthritis.webmd.com/news/20101110/gout-cases-on-the-rise-in-u-s" target="_hplink">rise in gout cases</a> may be due to people living longer, as the condition is seen in women only after they have passed menopause. In addition, "you can go years with hyperuricemia and no symptoms. But at some point, enough uric acid accumulates to have a flare-up of gout, so if you're living longer you are more likely to reach that threshold," gout expert Dr. John S. Sundy told WebMD.

    In addition, Gaynes speculated that it may not even be that gout rates are actually rising -- rather, detection and diagnosis may have improved throughout the years.