Matt Rourke, Associated Press
A line of mostly students wait to enter a vaccination clinic amid a mumps outbreak on the Temple University campus in Philadelphia on Wednesday, March 27, 2019.

SALT LAKE CITY — The year is already shaping up to be one of the worst for measles outbreaks across the nation.

And while the highly contagious respiratory disease has yet to hit Utahns, "we're only one airline flight within a case coming here," said Dr. Tamara Sheffield, medical director for community health and prevention at Intermountain Healthcare.

"Utahns don't need to panic, but rather carefully consider their vaccination status," she said, adding it isn't too late to get the vaccine. "If we're not getting vaccinated, we're putting other people at risk."

New York City health officials have made vaccinations mandatory in its hardest hit communities, threatening fines up to $1,000 for noncompliance, The Associated Press reports. An executive order issued there has also banned unvaccinated children from indoor public spaces to help prevent further spread of the highly contagious disease.

" If we're not getting vaccinated, we're putting other people at risk. "
Dr. Tamara Sheffield, medical director for community health and prevention at Intermountain Healthcare

"Our goal is not to fine anyone," New York Mayor Bill de Blasio said, calling the situation "a public health emergency."

"Our goal is to get people vaccinated," he said. "But we're also trying to help everyone understand there is urgency here. … The reason the city government is empowered in a public health emergency is to save lives."

Measles outbreaks have appeared in 19 states since the beginning of the year with the growing number of cases contributing to the now-second-largest outbreak in the United States since measles was eliminated in 2000, the Centers for Disease Control and Prevention reports.

The states that have reported cases to the CDC are Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Texas and Washington.

The federal agency says that disease transmission for the recent cases likely originated in countries where measles is more common — throughout Europe, Asia, the Pacific and Africa and the Philippines — places people commonly visit. It encourages people to check CDC travel advisories online before traveling to any foreign location.

Nearly 90,000 people in the world die from the disease every year, the CDC reports.

" In order to prevent an outbreak in your community, you have to have a 97 percent herd immunity rate. "
Dr. Tamara Sheffield, medical director for community health and prevention at Intermountain Healthcare

Sheffield said symptoms of measles include coughing, runny nose, sneezing and a high fever, which leads to a head-to-toe rash four days later. It is transmitted through the air and on surfaces and is contagious before and after bumps show up, which is why it transfers so quickly from person to person.

"It's the most highly infectious vaccine-preventable virus that's out there," Sheffield said. The virus can exist up to two hours after an infected person leaves the room and a person can be infected for 14 days before symptoms appear.

Babies and people with immune-compromised conditions who cannot be immunized against measles, she said, can develop serious complications from contracting measles, including brain swelling, which can lead to brain damage and even death.

"In order to prevent an outbreak in your community, you have to have a 97 percent herd immunity rate," Sheffield said.

A growing number of vaccine exemptions are being filed at school districts across the state, with the majority of exempting parents in Utah claiming personal reasons over religious or medical reasons. The result is that 95.6 percent of Utah children from kindergarten to 12th grade are adequately immunized against measles, according to a 2018 report from the Utah Department of Health.

"When individuals are not vaccinated, there is a high likelihood of catching the disease," Sheffield said. "You have to have high levels of protection to prevent an outbreak."

So far this year, 465 people in America have been infected, according to the CDC. In all of 2018, 372 people were infected; and the biggest outbreak since eradication of the disease in the U.S. was in 2014, when 667 cases were reported.

The last time a measles outbreak popped up in Utah was in 2015, after some Utahns traveled to Disneyland in California, where the disease was spread to many communities and countries.

It is too early to know if the highly contagious respiratory disease spread during recent spring break travels, and the Utah Department of Health was reporting no cases as of Thursday.

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Sheffield said that before 2000, millions were infected every year across the world. The MMR vaccine, she said, is "one of the most highly effective vaccines in terms of protection and it is lifelong."

If vaccine exemptions continue to increase throughout Utah, Sheffield said the disease will re-emerge as a bigger threat, leading to increased hospitalizations, death and disability. And, if that's not enough of a reason to be vaccinated, she said, the public cost of tracking cases and quarantining their contacts with exposure to the disease can be extraordinary.