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How Many People Have Died from Measles in 2019?

As measles cases climb, some folks are interested in just one thing, how many people have died from measles this year?

A lot of people are dying from measles this year.
A lot of people are dying from measles this year.

The rest of us?

We understand that as we see more and more cases, it simply increases the chances that someone might eventually die.

How Many People Have Died from Measles in 2019?

So far, we have been very lucky that there have been no measles deaths, even as we pass 1,000 cases.

Not that 1,000 cases is some magic number where you start to see deaths.

Consider that we only had 188 cases in 2015, when we had the last measles death in the United States. That year, a woman got caught up in a small outbreak in Washington.

Where Are People Dying of Measles in 2019?

There are also many countries with rather small numbers of cases that are seeing measles deaths.

The last death in France, in April 2019, occurred after only 852 cases were reported.

In Romania, the first death of 2019, in January, came after just 133 cases.

Measles acts quickly. Do your part to protect yourself and others.

And since the outbreaks in Europe started in 2016, there have been deaths in:

  • Bulgaria – only 416 cases
  • Portugal – only 202 cases
  • Spain – only 457 cases
  • Switzerland – two deaths and only 197 cases!

Of course, there are more deaths in countries that are seeing more cases.

Again, since 2016:

CountryDeathsCases
Romania5917,850
Greece43,270
Italy139,277
France44,138
UK12,000
Germany12,000
Israel24,256 (since 2018)
Ukraine1752,034 (2019)
Serbia155,797 (since Oct 2017)
Brazil1219,036 (since 2018)
Tunisia303,141 (2019)
Malaysia62,129 (since 2017)
Thailand235,893 (since 2018)
Guinea141,359 cases (2019)

And a lot more deaths in some countries:

  • Madagascar – at least 1,233 reported deaths among 122,840 registered cases
  • Philippines – at least 389 deaths in 2019, with over 30,000 cases.
  • Venezuela – at least 134 deaths since 2017, with over 9,585 cases
  • Democratic Republic of Congo – at least 1,460 deaths this year, with over 84,000 cases
  • Nigeria – at least 89 deaths this year, with nearly 29,000 cases
  • Chad – at least 191 deaths this year, with over 18,000 cases

Measles is on the rise.

Measles deaths are on the rise too. While the risk of complications of measles can be reduced with vitamin A treatment, that doesn’t eliminate them. And the benefit is mostly in those who are already vitamin A deficient. Vitamin A has a much more modest effect in developed countries, where measles deaths still occur.

What to reduce your child’s risk of dying from measles?

Get them vaccinated and protected.

Tragically, this all comes after we were making progress towards measles elimination, reaching a record low for global cases and deaths just a few years ago.

How will we respond? An even stronger effort to finally get measles under control? Or continued worsening, with more cases and more deaths?

More on How Many People Have Died from Measles in 2019

How Could Seven of My Vaccinated Kids Have the Measles Right Now?

Seven vaccinated kids with measles?!?

But doesn’t the measles rash typically show up after three to five days of fever?

Wait, that couldn’t really happen, could it? Seven vaccinated kids with measles in one family?

How Could Seven of My Vaccinated Kids Have the Measles Right Now?

While anything is possible, this story is very improbable once you look at the details…

“When her 12-year-old son spiked a fever and started complaining of a sore throat right before Passover, Mrs. Pearl (not her real name) wasn’t worried. She confidently crossed off a host of possible infections that he was fully vaccinated for.

She thought he had strep throat, like two of his siblings.

They headed to urgent care for a rapid strep test, but the result was negative. Undeterred, she put her son on antibiotics at the nurse’s recommendation, and sent her son to bed.

He’d worsened by morning.

He woke feeling feverish and broken out in a rash.”

Jennifer Margulis

Could that be measles?

He ended up testing positive for measles, even though he was fully vaccinated. Only two days of fever before he developed his rash though, and no word that the fever continued, as you would expect with measles…

“Not long after, Mrs. Pearl’s 10-year-old broke out in a similar rash.

This child didn’t spike a fever but his breathing was labored and he complained that his eyes hurt.

He also tested positive for the measles.”

Jennifer Margulis

Although they all could have been exposed to someone else, it is important to note that the incubation period for measles is 7 to 14 days. The “not long after” scenario sounds like too short a time to get “measles” from his brother. Also, no fever, which would be very strange for measles…

But the other five kids had more classic symptoms of measles, right?

Nope.

“Of the seven other children that Mrs. Pearl had tested—all of whom had been fully vaccinated—five more showed no immunity to measles.”

Jennifer Margulis

What about the negative titer tests?

That’s actually not unusual after measles vaccination. It’s not proof or any kind of indication that the vaccine didn’t work. It has been long known that most vaccinated people who have negative measles titers will show an anamnestic immune response if they get another dose of MMR.

What does that mean? It means that they were likely immune, even with the negative titer.

“In the event that a HCP who has 2 documented doses of MMR vaccine is tested serologically and determined to have negative or equivocal measles titer results, it is not recommended that the person receive an additional dose of MMR vaccine. Such persons should be considered to have presumptive evidence of measles immunity. Documented age-appropriate vaccination supersedes the results of subsequent serologic testing.”

Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices

In fact, we don’t routinely check titers after MMR, at least not for measles.

And their symptoms?

“Two hours after getting the MMR booster, Mrs. Pearl’s 16-year-old spiked a 102-degree fever and broke out in a measles rash.

Four days later her three other children, all of whom had received the MMR booster, all had measles rashes, canker sores in their mouths, gastrointestinal problems, and lethargy.”

Jennifer Margulis

Canker sores with measles? Kids with measles get Koplik spots, but no one describes them as canker sores.

Fever and a rash developing at the same time?

Yeah, none of that sounds like measles. At all.

Remember, the classic symptoms of measles include 3 to 5 days of a high fever with cough, coryza, and conjunctivitis, followed by a rash, with continued fever.

“According to Mrs. Pearl, the health department official also told her that measles vaccine failure is common and that about half the people getting measles in the current measles clusters in Brooklyn are fully vaccinated.”

Jennifer Margulis

Actually, only 27 of the 566 people in Brooklyn with measles have been known to be fully vaccinated, with two doses of MMR. How much less than half is that? It is less than 5% of cases.

Measles vaccine failure is not common at all.

Why Did They Say That Seven of My Vaccinated Kids Have Measles?

So how do you explain what happened to this family?

Besides the likelihood that they had another, more common virus causing their symptoms? With mouth ulcers and diarrhea, like maybe Coxsackie virus?

Do you really need another explanation?

How do you explain the positive measles tests?

They were almost certainly a false positive.

“The test kits in use have been shown to have high sensitivity and specificity. However, cross-reactions with other viral diseases, e.g. rubella and Parvovirus, may occur.”

Dietz et al on The laboratory confirmation of suspected measles cases in settings of low measles transmission: conclusions from the experience in the Americas.

They didn’t state which test was done, but it is important to note that several are available. This includes an immunoglobulin test, PCR from a throat swab, and PCR from a urine specimen. The most accurate testing is done by the CDC.

“Detection of specific IgM antibodies in a serum sample collected within the first few days of rash onset can provide presumptive evidence of a current or recent measles virus infection. However, because no assay is 100% specific, serologic testing of non-measles cases using any assay will occasionally produce false positive IgM results.”

Serologic Testing for Measles in Low Prevalence Setting

Did they have confirmatory tests, after their initial positive test? Were they done at a state lab? Did all of her other kids test positive for measles?

“She’s angry at the measles vaccine failure and worried about her family members, especially her pregnant daughter.”

Jennifer Margulis

She should be angry at folks pushing misininformation in her community.

“I used to think people who don’t vaccinate were crazy,” Mrs. Pearl says. “Now I’m not so sure. Maybe they’re right. Maybe my body doesn’t want to take garbage. Something is a red flag. After my story, I’m not so sure where the measles started. I’m legit. I did vaccinate. All my kids are up to date. Children ages 22 to 7 all getting the measles?”

Jennifer Margulis

Something is indeed a red flag. To get to the bottom of it, Mrs. Pearl should revisit the idea that her kids really had measles.

More on Vaccinated Kids with Measles

Decoding Anti-Vaccine Protests

Yes, even in this age of record–breaking measles cases, there are some anti-vaccine folks protesting because they want to keep their kids unvaccinated and unprotected.

Decoding Anti-Vaccine Protests

What reasons do they have to intentionally not vaccinate their kids?

Who's protecting us from the people protesting against vaccines?
Who’s protecting us from the people protesting against vaccines?

As many reasons as there are anti-vaccine talking points…

What is truly disturbing though, is that today’s anti-vaccine protestors are co-opting many symbols, language, and slogans and using them to get attention.

Del Bigtree wasn't the only one to wear a yellow star during anti-vaccine protests.
Del Bigtree wasn’t the only one to wear a yellow star during anti-vaccine protests.

Remember when anti-vaccine folks had to be called out for using Holocaust imagery to protest against vaccines.

How Did These Become Anti-Vaccine Slogans?

That’s not all they are doing though.

Did you know that they are also using:

If you do not consent, you won't get vaccinated and protected.
  • Me Too – a movement to support survivors and end sexual violence, anti-vaccine folks use it to when they talk about vaccine injuries.
  • I do not consent – typically about limiting searches when police don’t have a warrant, the anti-vaccine movement abuses it for something that they do have to consent for – getting vaccinated! If you do not consent, you won’t get vaccinated and protected.
  • Informed consent – again, this is something anti-vaccine folks abuse, as their decisions are being influenced by myths and misinformation, so it is not informed consent. It’s more like misinformed consent.

And then there are the anti-vaxxers who use “choice” as their argument.

If you weren't aware, this post makes it obvious where the choice argument comes from. No, it's not AoA, but from the pro-choice movement.
If you weren’t aware, this post makes it obvious where the choice argument comes from. No, it’s not AoA, but from the pro-choice movement.

Anti-vaxxers are only pro-choice for not vaccinating their kids though. They don’t care if we have a choice about wanting to be protected from being exposed to vaccine-preventable diseases.

Dog Whistles for Refusing Vaccines

What’s the big problem with choice as an argument for anti-vaccine folks?

Parents already have a choice to leave their kids unvaccinated and at risk for measles and other vaccine-preventable diseases.

They already have choices!

No one is forcing them to vaccinate their kids.

Of course, what they want is more choices. They want the option to send their intentionally unvaccinated kids to daycare and school, where they would pose a risk to others. They want to limit our choices for decreasing the risks of keeping our kids safe from vaccine-preventable diseases.

How? Their intentionally unvaccinated kids are at greater risk to get measles and other vaccine-preventable diseases, which they can then spread to others.

What does all of this really mean?

Just realize that all of these slogans are being co-opted and are being used as dog whistles for the anti-vaccine movement, diluting their original meaning.

More on Decoding Anti-Vaccine Protests

Who’s Getting Measles?

We will soon pass the last record high number of measles cases – 963 cases – set in 1994.

We will soon pass the last record high number of measles cases - 963 cases - set in 1994.

With 839 cases as of mid-April, it’s hard to believe that only 55 cases were reported during all of 2012!

Who’s Getting Measles?

So what do we know about the people who are getting measles?

More importantly, the thing that most parents want to know – are their families at risk?

We know that of the 839 cases right now:

  • 442 are in Brooklyn among the Orthodox Jewish community, where only 4% of cases have been fully vaccinated
  • 125 are in Rockland County, New York, among the Orthodox Jewish community, where only 3% of cases have been fully vaccinated
  • 78 were in the Pacific Northwest Outbreak (Washington and Oregon), where none were fully immunized – (ended)
  • 43 are in Michigan, mostly among Oakland County’s Orthodox Jewish community, triggered by a man who had recently traveled from New York

So just over 80% of cases are associated with four outbreaks, one of which has been declared over, and mostly among children and adults who were intentionally not vaccinated.

The rest of the 200 cases?

Among 45 cases in California, are 30 cases in these four outbreaks.
Among 45 cases in California, are 30 cases in these four outbreaks.

They are spread out in smaller outbreaks in other states, including Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, Oklahoma, Pennsylvania, Tennessee, and Texas.

Does that mean that you don’t have to worry about measles?

It means that you don’t have to panic about measles.

Get your kids vaccinated and protected, which might include an early dose of MMR, learn the signs and symptoms of measles, and keep up on news of outbreaks in your area.

That should help decrease the risk that they get caught up in an outbreak.

And double check your own vaccine records! Have you had an MMR vaccine? Have you had two doses?

Unfortunately, not everyone can get vaccinated and protected, which is causing some folks to panic. This includes those who are too young to be vaccinated, or fully vaccinated, and those with immune system problems.

That’s not fair.

Let’s stop the outbreaks so we don’t get to the point that measles truly is everywhere and even more high-risk people are put at risk.

More on Who’s Getting Measles