Pennsylvania Braces for Wider Spread as Measles Cases Near 1,000

Public health officials in Pennsylvania are preparing for the state’s measles outbreak to spread beyond the rural communities where it began, as the case count approaches 1,000 and the country endures its worst measles year in more than three decades.

Last week the state reported 943 confirmed cases across 39 counties, the Guardian reported. Lancaster County, home to large Amish and Mennonite communities with historically low vaccination rates, accounts for the largest share. State officials have counted several deaths associated with the disease. The Centers for Disease Control and Prevention has disputed whether measles caused those deaths and lists only two measles deaths nationally this year, a disagreement both NPR and the Guardian have reported.

Nationally, the CDC counted more than 3,600 confirmed cases as of late September, nearly all among people who were not vaccinated, NPR reported. In recent weeks Pennsylvania, Ohio and New York have recorded the most new cases, NPR reported, citing a tracker kept by the Johns Hopkins Bloomberg School of Public Health.

Neighboring counties are bracing for what they see as inevitable. Jeanne Franklin, who directs the health department in Chester County, which shares a long border with Lancaster, told the Guardian that her staff is working on the assumption that the virus will eventually reach residents outside the Plain communities. She said many Amish families are not opposed to vaccines but have had less contact with the health care system, and that many have been open to vaccination now that neighbors are falling ill. She added that nurses still encounter myths, including claims that the vaccine causes sterility or contains a microchip.

Pennsylvania’s structure complicates the response, according to the Guardian. Only seven of its 67 counties operate their own health departments, leaving most to rely on the state. Officials in Lancaster are now trying to set one up. In Montgomery County, the state’s third most populous, the public health office is offering vaccination regardless of insurance status.

Measles is among the most contagious diseases known. It spreads through the air and can linger in a room for up to two hours after an infected person leaves, and one case can infect 15 to 18 susceptible people, Dr. Paul Offit of Children’s Hospital of Philadelphia told NPR. He said the true number of infections is probably higher than reported because many people never see a doctor. Two doses of the measles, mumps and rubella vaccine are considered protective.

The outbreak is unfolding amid broader concern about falling vaccination rates and mixed messages from federal health leadership under Health Secretary Robert F. Kennedy Jr. Some parents argue that vaccine decisions should rest with families. Public health experts respond that community coverage of about 95 percent is what keeps measles from spreading, and that the country has fallen below that line.

International health officials are expected to meet in November to decide whether the United States has lost the measles elimination status it achieved in 2000.