Disneyland Measles Outbreak - California Measles Cases

Get Educated. Get Vaccinated. Stop the Outbreaks.

Does it surprise you that the latest measles outbreak is in California?

Or are you surprised that it hasn't happened before? You shouldn't be, because it has. California got a lot of attention for measles outbreaks in 2008 and 2011. They are also leading the country in pertussis cases and are one of the leaders in vaccine exemptions for school children.

It is also the home of Dr. Bob Sears and Dr. Jay Gordon and many other pediatricians who pander to parents who are afraid of vaccinating their kids.

There have not been any new measles cases in California in the few weeks. In fact, the last reported measles case in California had a rash onset on March 2. The latest California Measles Surveillance Update does include a 'new' case, but it was from the end of February.

Is the outbreak over? Yes, the outbreak has officially ended.

Dr. Bob Sears is crowing about his community being "measles-free once again," but it is important to note that in most years, we tend to see relatively few measles cases before Spring. As of April 17, 2015 there were at least 162 measles cases in 19 states in the United States. In other years, at this same time of year, the case count was just:

  • 112 (2014) - year ending case count 648
  • 18 (2013) - year ending case count 187
  • 27 (2012) - year ending case count 55
  • 42 (2011) - year ending case count 220
  • 7 (2010) - year ending case count 63
  • 14 (2009) - year ending case count 71
  • 15 (2008) - year ending case count 140

So there are typically relatively few cases before Spring. Even if the current outbreak in California is over, with more measles cases so far this year than we have had in 15 of the last 18 years, it would be foolish to think that the measles outbreaks are over.

Get Educated. Get Vaccinated. Stop the Outbreaks.

Disneyland Measles Outbreak

Although it hasn't been confirmed who started the Disneyland measles outbreak, officials have stated that people began to get sick after visiting Disneyland and Disneyland California Adventure between December 17 to 20.

Because the incubation period of 21 days is now over from the initial exposure period at Disneyland, all newly reported measles cases are ​secondary cases.

Cases have been confirmed in Arizona, California, Colorado, Nebraska, Oregon, Utah, Washington, Mexico, and Canada.

California / Disneyland Measles Outbreak Update

The Disneyland Measles Outbreak has spread beyond Disney now
A sick visitor likely started the Disneyland measles outbreak. Photo by Doc

The current count is up to at least 307 cases directly associated with this measles outbreak, including 134 cases in California and an additional 173 cases in Arizona (5), Nebraska (1), Utah (3), Colorado (1), Washington (2), Mexico (1), Oregon (1), and now Canada (159)

Of note though, 50 cases in California have an unknown source, "but are presumed to be linked to the outbreak based on a combination of descriptive epidemiology or strain type."

In addition to case counts rising daily, some other news about the Disneyland measles outbreak includes that:

  • the case count in Quebec is up to 155 cases and the number is still rising
  • there are now 119 measles cases in Quebec in an outbreak that originally started when unvaccinated members of an anti-vaccine eugenics community group 'took a trip to Disneyland.' Members of this religious group/cult say "that their prophet warns them vaccines result in illness." The group's original leader thought that he was the reincarnation of the Holy Spirit.
  • a case in Merced led to an additional 12 people being tested for measles
  • a third strain of measles is now being reported in California - the D4 strain (prominent in European outbreaks), but also recently found in a large outbreak in Toronto
  • there are now 32 measles cases in Quebec in an outbreak that originally started when unvaccinated members of a religious group 'took a trip to Disneyland.'
  • at least 6 unvaccinated students at Amelia Earhart Middle School in Riverside, California are being kept from school after another student contracted measles
  • at least two cases with a D8 strain of measles have been reported (endemic in India), with previous reports finding the B3 strain (normally found in the Philippines)
  • at least 10 unvaccinated people in two families in Quebec, Canada have been linked to the Disneyland outbreak
  • a 4-month-old from Pasadena likely got measles while visiting Disneyland in mid-January and required hospitalization.
  • a day care center in Santa Monica, California has been closed after a baby at the center developed measles, exposing up to 24 babies and staff members.
  • 66 students at Palm Desert High School in California have been excluded from school because they are not fully vaccinated against measles (Wednesday 1/28)
  • two more cases in Arizona that are linked to the Disneyland outbreak including a woman in Phoenix that could have exposed almost 200 children at the Phoenix Children's East Valley Center (Tuesday 1/27)
  • more and more possible measles exposures are being reported in California (Monday 1/26)
  • Orange County, with 23 measles cases this year, has already passed their total number of cases for 2014 (22 cases)
  • 4 more cases in Arizona, an unvaccinated family from Kearny (Friday 1/23)
  • 30 babies in Alameda County, California were quarantined at home after a measles exposure (Friday 1/23)
  • a case in Oakland County, Michigan that is likely linked to the Disneyland outbreak (Friday 1/23)
  • new cases raise the case count directly associated with the Disneyland outbreak to 57 and in California alone to 68 (Friday 1/23)
  • a California Department of Health state epidemiologist recommends that people who are not vaccinated against measles "avoid visiting Disney" and "crowded places with a high concentration of international travelers, such as airports" (Thursday 1/22)
  • the Maricopa County Health Department in Arizona has announced that they had a case of measles that was linked to the Disneyland outbreak. (Thursday 1/22)
  • the California Department of Public Health reported new case counts including 42 that are epidemiologically linked to Disneyland  and 17 more cases in California that have no known epidemiological link to Disneyland, including new cases in San Mateo and Santa Clara Counties. They have also stated that while "Initial exposures occurred in December, but additional confirmed cases visited Disney parks while infectious in January." (Wednesday 1/21)
  • two new cases in Riverside County, California (Wednesday 1/21)
  • a new case in Lane County, Oregon that has been linked to the Disneyland outbreak. This is the first case in Oregon tied to the outbreak. Of note, Oregon has the highest rate of vaccine exemptions in the United States! (Wednesday 1/21)
  • there are 2 new cases in Orange County and 1 new case in Alameda County (Tuesday 1/20)
  • at least 5 employees of Disneyland have gotten measles as part of the outbreak (Tuesday 1/20)
  • an urgent care clinic in San Diego had to temporarily close after someone showed up seeking treatment for measles symptoms, exposing up to 20 patients inside the clinic (Monday 1/19)
  • three unvaccinated people in San Diego are being tested for measles as part of the original Disneyland outbreak - they had been at Disney on December 18. Two of the people have already recovered, but a third is now sick, which may be a secondary case. (Monday 1/19)
  • at least one preschool in Orange County is excluding unvaccinated students
  • at least 24 unvaccinated students at Huntington Beach High School are being excluded from school until the end of January
  • an unvaccinated women in Pasadena is refusing to be quarantined after being exposed to her sister with measles
  • a health clinic in San Diego had to close for most of the day after an unvaccinated family came in with measles

California Measles Cases

Welcome to California
California is experiencing a large outbreak of measles that started at Disneyland. Photo by Getty Images

The majority of the measles cases in the Disneyland outbreak are in California, including:

  • Alameda County - 6 cases
  • Contra Costa - 1 case
  • Los Angeles - 28 cases
  • Pasadena - 4 cases
  • Long Beach - 2 cases
  • Marin County - 2 cases
  • Merced County - 1 case
  • Orange County - 35 cases
  • Riverside County - 8 cases
  • San Bernardino County - 12 cases
  • San Diego County - 14 cases
  • San Mateo County - 4 cases
  • Santa Clara County - 3 cases
  • Solano County - 1 case
  • Ventura County - 13 cases

The last case was in Ventura County.

Again, at least 50 of these cases have no known source of exposure.

Many more people are being observed after they were exposed to these initial cases and we will likely see more cases in the coming days and weeks.

After a record year for measles in 2014, at least 644 cases, we will have to see if the Disneyland outbreak helps to push the number of cases in 2015 even higher.

Utah Measles Cases

Two people returned to Utah from Disneyland with measles
There are at least three cases of measles in Utah associated with the Disneyland measles outbreak. Photo by Getty Images

Two unvaccinated people developed measles after visiting Disneyland in mid-December. They returned to Utah and exposed many other people while contagious at a number of places in Orem and Provo, Utah between December 26 and January 3.

All together, 395 people were exposed to measles in Utah and 166 people have been placed in quarantine.

A third person, also unvaccinated, has since developed measles.

There are now 3 cases of measles in Utah that are associated with the Disneyland outbreak.

Washington Measles Cases

Washington is part of the Disneyland measles outbreak
In addition to the two cases of measles in Washington, a California woman traveled through Sea-Tac airport. Photo by Philip Kramer/Getty Images

An unvaccinated resident of Aberdeen, Washington  developed measles after a trip to Disneyland.

An unvaccinated sibling of the first person also became positive for measles.

In addition to these two cases, an unvaccinated young adult from California who had developed measles at Disneyland "traveled to Sea-Tac Airport and visited several public areas in King and Snohomish counties while contagious" before returning to Orange County, California.

There are now 2 cases in Washington that are associated with the Disneyland outbreak.

Colorado Measles Cases

A peson in Colorado is associated with the Disneyland mesales outbreak
The Colorado measles case was hospitalized in Colorado Springs. Photo by Getty Images

There is only one case of measles in Colorado that is associated with the Disneyland measles outbreak.

They exposed 300 other people, some of which are now being quarantined.

Although this has been unconfirmed, it is possible that this person was vaccinated in the 1960s with the original inactivated measles vaccine.

Mexico Measles Case

In addition to spreading within California and to Colorado, Utah and Washington, the Disneyland measles outbreak spread to Mexico.

A 22-month old unvaccinated girl developed measles after being exposed to the disease while visiting Disneyland.

While this likely won't surprise any of the folks who push the idea the immigrants from Mexico are responsible for starting most of the outbreaks in the United States, measles in Mexico is actually very unusual. In fact, in 2011, when we were seeing high numbers of measles cases in the United States, Mexico had about three cases. All three were imported by travelers who had left Mexico - imported from France, London, and the United States.

Who is Getting Measles?

Measles is a vaccine-preventable disease.

So who is getting measles in this outbreak?

Although it is a common anti-vaccine myth that measles outbreaks are started by vaccinated children, it is not hard to see who is fueling this outbreak.

So far, of the cases with a known vaccination status, the CDC reports that:

  • at least 49 were unvaccinated
  • 5 were partially vaccinated (one dose of measles vaccine)
  • only 7 were fully vaccinated (two doses of measles vaccine)

And we know why these many of these people were unvaccinated. About 12 were too young to be vaccinated, but most (28) were intentionally unvaccinated.

The California Department of Health reports that 55 people are unvaccinated and 25 had one or more doses of MMR vaccine.

The age distributed of cases continues to shift lower. Twenty-seven percent of the measles cases in California were under the age of five years.

Avoiding Measles

An important message from the Surgeon General about getting a measles vaccine
Since 1963, the measles vaccine has been helping children avoid measles since 1963. Photo courtesy of the CDC

All of the talk about measles about likely has some parents worried.

So how can you avoid measles?

For most children and adults, the easiest way is to simply get vaccinated. Two doses of the MMR vaccine is a safe and effective way to avoid measles. In fact, following the latest immunization schedule is a good way to avoid measles and other vaccine-preventable diseases.

Can't you just avoid people who have measles?

While that makes sense, it is not usually possible, as people with measles symptoms can be contagious for up to four days before they develop the classic measles rash and they even know that they have measles. Also, the measles virus is spread by respiratory droplets and can stay in an area for up to two hours after a person with measles has left. That's why so many people get exposed during these outbreaks.

Unfortunately, even if you are avoiding alternative immunization schedules and are fully vaccinating your kids, they could be at risk during a measles outbreak. Since children are normally vaccinated against measles with the MMR vaccine when they are 12 to 15 months (first dose) and again at 4 to 6 years (second dose), that means that most infants (too young to be vaccinated) and many toddlers and preschoolers aren't fully protected.

Children and adults with immune system problems and are also at risk.

Vaccines Work

Get Educated. Get Vaccinated. Stop the Outbreaks.

And remember to call your pediatrician if you think your child has measles (don't just show up at their office or in the ER), especially if he develops a high fever and/or rash during a local measles outbreak or after a trip out of the country.

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