Outbreaks of Vaccine Preventable Diseases

Vaccines have helped to eradicate and eliminate many diseases in the United States:

—small pox (eradicated)

—rubella (eliminated)

—congenital rubella syndrome (eliminated) 

—measles (eliminated)

—polio (eliminated)

—neonatal tetanus (eliminated)

—diphtheria (eliminated)

Most others, like hepatitis B, Hib, and rotavirus, etc., are under good control and way below their pre-vaccine levels. That doesn't mean that we don't still see some outbreaks of vaccine preventable diseases though. International travel to and from areas where these diseases are more common, waning immunity, and intentionally unvaccinated children and adults all combine to keep these outbreaks going.

In addition to getting your kids fully vaccinated, knowing about current outbreaks can help you avoid these vaccine-preventable diseases.

Chicken Pox Outbreaks

A boy quarantined in his home for chicken pox.
Children with chicken pox and contacts who are unvaccinated are still often quarantined and kept from going to school. Getty Images

The chicken pox vaccine was introduced in 1995. A booster was added to the schedule in 2007. While two doses of the chicken pox vaccine are very effective at preventing severe disease, it is still possible to get more mild breakthough chicken pox despite being vaccinated.

And chicken pox is certainly possible among those who are intentionally unvaccinated, as we can see in many of these outbreaks:

  • at least 75 children, mostly unvaccinated, in the Orthodox Jewish community of Williamsburg in Brooklyn, New York
  • 9 students at the Dehesa Charter School’s Chula Vista Resource Center in San Diego, almost all unvaccinated in an ongoing outbreak (2016)
  • multiple, ongoing outbreaks in Michigan (2016)
  • at least 5 kids at Wando High School in South Carolina in an ongoing outbreak (2016)
  • at least 8 children, mostly unvaccinated, at Plumb Elementary School in Clearwater, Florida (2016)
  • multiple outbreaks in Michigan that left several kids hospitalized (2015)

Most of these outbreaks have led to quarantines of unvaccinated students for 21 days or longer.

Postexposure vaccination, getting a chicken pox vaccine within 3-5 days of exposure, can help prevent an unvaccinated child or adult from getting chicken pox after they are exposed.

Influenza Season

May 2016 flu season report
The 2015-16 flu season is almost over. Courtesy of the CDC

The 2015-16 flu season winded down with only one state continuing to report widespread flu activity.

And with 70 pediatric flu deaths, 2016's flu season was perhaps not as mild as folks were led to believe.

Measles Outbreaks

A measles alert posted on a home of a child with measles by the health department.
A warning notice put on homes of children with measles to show that they were quarantined because of a measles infection. Photo by Buyenlarge/Getty Images

With only 25 cases in seven states (Arizona, California, Georgia, Illinois, Massachusetts, Tennessee, and Texas), measles has definitely gotten off to one of the slower starts in recent history this year.

Unfortunately, over 40 percent of those cases came in a single outbreak within a week in mid-2016, and there's potential for 40 to 60 more cases.

Children typically get their MMR vaccines when they are 12 months and 4 years old. Postexposure vaccination can help prevent infection if given within 3 to 5 days of exposure to someone with measles and younger infants might even be given measles immunoglobulin.

Meningococcal Disease Outbreaks

College students taking a selfie.
College students living in a dorm are at risk for meningoccal disease. Getty Images

While most cases of meningococcal disease are not related to outbreaks, there have been some outbreaks at:

  • Santa Clara University - Three cases of serogroup B meningococcal disease. (2016)
  • University of Oregon - Seven cases of serogroup B meningococcal disease. (2016)
  • Providence College - Two cases of serogroup B meningococcal disease. (2015)
  • Princeton University - Nine cases of serogroup B meningococcal disease. (2013-14)
  • University of California, Santa Barbara - Four cases of serogroup B meningococcal disease. (2013)

Used on an investigational basis during the outbreaks at UC, Santa Barbara and Princeton University, two vaccines (Bexsero and Trumenba)  that can protect teens and young adults against serogroup B meningococcal disease are now available.

This is in addition to the meningococcal vaccines (Menactra and Menveo) that can protect them against serogroup A, C, W, or Y meningococcal disease.

Mumps Outbreaks

A photo of a child with classic mumps.
The classic swelling in the cheek and jaw bone area of a child with mumps. CDC/ Patricia Smith; Barbara Rice

After the two dose MMR recommendation helped us get to a low of just 231 mumps cases in 2003, cases have been rising and there have been more than a few large outbreaks of mumps, including:

  • at least 45 cases in an ongoing outbreak at Harvard University and other cases at Boston University and Tufts in Boston (2016)
  • an ongoing outbreak of mumps in Illinois, affecting the University of Illinois' Urbana-Champaign campus (301 cases), Illinois State University (27 cases), Eastern Illinois University (11 cases), and two high schools in Normal, Illinois (2015-16)
  • at least 8 students at the University of Texas at Austin (2015)
  • at least 21 cases at the University of Idaho in Moscow (2015)
  • at least 482 cases in Ohio (2014)
  • over 3,000 cases in New York (2009-10)
  • a multi-state outbreak of mumps in 2006 (over 6,500 cases)

Unlike most other outbreaks of vaccine-preventable diseases, most outbreaks of mumps are among highly vaccinated people.

A third dose of the MMR vaccine is often used for outbreak control during a mumps outbreak.

Still, even with at least 727 cases of mumps by mid-2016 and a high of 2,612 cases in 2010, we are far below the pre-vaccine era case counts. Before 1967, there were about 186,000 cases of mumps in the United States each year.

Pertussis Outbreaks

A Tdap shot can protect babies from pertussis.
A Tdap shot is recommend for all teens and adults who will be around an infant to protect the baby from pertussis. Photo by Getty Images

The first pertussis vaccines were developed in the 1930s and became more widely used in the 1940s when it was combined into the whole-cell DTP vaccine. This was replaced with the acellular DTaP vaccine in 1997, with the Tdap vaccine being added to the vaccine schedule in 2006.

Unfortunately, there has been a rise in pertussis cases.

In 2012, there were 48,277 cases of pertussis in the United States, the most since 1951, when we had 68,687 cases. Unfortunately, with the rise in cases, we are also seeing the tragic consequences of this disease—20 deaths in 2012, mostly infants under age 3 months.

Pertussis cases remained fairly steady, but high, in 2013 and 2014, at  28,600 to 32,971 cases. They were down in 2015 to 18,166 cases, although that means we are still seeing cases and outbreaks, such as:

  • an infant in Kern County, California who died (2016)
  • at least 20 cases in Dutchess County, New York (2016)
  • at least 80 cases in Yolo County, California, one of the highest rates in the state (2015)
  • at least 21 cases among several schools in the Grandview Heights City School District in Ohio (2016)
  • at least 8 cases in Teton County, Wyoming (2016)

Is the vaccine to blame for the rise in cases?

It is much more complicated that, with the CDC stating that "increased awareness, improved diagnostic tests, better reporting, more circulation of the bacteria, and waning immunity" are all factors for increased number of cases.

And even with the rise in cases, it should be clear that we are well below pre-vaccine levels of cases and deaths.

Other Cases and Outbreaks

In addition to the above vaccine preventable diseases, we have also seen:

  • A case of rubella in a student at TCU in Fort Worth, Texas (2015). While we don't often hear about them, there are about 4 to 9 cases of rubella in the US each year.
  • a hepatitis A outbreak in 2013 that led to 165 people getting sick and 71 hospitalizations in 10 states and was linked to pomegranate seeds
  • At least three cases of congenital rubella syndrome in 2012 and another in 2013.
  • Multiple cases of rabies in animals (wild animals, dogs, and cats, etc.) and exposures in people.

There have not been any cases of polio or diphtheria in many years.

Deaths from vaccine preventable diseases are still more common than people think though.

Get Educated. Get Vaccinated. Stop the Outbreaks.

In addition to getting your kids fully vaccinated, knowing about current outbreaks of measles, mumps, and pertussis can help you avoid these vaccine-preventable diseases.