245
per 100,000
11. 2
per 100,000
U.S. measles
incidence in
1960
U.S. measles
incidence in
1990
0.01
per 100,000
U.S. measles
incidence in
2007
Measles spikes in U.S. and Canada
Countries report the highest numbers since the mid-1990s
By Nathan Seppa
Measles, a preventable disease that has
been largely vanquished in the United
States, continues to show up sporadically in the population as unvaccinated
people traveling to other countries
unwittingly bring back infections. New data reported on
October 22 show that 2011
has been a bad year for this
kind of spread, with the
highest number of U.S. measles cases since 1996.
Other data indicate that
many U.S. pediatricians
are doing their best to keep
these cases away from
their patients, turning away families
that refuse to have their children vaccinated — whether against measles or
other diseases.
There have been 214 measles cases
in the United States so far this year,
says epidemiologist Huong McLean of
the Centers for Disease Control and
Prevention in Atlanta. Of these patients,
68 were hospitalized and 12 developed
pneumonia. Roughly 86 percent of people who contracted measles were either
unvaccinated or had unknown vaccination status, the CDC data show.
The measles influx has been highly sporadic, with 73 different people bringing
in an infection, McLean says. Most were
U.S. residents visiting Europe. “They’re
having a big year in Europe, and we’re
feeling the effects here,” she says, noting
that Europe has reported 28,000 cases of
measles in 2011 so far, many in France.
In Canada, Quebec province has
had 759 cases, says Gaston De Serres, a
physician and epidemiologist at Laval
University in Quebec City. The 2011 toll
in Canada as a whole is now 783, the
highest since 1995.
The spotty measles outbreaks are a
far cry from the pre-vaccination days
in the 1960s, when the United States
could expect hundreds of thousands of
infections and thousands of people hos-
pitalized. But the numbers are notable
compared with the past decade, which
has typically seen no more than a few
dozen measles cases annu-
ally in the United States.
When a measles outbreak
is reported, standard public
health measures are mobi-
lized to limit the spread. For
example, in Utah this spring,
184 people were quarantined
when an unvaccinated stu-
dent returned home from
Europe with measles and
nine people became ill, according to
epidemiologist Karyn Leniek of the Utah
Department of Health in Salt Lake City.
At the clinical practice level, some doctors are taking a preemptive approach.
Physicians Chris Harrison and Tom
Tryon of the University of Missouri in
Kansas City presented data on October
21 from a survey in nine states of more
than 900 pediatricians. Of those, 21 percent stopped accepting appointments
from families that refused to have their
children vaccinated. In Minnesota that
rate was only 1 percent, but in Iowa it was
around 38 percent, Tryon says.
“There is a misperception regarding
vaccines,” says Saad Omer, an epidemi-
ologist at Emory University in Atlanta
who has studied the vaccine refusal
issue. Many younger parents, he says,
“are coming of age in an era where they
don’t see these diseases. But they hear
of real or perceived adverse events from
vaccinations.”
Resolving doubts about vaccination
will require physicians to communicate
with and counsel their patients, he says.
“This issue is not going to go away on
its own.” s
“They’re
having a big
year in
Europe, and
we’re feeling
the effects
here.”
HUONG MCLEAN
Bacteria, bacteria everywhere
The quality of hand-washing in
restrooms isn’t up to par, epide-
miologist Lennox Archibald of the
University of Florida in Gainesville
reported on October 21. A sam-
pling of common surfaces and han-
dles in public restrooms revealed
substantial amounts of well-known
bacterial culprits such as Staphy-
lococcus aureus and Escherichia
coli. Archibald’s team took swabs
from four airplane restrooms and
18 restrooms in U.S. restaurants,
offices, libraries, hotels and other
public establishments, noting that
many microbe-laden surfaces were
those typically touched after hand-
washing. “I don’t want the public
to get paranoid,” Archibald said.
“But I think in the current era of
[methicillin-resistant S. aureus] and
community-acquired infections, you
just need to wash your hands
carefully.” — Nathan Seppa
C. diff vaccine progresses
An experimental vaccine against the
bacterium Clostridium difficile has
cleared an early hurdle. The vaccine
is designed to boost a person’s
ability to produce antibodies against
two toxins, dubbed A and B, made
by C. difficile. The toxins cause colitis with fever, diarrhea and cramps.
Researchers gave 72 adults three
injections of the vaccine over 56
days in low, medium or high doses.
Another 24 volunteers got placebo
shots. Blood drawn six months
after the last shot showed that
nearly all vaccinated people developed an antibody response against
toxin A; more than half did against
toxin B, reported Ginamarie Foglia
of Sanofi Pasteur on October 21.
— Nathan Seppa
www.sciencenews.org
November 19, 2011 | SCIENCE NEWS | 13
