Measles Outbreaks 2023

Measles Outbreaks September 2023

Measles cases worldwide increased by about 80% during 2022 compared with 2021, and experts warned of increasing measles outbreaks in various countries in 2023. In 2021, an estimated 9 million measles cases and 128,000 deaths from measles were reported by the World Health Organization (WHO) on May 31, 2023. According to the U.S. Centers for Disease Control and Prevention (CDC), the top ten measles outbreaks as of August 10, 2023, were led by India, with 57,550 cases over the past year. In addition, the CDC published a global Watch-Level 1, Practice Usual Precautions, Travel Health Notice on June 29, 2023, identifying measles outbreaks in Africa and other countries.

United States Measles Outbreaks

As of September 8, 2023, the CDC reported 22 measles cases in fourteen U.S. jurisdictions in 2023. In 2022, there were 121 measles cases, and 49 in 2021. Chicago indicated a possible measles outbreak (three cases) on June 4, 2023, and Texas confirmed two measles cases in 2023.

As of April 21, 2023, the Kentucky Department for Public Health (KDPH) confirmed three recent measles cases in 2023. The U.S. CDC issued CDCHAN-00487 on March 3, 2023. On February 24, 2023, the KDPH identified an unvaccinated individual who, while infectious, attended a gathering between February 17–18, 2023, at Asbury University in Wilmore, Kentucky. An estimated 20,000 people from Kentucky, other U.S. states, and countries participated in the event. "Anyone who attended the revival on February 18 (Asbury University) may have been exposed to measles," said Dr. Steven Stack, commissioner of the KDPH, in a press release. In addition, a previous measles case was reported in January 203 in Powell County, Kentucky, without connections to Ohio's outbreak. On January 20, 2023, Kentucky confirmed a measles case in December 2022 in Christian County that was associated with Ohio's measles outbreak, according to Kentucky Cabinet of Health and Family Services spokesman Brice Mitchell. As a result, Louisville, Kentucky, and the Jefferson County Public Schools are conducting measles vaccination clinics for about 10,000 unvaccinated students in 2023. In addition, on January 20, 2023, local media reported on-campus measles clinics at Iroquois High School, Marion C. Moore School, Newcomer Academy, and Fern Creek High School on February 7, 2023.

The Health Department of the City of Columbas, Ohio, and Franklin County Public Health (FCPH) reported that since June 2022, there have been (85) confirmed measles cases in children, of which (80) were unvaccinated and (36) were hospitalized as of February 10, 2023. A study published by The Lancet on June 27, 2023, estimated a significant immunity gap in the exposed population during the early phase of the 2022 Central Ohio measles outbreak. VaxEstim estimated the early-phase vaccination coverage as 53% (95% credible interval, 21%–77%) and the immunity gap as 42% (95% credible interval, 18%–74%).

Africa Measles Outbreak 2023

The WHO AFRO reported in 2023, measles outbreaks were reported in Botswana, Cameroon, Central African Republic, Chad, the Democratic Republic of the Congo (DRC), Ethiopia, Kenya, Liberia, Mali, Mauritania, Niger, Senegal, South Africa, South Sudan, Yemen, and Zambia. On July 18, 2023, the U.S. CDC reported Yemen had confirmed 23,680 measles cases in the past year. As of September 2023, Yeman's measles outbreak in children has exceeded 4,000.

A measles outbreak was declared in South African provinces except for the Eastern Cape in 2023. The National Institute for Communicable Diseases (NICD) confirmed on September 14, 2023, that in the past weeks, 17 laboratory-confirmed measles cases were detected across the country from four of the eight provinces where measles outbreaks have been confirmed. Gauteng reported most of the cases. The measles strain detected in Limpopo and North West provinces is genotype D8, similar to the strain in Zimbabwe in the 2022 measles outbreak.

The ongoing measles outbreak in Mauritania has affected 28 districts in 11 regions in 2023, with most cases reported from the Bassiknou district. Cumulatively, from January to May 14, 2023, 332 suspected measles cases were reported. Four deaths were reported, resulting in a case fatality rate of 2%.

American Samoa Measles Outbreak 2023

An active measles outbreak in the U.S. Territory of American Samoa was declared on April 24, 2023. As of April 30, 2023, 2 confirmed and 52 probable measles cases were reported by the Department of Health. Therefore, travelers from the Territory (including infants) should be vaccinated with a measles-containing vaccine before entering American Samoa as of May 2023.

Austria Measles 2023

Austria has reported 121 cases of measles in 2023. As of June 13, 2023, Styria is the most affected region in Austria, with 102 cases reported since the beginning of the outbreak in early 2023.

Australia Measles 2023

Western Australia reported its first measles cases in three years on April 20, 2023, and then on September 13, 2023. Australia's NSW Health notified people to be alert for symptoms of measles after a Western Sydney infant was diagnosed with the infection. The infant, too young to be vaccinated against measles, acquired the infection in India before returning to Sydney and recently spent time while infectious in Parramatta and Westmead in late March 2023. NSW Health confirmed a local measles case in September 2022.

Europe Measles Outbreak 2023

The ECDC reported that ten EU/EEA countries reported 22 confirmed measles cases on July 28, 2023.

India Measles Outbreak 2023

The U.S. CDC reported in September 2023 that India has reported about 46,231 measles cases over the past year. The WHO announced in August 2023 that India had vaccinated over 348 million children between 2017 and March 2023. A measles vaccination for children program in Delhi was launched in February 2023 to reduce the number of cases. And according to West Bengal data reported for 2022, there were 1,804 measles cases. As a result, the West Bengal Health Department launched a Measles-Rubella Vaccination Campaign on January 9, 2023, focusing on schools. This program was extended into mid-February. Additionally, measles is spreading in Nadapuram, Kozhikode, and Maharashtra in 2023. Between 2019 and 2021, about 56% of children received the recommended two doses of the measles vaccine on schedule, according to India's National Family Health Survey.

Indonesia Measles Outbreak 2023

The WHO confirmed that on April 28, 2023, measles is endemic in Indonesia and is reported yearly. Between January and April 3, 2023, a total of 2,161 suspected measles cases have been reported across 18 of 38 provinces in Indonesia, primarily from the provinces of West Java (796 cases), Central Papua (770 cases), and Banten (197 cases). In 2022, a total of 4845 laboratory-confirmed measles cases and six deaths (CFR 0.1%) were reported across 32 of the 38 provinces. Therefore, based on the current data and available information, the overall risk of measles at the national level is assessed by the WHO as high.

Nepal Measles Outbreak 2023

Between November 2022 and March 10, 2023, a total of 690 measles cases, including one associated death (CFR 0.14%), have been reported in Nepal.

Paraguay Measles Outbreak 2023

On January 23, 2023, the Paraguay IHR National Focal Point notified the WHO of a confirmed case of measles in the Itapúa Department, Paraguay. Itapúa is close to the southern border of Paraguay with Argentina. Of 181 people surveyed, 107 were vaccinated against measles and rubella, with a coverage of 59%. The official measles vaccination coverage for the first and second doses of MMR in 2021 was reported to be  56% and 55%, respectively.

Pan American Health Organization Measles Outbreaks

The Pan American Health Organization (PAHO) estimated more than 1.7 million children in 28 countries and territories of the Americas did not receive an initial dose of the measles vaccine by their first birthday. 

Philippines Measles Outbreak 2023

The Philippines Department of Health reported the ongoing measles outbreak in 2023 has reached 100. In addition, these. The Philippines reported 589 confirmed measles cases in 2022 and 206 cases in 2021.

South Korea Measles Outbreak 2023

In January 2023, the Korea Centers for Disease Control and Prevention (KCDC) reported a travel-related local measles case. Previously, a measles outbreak with 20 confirmed cases occurred at a children's hospital in Daejeon, South Korea, from March 28 to April 21, 2019. 

United Kingdom Measles Outbreak 2023

The U.K. Health Security Agency (UKHSA) HPR volume 17 issue 7 data shows a steady rise in measles cases in 2023. Between January and June 30, 2023, there have been 128 measles cases, compared to 54 cases in 2022, with 66% of the cases detected in London. The UKHSA risk assessment of a measles epidemic across the U.K. is considered low.

Measles Outbreak Costs

The AAP's journal Pediatrics published a study in April 2021 that indicates that during a measles outbreak in Washington, costs were $47,479 per case or $814 per contact. And on January 22, 2020, Clinical Infectious Diseases published a meta-study that calculated the median price per measles case was $32,805 (range, $7,396-$76,154).

Measles Vaccines

As of August 2023, the U.S. CDC published the updated measles vaccination schedule. In addition, various measles vaccines are listed on this Precision Vaccinations webpage.

Measles Vaccination For Travelers

This CDC web tool empowers international travelers to determine whether or not they need an additional measles vaccination before departure. 

Measles Diagnosis and Treatment

The CDC's Clinician Outreach and Communication Activity Call on  August 17, 2023, included these presentations. Vitamin A deficiency is a recognized risk factor for severe measles infections. The WHO says children diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. In 2002, there was evidence that the same dose given for two days was associated with a reduced risk of overall mortality and pneumonia-specific mortality. The CDC says since there are no approved treatments, people exposed to measles who cannot readily show that they have evidence of immunity against it should be offered post-exposure prophylaxis to potentially provide protection or modify the clinical course of the disease, either administering a measles vaccine within 72 hours or immunoglobulin (I.G.) within six days of exposure. However, do not simultaneously administer a vaccine and I.G., as this practice invalidates the vaccine.