Measles a threat to your area? Study reveals 25 U.S. counties most likely to report outbreak

AUSTIN, Texas — As the 2019 measles outbreak continues to rank among the worst in decades for the potentially deadly disease, a study by researchers at the University of Texas and Johns Hopkins University identified the 25 counties in the U.S. most likely to experience an outbreak.

These counties were identified by researchers as the most at risk by their low measles vaccination rates compared to other areas, and high volumes of international travel.

Since January of 2019, more than 800 measles cases have been confirmed in 23 states according to the Centers for Disease Control and Prevention, the highest total recorded since the disease was eradicated in the United States in 2000. This most recent research warns of a worsening epidemic.

“For measles, most experts believe that there will be one to two deaths per 1,000 cases, most likely infants. We are set to see over 1,000 cases in the U.S. in 2019. So, for the first time since the 1980s, we may expect infant deaths from measles in the U.S.,” says study author Sahotra Sarkar, a philosophy and integrative biology professor at UT Austin, in a statement. “We have long known that vaccine avoidance is a critical public health issue in the U.S. and Europe. Our results show how travel from regions elsewhere compounds this risk.”

The authors correctly predicted areas in Oregon, Washington, and New York now experiencing major measles outbreaks with their risk analysis models. Their research also revealed that 30 of the 45 counties that have reported measles cases to the CDC were either on this list of high-risk counties or are adjacent to a county listed.

The counties:

  1. Cook, Illinois
  2. Los Angeles, California
  3. Miami-Dade, Florida
  4. Queens, New York
  5. King, Washington
  6. Maricopa, Arizona
  7. Broward, Florida
  8. Clark, Nevada
  9. Harris, Texas
  10. Honolulu, Hawaii
  11. Wayne, Michigan
  12. Tarrant, Texas
  13. Multnomah, Oregon
  14. Orange, Florida
  15. Essex, New Jersey
  16. Denver, Colorado
  17. Hillsborough, Florida
  18. San Mateo, California
  19. Salt Lake, Utah
  20. Suffolk, Massachusetts
  21. Clayton, Georgia
  22. Travis, Texas
  23. Hennepin, Minnesota
  24. Loudoun, Virginia
  25. San Diego, California

The researchers urged their risk analysis model be applied to other vaccine-preventable diseases like mumps, rubella, and pertussis (whooping cough) and their results should be used to affect public health policy as non-medical exemptions to vaccines rates rise.

“The vaccine avoidance problem is not limited to measles. Pertussis — whooping cough — is another disease making a comeback because of dropping vaccination rates, and we predict serious outbreaks in the U.S. in the near future,” says Sarkar said. “Policymakers must focus on centers of vaccination refusal as well as regions with a lot of passenger inflow from affected countries worldwide if there are even small local pockets of unvaccinated people.”

The study is published in the journal The Lancet Infectious Diseases.

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