New York: How a single patient caused a measles epidemic

New York: How a single patient caused a measles epidemic

The patient, who was not vaccinated against the disease, infected 58 people in a few weeks. The total cost of the epidemic has been estimated at $ 400,000.

In March 2013, when a teenager returns to New York for his vacation, he does not suspect he will cause the biggest measles outbreak the city has seen in 20 years. In total, 58 people were infected in the US East Coast city between March and June 2013, according to a study published July 30, 2018 in the journal JAMA Pediatrics. A team of researchers from the city's health department looked into the economic cost of this epidemic.
Thanks to good immunization coverage, the disease disappeared from the United States in 2000. How was it reintroduced in the country? Blame for refusals and voluntary delays in vaccination in recent years, according to researchers. Indeed, the young man was not vaccinated when he was infected in London, where he was studying. Originally from New York, it is when he returns to his family that the first cases of infection are declared. None of the family members were vaccinated. In France, 11 vaccines have been mandatory since 1 January 2018, including the measles vaccine. But in the United States, most states leave parents free to vaccinate or not to vaccinate their children.

A case of pneumonia and miscarriage

The epidemic then spread to the places infected by infected people, with measles being transmitted by saliva droplets suspended in the air. In total, researchers identified 3351 people who had been in contact with the virus, including 58 people who contracted measles. 45 were at least 12 months old, but were not vaccinated because of a refusal by their parents. Some have developed complications, including one case of pneumonia, miscarriage and mother to newborn transmission. Finally, another 12 patients were too young to receive the vaccine.

"Most of the cases in the US are unvaccinated," says Jason L. Schwartz, professor of public health at Yale University (USA), who was not involved in the study. . "Given the highly contagious nature of the virus, even one isolated case of measles can cause a large number of cases," he says.

"A high rate of vaccination is of public utility"

The outbreak mobilized 87 health professionals, who spent a total of 10,054 hours trying to control it. By adding their salary to the price of the medical equipment used, the total cost of this epidemic is about 400,000 dollars (350,000 euros), say the researchers.

"In addition to the health risks that unvaccinated individuals place on themselves and others, especially the younger ones, the economic burden of epidemics is another lamentable consequence of these individual decisions to reject recommendations for vaccination," says Jason L. Schwartz. A high vaccination rate is of public utility. Indeed, it reduces the likelihood that a person, vaccinated or not, meets a vaccine preventable disease. "Those who voluntarily chose not to be vaccinated are free riders, taking advantage of this public effort without contributing," he denounces.
Measles is a highly contagious viral disease that affects mostly children and young adults. During the first 2-3 days, the symptoms resemble those of an influenza: cough, runny nose and fever. Then, an eruption of reddish patches on the skin appears, first on the face and then on the whole body. Its complications include diarrhea, ear infections, but also pneumonia or encephalitis, an inflammation of the brain that can be fatal. The combined MMR vaccine helps prevent it, as well as rubella and mumps. The first injection is between 12 and 15 months, then a second at 4-6 years.


In France, a measles epidemic raging since November 2017. Nearly a thousand cases have been declared and among them, three deaths. Public Health France points to insufficient French vaccination coverage, recalling that "vaccination is the only individual and collective protection against measles."