Vaccination refusal and importation of the disease has led to increased incidence of measles in the United States. Before widespread vaccination, approximately 500,000 measles cases occurred annually, resulting in 500 deaths and 48,000 hospitalizations. Vaccination programs helped to eradicate endemic measles by the year 2000, reducing the median number of cases per year to 60. But in just the first three months of 2014, 106 measles cases were reported, prompting health officials to become concerned.

Measles is one of the most contagious infectious diseases known. Most postelimination measles cases have been due to outbreaks that can be linked imported disease. The author of a new commentary being published in Annals of Internal Medicine says many clinicians have never seen measles and now need to become familiar with the deadly disease so that they can apply the necessary control measures to contain it.

Physicians should maintain a high level of suspicion for measles in returned travelers with a fever accompanied by rash. This is especially important because measles rash may be confused with other viral rashes, Kawasaki disease, or scarlet fever. The author suggests that physicians talk to their patients about the importance of measles vaccination and be vigilant about recognizing infection and implementing control measures to prevent further spread in health care facilities.

Article: http://www.annals.org/article.aspx?doi=10.7326/M14-0892