The number of new U.S. measles cases climbed again last week, and health authorities are worried about a potential surge in cases after families travel for Passover.
There were 626 cases of measles in 22 states as of April 19, the Centers for Disease Control and Prevention reported Monday, 71 more than the previous week.
At that rate, 2019 is on track by this week to become the worst year for measles in the U.S. since the disease was officially eliminated in 2000, meaning that it stopped circulating continuously.
This year's total so far is 41 cases shy of the 667 cases reported in 2014.
This year's largest outbreaks are concentrated in the ultra-Orthodox Jewish community in New York City and have led to more outbreaks and cases outside the city as well as outside Detroit.
New York City imposed mandatory vaccinations and a $1,000 fine for violating the order in certain ZIP Codes to try to curb the outbreak.
New York City's Department of Health and Mental Hygiene said Thursday that it issued three civil summonses to parents who failed to comply with the vaccine mandate, as the number of confirmed measles cases in the city jumped to 359 from 329.
On the same day, a judge dismissed a lawsuit brought in state court in Brooklyn by five parents seeking a temporary restraining order against the city's mandatory vaccine order.
This year is poised soon to become the worst for measles since 2000.
New York City health officials have said they expect the number of cases to increase over the next several weeks after Passover, one of the holiest Jewish celebrations, when there are large get-togethers.
Many of those who have contracted measles in the current outbreaks are children, including babies too young to be vaccinated. Some of the sick have been adults, including those who were vaccinated.
Adults in their early 30s through early 60s may have had one dose of the measles mumps-rubella vaccine rather than the currently recommended two doses, vaccine experts say. One dose provides 93% protection against the disease.
Health officials say in an outbreak, though, when transmission of the virus is intense, adults who have had one dose or don't know how many doses they have had may want to get another one too boost their level of protection to the maximum achievable. Two doses provide 97% protection.
In Oakland County, Mich., where 26 of 40 measles cases have been among adults, officials recommend that people who aren't sure of their vaccination status talk with their doctor about getting another shot.
“In an outbreak situation, we suggest you have two documented doses or get another dose,” said Leigh-Anne Stafford, the county's health officer. She added, “It's a conversation you really need to have with your provider.”
A second dose isn't necessary for people who are not in areas with an outbreak, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“You're still 93% protected with one dose,” he said. The vaccine is also long-lasting, he said, meaning that a shot given decades ago is still highly protective.
The measles vaccine was licensed in the U.S. in 1963. An improved version was introduced in 1968. It has since been combined with vaccines against mumps and rubella.
BY BETSY MCKAY