While Utah’s measles cases appear to be slowing, infectious diseases expert Dr. Andrew Pavia said the state and broader United States should anticipate more outbreaks in the future.
“Until we can restore faith in vaccines, restore funding for our public health agencies and increase measles vaccine coverage, we have to anticipate that there will be many more outbreaks,” Pavia said. “And some of these may blow up into very large conflagrations.”
Pavia, chief of the University of Utah’s Division of Pediatric Infectious Diseases, spoke at a briefing titled “Measles: Is the United States Adapting to a New Reality?” hosted by The Infectious Diseases Society of America.
Utah’s current outbreak started in a remote community that straddles the border with Arizona, but has since spread statewide. According to the latest numbers from the Utah Department of Health and Human Services, there have been 673 confirmed measles cases since last summer — 476 of which were this year alone.
Utah’s new cases per week peaked in March, reaching into the 50s. In the last few weeks, there have been fewer than 10 new cases each week.
Every couple of weeks, Pavia said he’s on a call with other Utah doctors and the state health department to talk about a variety of infectious diseases. When they talk about measles, the common refrain is “this isn't over yet.”
“Because we still have pockets of very low immunization,” Pavia said. “Any place — you know, whether it's Utah or a state that hasn't yet experienced bad measles — that you have these pockets of low immunization rates, you're at risk.”
He compared outbreaks to wildfires, where the fuel is unvaccinated people. If more than 95% of people are vaccinated, also known as herd immunity, Pavia said, there’s not enough fuel. Next, he said there needs to be a spark, or a case of measles brought in from another community.
“When that spark hits, you do have a limited amount of time to contain it before it spreads, similar to a wildfire.”
Measles is a highly contagious disease, he said, “many times more contagious than COVID, Ebola or hantavirus.”
Pavia will be watching what happens this summer to see if cases flare up again with large gatherings around the holidays. Even if things are calm in the coming months, in the fall, it just takes one spark in a school with high vaccine-exemption rates for another outbreak to occur.
“We are going to stay on high alert,” Pavia said. “Hopefully we're going to get a break here for a couple of months.”
Measles has officially been declared eliminated in the U.S. since 2000. An international panel is expected to review it this fall, and Pavia said he strongly believes the U.S. will lose that elimination status.
“We’ve been lucky for the past several decades that we've been protected by very high vaccination rates,” he said. “But that's no longer true here in the U.S., and in many other countries.”
Still, he has hope for the future. He said he trusts parents and the American public to eventually realize they’ve “gone down an unfortunate path in the interest of doing what they think might be right.”
“I don't think we should accept it as the long-term new normal,” Pavia told KUER after the panel.
Reestablishing trust in vaccines and strengthening public health can’t happen overnight, Pavia said. And he doesn’t think it will happen “until we have more effective leadership at the top.” Because of that, he thinks the United States will face ongoing measles challenges for the next several years.
“If you look at the conditions that it takes to have a large outbreak, they exist in many states,” he said. “I don't think measles is done with us.”
Editor’s note: KUER is a licensee of the University of Utah but operates as an editorially independent news organization.
