Ohio Measles Outbreak Originated in Philippines

A measles outbreak that sickened 383 people two years ago originated in the Philippines, a new report says.

Measles is a highly contagious disease that can lead to serious complications. Although the disease was declared eliminated in the U.S. in 2000, it remains common in large parts of the world.

Americans traveling to such places can bring it back with them, especially if they live in unvaccinated communities, and this is exactly what happened in 2014, a new analysis in the New England Journal of Medicine finds.

According to the report, two members of an Amish sect returned to Ohio after performing typhoon relief work in the Philippines, unknowingly bringing the disease with them.

The Amish, a Christian sect, do not prohibit vaccinations, but due to their cultural believes, their rates are much lower than among non-Amish people in the same areas, came down with measles, the report says.

During 2014, the World Health Organization reported that there were 21,403 confirmed cases of measles and 110 measles-associated deaths in the Philippines.

The two relief workers, both young men, returned to Knox County, Ohio from the Philipines on March 21 and began experiencing symptoms the next day. Two additional relief workers, who also became ill, followed, the report says.

Initially, their illness was initially suspected of being dengue fever, but after 12 additional Amish people became ill, the disease was correctly identified as measles.

During the outbreak, 573 suspected cases of measles were investigated in the community, which has an estimated population of 32,630, and is one of the largest in the U.S. Of that number, 190 people were ruled out, which resulted in 383 confirmed cases, the study says.

Despite considerable societal interaction among Amish and non-Amish persons in Ohio, the spread of the disease was limited almost exclusively to the Amish, which indicates that high baseline vaccination coverage in the general community was probably effective against further spread of measles, the report notes.

 The study’s authors suggest these takeaway points when dealing with measles outbreaks:

• The disease was allowed to spread until it was finally identified, which shows, health care providers should maintain a high awareness of measles when returning unvaccinated travelers present with a fever and rash.
• When the measles vaccine is administered within 72 hours after exposure, it may prevent or modify illness. The finding that measles developed in 16 persons who had received a vaccination near the time of exposure underscores the need to administer the vaccine as early as possible during outbreaks.
• Outreach attempts to convince groups that have lower rates of vaccination, but are not strictly opposed to it, such as the Amish, should continue, as the single best means of containment is the maintenance of high initial levels of measles immunity in the population.