Florida's measles outbreak is growing. On Friday, Broward County health officials confirmed a seventh case in a child under 5 years old.
The patient is the youngest person infected in the outbreak so far and the first confirmed case outside Manatee Bay Elementary School in Weston, near Fort Lauderdale.
It is unclear what connection the youngest measles cases had to school, but spread beyond school-age children was expected.
“If the virus is as contagious as it is, it's unlikely that the cases will be confined to that school,” said Dr. David Kimberlin, co-director of the Division of Pediatric Infectious Diseases at the University of Alabama at Birmingham.
The Centers for Disease Control and Prevention reported that as of Friday, there were at least 35 measles cases in 15 states in 2024, most of them related to international travel. In January, there were nine measles cases in Pennsylvania, eight of which were in Philadelphia. (An outbreak in Philadelphia is declared over if no cases are reported in Philadelphia by early next week.) Late Friday, the Michigan Department of Health confirmed a case of measles in the state. announced. This is the first time this has happened since 2019.
The outbreak in Florida is currently the largest in the United States. And what Florida health officials are doing, or not doing, is drawing criticism from experts who study the spread of the disease.
Because measles is highly contagious and has a very long incubation period, the state's Surgeon General, Dr. Joseph Ladapo's decision to leave it up to parents to decide whether to isolate their children or keep them in school, has led to an increase in cases. Experts warn that it could spread.
“Measles is the most contagious human pathogen that we know of,” Kimberlin said. “It's like a heat-seeking missile. You'll find people who don't have immunity, and they'll get sick.”
If an unvaccinated person becomes infected, there is a 90% chance of infection.
“Epidemiology 101 is identifying and isolating,” said Caitlin Jetelina, who tracks the disease on the website Your Local Epidemiologist. This is especially true for measles outbreaks. This is because the virus is highly contagious and infected people can spread the virus for up to three weeks.
In a letter to elementary school parents “Due to the high community immunity rate and the burden on families of healthy children who miss school and the burden of educational costs, the DOH has decided that decisions regarding school attendance should be made to parents or guardians,” Ladapo said on Tuesday. It has been postponed to.''
The letter said parents should be on the lookout for measles symptoms (high fever, rash, bloodshot eyes, watery eyes) but did not recommend vaccination.
How Ohio quickly brought measles under control
In 2022, when Dr. Misheika Roberts, the health commissioner in Columbus, Ohio, faced a surge in measles cases, parents in the state also received a letter with a very different message.
In central Ohio, 85 children, mostly unvaccinated infants, became infected with measles. Almost half, 42%, had to be hospitalized.
At the beginning of the Ohio outbreak, Roberts recommended that unvaccinated children who had been exposed to measles be given mumps-measles-rubella (MMR) as part of “post-exposure prophylaxis.” ) advised her to get one dose of the vaccine, she said.
The 21-day quarantine period for vaccinated children has been reduced to just 72 hours.
Infectious disease experts told Roberts it could take more than six months to bring the infection under control. She and her team did it in her third inning.
“By February, we were able to declare the outbreak over,” Roberts said.
Roberts credited the success to sticking to standard public health guidelines: identifying patients, isolating them, and telling the public what to do.
“We were very clear about what we needed to do to get this outbreak under control,” Roberts said.
Ohio State's guidance included:
- We encourage the MMR vaccine, which prevents infection by 97%.
- Prevent unvaccinated children who have been exposed to the virus from attending school, day care, or other activities for 21 days.
A letter from Columbus public health officials strongly suggested that families follow the proposed quarantine.
“We didn't leave it up to our parents,” Roberts said. “It wasn't a command, but the way we wrote our letters, people probably felt they had no choice.”
Since the 2022 outbreak, Ohio has reported only one measles case in 2023 and at least one case so far in 2024.
According to the CDC, it is estimated that one in five people with measles is hospitalized. And 1 to 3 out of 1,000 patients die.
In Florida, dozens of elementary school students are vulnerable, some with siblings too young to be fully vaccinated. Meanwhile, vaccine exemptions in Florida have been on the rise in recent years, according to CDC data.
At Wednesday's school board meeting, Broward County Public Schools Superintendent Peter Licata said 33 of the 1,067 students at Manatee Bay Elementary School have not been vaccinated.
said Maria Caballero, whose daughter attends Manatee Bay. NBC News announced earlier this week that she would not be sending the girl to school for now. She has twin boys who were born prematurely, but she is not yet old enough for her first dose of the MMR vaccine, which is given to her from age 1.
“My 10-year-old is fully vaccinated, but I'm worried about him getting the virus and bringing it home,” Caballero said.
Florida's outbreak comes at a time when vaccine exemptions nationwide are at an all-time high. A November CDC report found that 3% of children entering kindergarten during the 2022-2023 school year had a vaccine exemption from their state.This is the highest exemption rate ever reported in the United States.
“More and more people are starting to have questions about vaccines and why they need them,” said Dr. Kimberlin of the University of Alabama. “They'll find out soon enough.”
