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Measles cases continue to soar; Florida counties are at high risk

South Florida Sun Sentinel - 5/14/2019

May 14--Measles is continuing to spread in the U.S., and researchers say some Florida counties are at high risk, although the state appears to be more prepared than others to react if outbreaks occur.

In the last week, health officials reported 75 more measles cases in the U.S., bringing the total to 839 for the year. The new counts bring the country closer to the 963 cases reported in 1994 -- the highest number of cases in a year in the last 25 years.

Although most of the measles cases this year are in New York, as the diseases spreads, four counties in Florida could be at high risk for a measles outbreak, a new analysis shows. In Florida, Miami-Dade, Broward, Orange and Hillsborough counties ranked in the top 25 counties nationwide most likely to see the next measles outbreak.

Researchers at the University of Texas at Austin and Johns Hopkins University identified the 25 American counties most at risk of measles outbreaks because of their higher vaccine-exemption rates and proximity to airports. The researchers focused on counties with international airports, because every American outbreak since 2000 has begun with a case imported from overseas. The study, published in "The Lancet Infectious Diseases," looked at current vaccination rates in counties and what would happen if they dropped.

So far this year, Florida has had only two reported measles cases -- in Broward and Pinellas counties. Both cases were adults who had traveled outside the United States. Health officials have doubled down on efforts to recommend vaccination.

While this new analysis shows Florida counties at risk for outbreaks, a separate assessment released this week shows Florida's health security officials are better prepared than five years ago to respond to public health emergencies.

Based on models devised by health experts, the 2019 National Health Security Preparedness Index shows Florida scores are above the national average for the state's ability to detect concerns, deploy people and supplies to needed locations and contain health threats. Overall, the Robert Wood Johnson Foundation gave Florida a 6.7 on a 10-point scale for preparedness to manage community health emergencies, up from 5.8 in 2013.

"The good news is Florida is consistently trending upward in improving its score for health security, but there is still room for improvement," said Glen Mays, professor of health policy at the University of Kentucky and director of the team that produces the preparedness index.

"Florida is a part of country that faces a number of hazards -- from hurricanes to infectious diseases -- on pretty regular basis. Putting in protections is especially important," he said.

One of the state's biggest health threats for infectious diseases is its vaccination rate. The immunization rate for kindergartners in the 2018-19 school year hovered around 94 percent, slightly below the state's goal of 95 percent. Public health experts worry about the potential effect of more parents not wanting to vaccinate their children. Meanwhile, South Florida medical professionals are seeing an increase in people who want the measles vaccine or a booster.

The Centers for Disease Control and Prevention recommends that people who were born during or after 1957 who do not have evidence of immunity against measles get at least one dose of MMR. Those born before 1957 are assumed to have had measles and are immune and don't need to be vaccinated.

At Cleveland Clinic Florida, Dr. Carla Sue McWilliams with the department of infectious disease said a simple blood test can determine an individual's immunity to measles, and anyone unsure should do one. "There really is no downside to getting a booster shot," she said. "And, if you know you have had exposure to measles, go to your primary care physician and get immunized immediately."

Last month, the number of cases this year became the highest number of cases in a single year since the virus was declared eliminated in the U.S. in 2000. The designation means measles was no longer being transmitted within the country.


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