Pennsylvania’s measles outbreak has grown to 1,338 confirmed cases in 44 counties this year, the state Department of Health reported Oct. 23. NPR reported Sunday that Pennsylvania is the hardest-hit state in a national outbreak that has pushed U.S. case counts to more than double last year’s total.

The department’s latest update added 21 cases since Oct. 21 and listed 255 hospitalizations and five confirmed measles-associated deaths. Only four of the 1,338 cases, less than 1 percent, involved vaccinated people, the department said. Crawford County in northwestern Pennsylvania became the 44th county to report a case.

Lancaster County remains the center of the outbreak with 474 cases, followed by Mifflin County with 193 and Chester County with 93, according to abc27 News in Harrisburg. The station reported that every county in its midstate coverage area, which includes Adams County, has now recorded at least one case except Fulton County.

Neighboring Franklin County reported a death this month. Franklin County Coroner Jordan F. Conner said on Oct. 12 that a 39-year-old woman who died Oct. 10 met the Department of Health’s definition of a measles-associated death. The Pennsylvania Capital-Star reported that, according to the coroner, the woman was unvaccinated and had multiple underlying conditions, and that her primary cause of death was “a probable acute cardiac event due to possible complications of the measles.” The Department of Health said it was conducting a thorough review, and its official count still stood at five deaths in the Oct. 23 update. The Philadelphia Inquirer reported that Franklin County had recorded seven cases.

The deaths the state has confirmed include two infants from Amish families in Lancaster County, an 18-year-old in Mifflin County who died of a serious neurological complication and a 40-year-old woman in Jefferson County with severe respiratory conditions, the Inquirer reported. The department announced on Sept. 30 that an unvaccinated Lancaster County resident who tested positive had also died.

The outbreak has driven a sharp rise in vaccinations. Pennsylvania health care providers typically give about 25,000 doses of the measles, mumps and rubella vaccine in a month, according to the department. They gave more than 56,000 in September and more than 39,000 in the first three weeks of October. State health center staff have given more than 6,500 doses at 226 pop-up clinics in affected communities since the outbreak began in late April, and about 300 department employees are working on the response.

Two doses of MMR vaccine provide 97 percent lifetime protection, the department says. Because of continued spread, it now recommends an extra early dose for infants ages 6 through 11 months who live in or travel to counties flagged on its dashboard for sustained community transmission; that dose does not replace the two routine doses. Children 12 months and older who have never been vaccinated should get a first dose now and a second at least 28 days later. Adults with only one documented dose, or who cannot find their records, should talk with a health care provider or pharmacist. The vaccine is available through doctors’ offices, county and municipal health departments, state health centers, federally qualified health centers and the Vaccines for Children program.

Measles spreads when an infected person breathes, coughs or sneezes, and the virus can remain infectious in the air and on surfaces for up to two hours after that person leaves. Symptoms usually appear seven to 21 days after exposure, starting with fever, cough, runny nose and red, watery eyes, followed a few days later by a rash that begins on the head and spreads downward. People are typically contagious from four days before the rash appears until four days after. Nearly 20 percent of Pennsylvania patients identified by the department have been hospitalized.

Nationally, the Centers for Disease Control and Prevention has confirmed 4,588 measles cases this year, the American Hospital Association reported. Pennsylvania accounts for more than a quarter of the nation’s cases, FOX 29 reported. The CDC said earlier this month it would send additional support to help Pennsylvania investigate the outbreak, Reuters reported, and the federal agency now relies on National Center for Health Statistics death records for its national count, which has drawn scrutiny because it lags behind state reports.

The department says dozens more vaccine clinics are scheduled in the coming weeks and months. People who think they were exposed and develop symptoms should call their health care provider before visiting, or call the department’s hotline at 877-PA-HEALTH (877-724-3258). Updated case counts are posted on the department’s measles dashboard.

Sources