If New York’s outbreak continues into October, the loss of measles elimination status will be a gut punch to public health.
Eliminating measles took decades of work to achieve. “It was a confirmation that our system of immunization was working really well,” said Hotez. “The fact that measles is back is a worrying sign there’s a problem nationally in our immunization system, that there’s been a breakdown.”
“It’s a line in the sand,” said University of Pennsylvania researcher Alison Buttenheim, “to go back to having regularly circulating measles in the country.”
If that happens, we’ll have to start worrying about the virus again in our communities. But even if America manages to hang on to its elimination status this year, we’ll have to wonder whether our children are in schools with high enough vaccine rates, and we’ll have to think about measles whenever we travel with newborn babies or family members who can’t be immunized. (Hotez said he got a booster shot to make sure he’s up to date, and anyone who’s worried about their measles immunization status can get a blood test to make sure they have antibodies for the virus.)
It’s also possible that America gets the measles under control again soon, and that this doesn’t lead to a full-blown disease resurgence.
On the other hand, measles could also be a signal for a bigger problem. Since it tops the list of contagious diseases, cases can begin to turn up even with a small decrease in vaccination coverage rates. And, again, the vaccine coverage rates required for herd immunity are much lower for other less contagious diseases, said Walter Orenstein, an infectious diseases professor at Emory University School of Medicine. “So measles may be the canary in the coal mine in terms of identifying a bigger problem with under-immunization. There’s the potential if this continues to worsen; it may mean other diseases are making a comeback.”