A leading federal health expert says that health officials across the country should expect to see only isolated cases or mini-outbreaks of diseases such as diphtheria and tetanus because those bacterial infections are not as contagious as the measles virus, which continues to affect an ever-increasing number of people nationwide.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said nationwide vaccination rates are relatively high, but the easily transmissible nature of measles has allowed it to flourish among pockets of unvaccinated people.
“There haven’t been the level of outbreaks that we’ve seen with measles because the one characteristic of measles that’s important is that measles is one of the most contagious viruses known to man,” Dr. Fauci said.
The Centers for Disease Control and Prevention reported an additional 75 measles cases Monday, making a total of 839 confirmed infections in 23 states — the most measles cases since 1994.
Dr. Fauci said national vaccination rates top more than 90%, but stressed that rates of at least 93% to 95% are needed to achieve herd immunity.
The CDC recorded state vaccination rates varying from 83% to 98% among children 19 months old to 35 months old in 2017.
States with the highest measles vaccination rates, ranging from 94% to 98%, were Massachusetts, New Hampshire, Connecticut, Rhode Island, Virginia, Minnesota and North Dakota.
Washington, Wyoming, Utah, Colorado, New Mexico, Alaska, Missouri, Indiana, Ohio, New Jersey and South Carolina had the lowest vaccination rates, ranging from 83% to 93% in 2017, according to the CDC.
New York, where the majority of measles cases have been reported, had a statewide vaccination rate of just under 93%.
What differentiates measles from other infectious diseases is that it is airborne and can live for hours, said Dr. Niva Lubin-Johnson, president of the National Medical Association. The viral disease can be serious for all age groups, even deadly. It starts with fever, sore throat, coughing, runny nose and red eyes, succeeded by a rash that spreads over the body.
Children younger than 5 years old and adults older than 20 are more likely to suffer from complications including ear infections, pneumonia and swelling of the brain.
Dr. Lubin-Johnson also said she anticipates only isolated cases of diseases such as diphtheria and tetanus.
A total of 197 cases and 16 deaths from tetanus were reported in the United States from 2009 to 2015.
Tetanus does not spread from person to person. The bacteria is usually found in soil, dust and manure and enters the body through cuts or puncture wounds from contaminated objects. It is can cause health problems such as infections, difficulty breathing and pneumonia.
For the DTaP vaccine, which covers diphtheria, tetanus and whooping cough, vaccination rates ranged from 76% to 93% among children 19 to 35 months in 2017, depending on the state.
The CDC says there were only two cases of diphtheria in the U.S. between 2004 an 2017, although the disease is still a global issue with many cases likely going unreported.
Diphtheria is a bacterial disease that can spread person-to-person through coughing, sneezing or contact with a contaminated object. It causes a thick covering in the back of the throat and can cause difficulty breathing, heart failure, paralysis and death.
Although there have been isolated cases with tetanus and diphtheria, whooping cough, or pertussis, is a common disease in the U.S., with peaks every few years and frequent outbreaks, according to the CDC. The most recent peak year was 2012, which saw 48,277 cases.
Whooping cough is a contagious respiratory disease that leads to uncontrollable, violent coughing. It can affect people of all ages, but can be serious and even deadly for children less than a year old.
The possible resurgence of other infectious diseases depends on how many more people avoid vaccines, Dr. Fauci said.
“How do we stop this? It’s very simple. People should get their children vaccinated,” he said.
• Shen Wu Tan can be reached at stan@washingtontimes.com.
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