Measles cases on the rise: Dartmouth Health Children’s pediatrician urges vaccination

Quote from Dartmouth Hitchcock Clinics Manchester pediatrician Jaisal K. Pragani, MD

Measles cases are surging in various parts of the world, highlighting the critical importance of measles vaccinations. The highly contagious virus is primarily transmitted through coughing and sneezing, causing symptoms such as fever, runny nose, and a distinctive red-brown rash. However, the American Academy of Pediatrics emphasizes that one dose of the MMR vaccine provides protection to approximately 95 out of every 100 individuals, while two doses offer even higher protection, ranging from 97 to 99 out of every 100 people.

Experts attribute the recent increase in measles cases abroad to the significant number of unvaccinated individuals and the highly contagious nature of the disease, which ranks among the most infectious diseases globally. The World Health Organization (WHO) reported 941 measles cases in the WHO European Region in 2022. Shockingly, this number skyrocketed to over 42,000 by the end of December 2023, as stated in the mid-December bulletin.

“The recent rise in measles cases abroad is concerning,” said Dartmouth Hitchcock Clinics Manchester pediatrician Jaisal K. Pragani, MD. “Measles vaccination rates have dropped across the world since the start of the pandemic and we are seeing the effects of that in some countries among the unvaccinated. To me, this uptick in cases underscores the importance of getting your children vaccinated no matter where you are.”

The United Kingdom has been sounding warning bells concerning the rise in measles cases, with over 300 reported between October and January. The Health Security Agency warns that the virus poses a significant risk of further spreading among the unvaccinated population. Researchers in the UK attribute this surge to a low uptake of the measles vaccine, as recent data from the National Health Service (NHS) reveals that only about 85% of children in England received the recommended two MMR vaccine doses by the age of 5. This falls below the WHO's recommended vaccination rate of at least 95% to achieve herd immunity, which substantially reduces disease transmission.

While the United States has been relatively unaffected by the global measles outbreak, recent isolated outbreaks among unvaccinated individuals in some states have raised concerns among medical experts. Between December 1, 2023, and January 23, 2024, there were 23 confirmed cases of measles in the country. Alarming trends in vaccination rates have been observed, as the national MMR vaccination rate among kindergarten students fell below the Healthy People 2030 target of 95% for the second consecutive year. In 2021 through 2022, approximately 93% of kindergarteners received all state-required vaccines, including MMR, DTaP, and varicella, marking the lowest reported MMR rate in nearly a decade. Consequently, around 250,000 school children remain unvaccinated and vulnerable to measles.

Specifically, New Hampshire and Vermont have fallen below the national MMR vaccination average, with rates of 88.7% and 93.4%, respectively, according to CDC data compiled by the independent research organization KFF. Both states have yet to meet the Healthy People target.

“We have seen drops in vaccination rates in New Hampshire as well,” notes Pragani, pointing to a report by the New Hampshire Department of Health and Human Services suggesting that many children and adults fell behind on receiving recommended routine vaccines during the COVID-19 pandemic.

“All this is not to say that the US will experience what is happening in England or elsewhere where cases may be more concentrated due to population density of unvaccinated people,” said Pragani. “But as a pediatrician, my message has not changed. Get your children vaccinated.”

While the situation demands attention, it is crucial not to panic, especially if your children have been vaccinated. The American Academy of Pediatrics highlights that a high fever accompanied by a red or brownish blotchy rash is the most recognizable symptom of measles, although other symptoms such as cough, runny nose, fever, and red, watery eyes may precede the rash. For more information on protecting your children during a measles outbreak, refer to the resources provided by the American Academy of Pediatrics.

About Dartmouth Health

Dartmouth Health, New Hampshire's only academic health system and the state's largest private employer, serves patients across northern New England. Dartmouth Health provides access to more than 2,000 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, NH, as well as across its wide network of hospitals, clinics and care facilities. DHMC is consistently named the #1 hospital in New Hampshire by U.S. News & World Report, and recognized for high performance in numerous clinical specialties and procedures. Dartmouth Health includes Dartmouth Cancer Center, one of only 56 National Cancer Institute-designated Comprehensive Cancer Centers in the nation, and the only such center in northern New England; Dartmouth Health Children’s, which includes Children’s Hospital at Dartmouth Hitchcock Medical Center, the state’s only children’s hospital, and multiple clinic locations around the region; member hospitals in Lebanon, Keene and New London, NH, and Bennington and Windsor, VT; Visiting Nurse and Hospice for Vermont and New Hampshire; and more than 24 clinics that provide ambulatory services across New Hampshire and Vermont. Through its historical partnership with Dartmouth and the Geisel School of Medicine, Dartmouth Health trains nearly 400 medical residents and fellows annually, and performs cutting-edge research and clinical trials recognized across the globe with Geisel and the White River Junction VA Medical Center in White River Junction, VT. Dartmouth Health and its more than 13,000 employees are deeply committed to serving the healthcare needs of everyone in our communities, and to providing each of our patients with exceptional, personal care.

About Dartmouth Health Children's

Dartmouth Health Children's is the only comprehensive pediatric healthcare system in the region. Fully integrated in Dartmouth Health and anchored for more than 30 years by Children's Hospital at Dartmouth Hitchcock Medical Center (CHaD)—in Lebanon, NH—Dartmouth Health Children's promotes health, advances knowledge, and delivers the best patient and family-centered care for infants, children, and adolescents across New Hampshire and Vermont. Dartmouth Health Children's conducts groundbreaking research and educates the next generations of health professionals as the primary pediatric partner of the Geisel School of Medicine at Dartmouth. Highly skilled and collaborative child health professionals provide care in multiple settings across the region. Outpatient specialty visits and same-day surgery services are available at Children's Hospital at Dartmouth Hitchcock Medical Center (CHaD) and Dartmouth Hitchcock Clinics Manchester. Primary care appointments in general pediatrics are available at Dartmouth Hitchcock Clinics in Bedford, Concord, Lebanon, Manchester and Nashua, NH and Bennington, VT; as well as at Dartmouth Health members: Alice Peck Day Memorial Hospital, Cheshire Medical Center, New London Hospital and Mt. Ascutney Hospital and Health Center.