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A measles outbreak where you live? Study ranks US places at highest risk

A new study ranks the US counties at highest risk of a measles outbreak, with the areas surrounding Chicago, Los Angeles and Miami topping the list.Th...

Posted: May 10, 2019 7:33 AM

A new study ranks the US counties at highest risk of a measles outbreak, with the areas surrounding Chicago, Los Angeles and Miami topping the list.

The authors say places like these should be kept under close surveillance because they "could serve as the fulcrum of continuous importation of the measles virus into the USA." Their paper was published Thursday in the journal The Lancet Infectious Diseases.

"What we're trying to do is identify what are the areas that are most likely to be affected by this [anti-vaccination] movement that's happening," said study co-author Lauren Gardner, an associate professor in the Department of Civil Engineering at Johns Hopkins University.

In order to rank the counties at greatest risk, the authors didn't even have to consider the locations of actual measles cases in the United States. Instead, they looked at factors including nonmedical vaccine exemptions, international air travel and the incidence of measles in countries people are traveling from.

"These outbreaks can only happen if someone brings measles into the country and there's a low vaccination rate in a population," Gardner explained.

"The places where measles outbreaks are happening this year were the ones that we ranked really highly in our risk model," which had largely been completed by February, she added.

According to the paper, of at least 45 counties reporting measles cases this year, 30 were among or adjacent to the researchers' top 25, including outbreaks in states like New York, Washington and Oregon.

This year, the United States has seen the highest number of confirmed cases since measles was declared eliminated in the country in 2000: now more than 760 cases, according to the US Centers for Disease Control and Prevention.

The new paper isn't the first that has tried to predict outbreak risks in the United States, but previous efforts did not include international travel, Gardner said.

"What's going to happen as we move into the summer months, with all that back-and-forth travel between Europe and the US ... there's opportunities to introduce a lot more measles into this country," said Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine.

"Europe is a disaster right now, even worse than North America, in terms of measles," added Hotez, who is also co-director of the Texas Children's Hospital Center for Vaccine Development.

This week, the World Health Organization announced that there had been more than 34,000 cases in its European region during the first two months of 2019. That's triple what it reported during the same time last year.

Last year, Hotez published an analysis in the journal PLOS Medicine, analyzing a subset of states that allow nonmedical exemptions for philosophical or personal beliefs, as opposed to religious ones. Nearly half of the top 15 hot spots identified in his paper have been stricken with measles this year, Hotez said.

"That's an all-star batting average in Major League Baseball," said Hotez, who was not involved in the new paper but whose previous study was one of its data sources.

The latest paper -- "version 2.0," he called it -- looks at the entire country and picks up hot spots that his analysis missed.

"The one we missed totally was the New York epidemic," Hotez said. "It wasn't even on our radar because it's not a state that has personal belief exemptions. And there, what seems to have happened is the anti-vaccine lobby ... identified the Orthodox Jewish community as a vulnerable group to target. And they flooded them with phony pamphlets and misinformation.

"That's something we could never have predicted."

In the new model, Queens -- which is adjacent to Brooklyn, one of the focal points of the ongoing New York measles outbreak -- is ranked fourth.

A total of 47 states allow nonmedical vaccine exemptions: all but West Virginia, Mississippi and California. Some allow only religious exemptions, while others allow exemptions based on personal or philosophical beliefs.

Hotez said that these maps can help target public health vaccination efforts where they're needed most. But he said the maps shouldn't just be coming from academics like himself; he believes they should be generated every year by public health agencies like the CDC.

Hotez, who was criticized this week by a Texas lawmaker who called his vaccine work "sorcery," said that "the anti-vaccine movement has become mainstream. It is now fully integrated into public life of this country.

"It's the consequence of allowing the anti-vaccine movement to run unopposed for so many years."

Minnesota Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 39589

Reported Deaths: 1523
CountyConfirmedDeaths
Hennepin12703789
Ramsey5013230
Dakota247993
Stearns242919
Anoka2293110
Nobles16726
Olmsted116817
Washington116340
Mower9652
Rice8598
Scott7834
Clay59538
Kandiyohi5821
Blue Earth5102
Wright4925
Carver4171
Todd4022
Lyon3272
Sherburne3275
Freeborn2980
Watonwan2400
Steele2391
Benton2213
St. Louis19816
Nicollet17612
Martin1715
Cottonwood1370
Goodhue1328
Winona13115
Le Sueur1101
Pine1100
Crow Wing10912
Chisago1021
Otter Tail1001
McLeod940
Dodge920
Carlton880
Unassigned8738
Polk842
Chippewa791
Isanti760
Waseca710
Douglas660
Murray660
Itasca6512
Pipestone632
Meeker611
Morrison611
Faribault600
Becker570
Jackson550
Sibley552
Pennington520
Brown372
Renville362
Beltrami350
Wabasha350
Mille Lacs342
Rock310
Fillmore300
Yellow Medicine300
Houston280
Swift231
Norman210
Wilkin213
Redwood200
Cass192
Big Stone170
Grant170
Koochiching171
Roseau170
Aitkin150
Kanabec151
Wadena150
Marshall120
Pope120
Lincoln110
Mahnomen101
Clearwater90
Hubbard80
Lake60
Stevens60
Traverse60
Lac qui Parle40
Red Lake40
Kittson20
Cook10
Lake of the Woods00

Iowa Coronavirus Cases

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Confirmed Cases: 32533

Reported Deaths: 735
CountyConfirmedDeaths
Polk6827181
Woodbury326444
Black Hawk235558
Buena Vista172411
Johnson13638
Linn132382
Dallas129829
Marshall106319
Scott88310
Story8194
Dubuque77122
Pottawattamie75812
Wapello71231
Crawford6793
Muscatine67544
Sioux4880
Tama47329
Wright3881
Louisa36313
Jasper32917
Plymouth3275
Warren2971
Dickinson2823
Webster2524
Washington2479
Cerro Gordo2011
Hamilton1921
Boone1571
Clay1421
Allamakee1354
Clarke1343
Mahaska11817
Shelby1170
Clinton1151
Poweshiek1078
Carroll1041
Pocahontas1011
Bremer987
Franklin980
Des Moines942
Emmet910
Henry883
Cedar851
Hardin830
Taylor810
Cherokee791
Monona770
Floyd742
Marion740
Benton691
Guthrie694
Jones650
Osceola640
Sac640
Jefferson620
Iowa611
Buchanan601
Butler602
Humboldt571
Calhoun552
Hancock541
Harrison540
Lee542
Delaware531
Fayette520
Monroe517
Madison492
Lyon470
Clayton463
Mills430
Winneshiek430
Davis421
Palo Alto420
Mitchell410
Grundy400
Howard370
Jackson370
Kossuth370
Union360
Lucas314
Winnebago300
Chickasaw290
Greene290
Cass240
Ida230
Appanoose213
Van Buren210
Keokuk201
Page200
Unassigned200
Worth200
Adair170
Audubon161
Ringgold150
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