Journal of Infectious Diseases
Volume 203 Issue 11 June 1, 2011
http://www.journals.uchicago.edu/toc/jid/current

EDITORIAL COMMENTARIES
Stephen M. Ostroff
Editor’s Choice: Measles: Going, Going, But Not Gone
J Infect Dis. (2011) 203(11): 1507-1509 doi:10.1093/infdis/jir125

Extract
For those of us engaged in disease investigation and response at the state and local level, the report by Chen and colleagues [ 1] in this issue of the Journal makes for sobering reading. It describes an outbreak of measles in Arizona where virus transmission predominantly occurred in the health care setting, a scenario of great concern to us all. In reading through the report, I was repeatedly reminded of the adage “What a fool does in the end, the wise do in the beginning.” One hopes that a report of this nature will spur at least some health care systems, hospitals, and physicians’ offices to act wisely before they too are confronted with a case of measles in their facilities. The Tucson outbreak also highlights many of the challenges faced by public health departments around the country with respect to a disease that, vaccine controversies notwithstanding, has been receding in memory and importance for many health care practitioners, institutions, and the public

In the United States, we entered the “postelimination” era in 2000 [ 2]. But in the context of measles, “elimination” does not mean that there are no cases occurring. This is because the disease continues to be still too common in other parts of the world, and international travels produce opportunities for continued introduction [ 3]. As a result, between 2000 and 2008, an average of 56 cases per year have been confirmed in the United States [ 3]. And paradoxically, the number of cases may actually be rising as segments of the population increasingly opt out of vaccination, producing uneven vaccination rates and pockets of susceptibility [ 4]. This raises concerns that …

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