More Measles In Michigan

Back in December of 2019 people were asking me about a new disease being reported in China. My usual response was something like, “yeah, new viruses crop up all the time, especially in populous countries. Let’s focus on what we know is coming—get your flu shot.”

A few weeks later I was writing up infection control plans for my office and telling friends to keep a couple weeks of necessities in the house. A couple weeks after that, my patients were ending up in ICUs and morgues.

My concerns about measles in Michigan are very different. I’m not worried about hospitals filling up and refrigerator trucks parked at hospitals to serve as auxilliary morgues. I’m not worried about societal disruption. I am worried about needless illness and preventable pediatric deaths.

The start of the 21st century saw the elimination of measles in the US. This doesn’t mean that there were no cases, but that there were so few that sustained transmission wan’t happening anymore—instead of a common childhood danger, it became an occasional freak case report or two. It’s too early to say how many cases in the US are tied to the original outbreak in Texas and New Mexico. It does look as if cases in Kansas and Oklahoma are. There is also an ongoing outbreak over the Texas border in Mexico, some of which were clearly imported from the US. We are in danger of losing our “eliminated” status. Most cases of measles in the US over the last quarter century have returned to the US with international travellers, but we are now becoming an exporter ourselves. And all of this is due to pockets of very low vaccination rates, as well as falling vaccination rates nationally.

Local media are reporting Michigan’s fifth measles case of 2025, this time in Ingham County. Given how contagious the disease is, and how low our vaccination rates are, this is likely to get much worse before it gets better. There are outbreaks over the state line in Ohio, and viruses don’t really care about state lines. And the lastest case here in Michigan is in a 1 year old who recently travelled out of state—the reports don’t indicate that the baby travelled internationally. Cases from abroad are one thing, but when measles is spreading from person to person here at home, we’re in very big trouble. The 800 or so cases currently reported in the US are probably the tip of the iceberg—we are likely seeing thousands of cases and just don’t know it yet. Despite the inane and clearly wrong statements of HHS Secretary Kennedy, we have not “plateaued”. 

Measles is potentially deadly and easily spread long before someone knows they have the disease. And vaccination is close to 100% effective. If you had asked me two weeks ago if you should worry I would have said probably not, unless you’re travelling to an outbreak area. At this point it’s safer to assume that we are already in a potential outbreak area. The most recent case isn’t far from my daughter. If she happened to be at the same venue as this latest case, and if I hadn’t had her properly vaccinated, she could have brought it home here to Oakland County, and given our poor vaccination rates, she could easily have spread it to vulnerable kids (she’s studying education, so she’s around kids a lot).

It’s time to assess you and your family’s vulnerability:

• All children should be vaccinated for measles on time.

• Adults born before 1957 are considered immune. If you are certain you had measles you are immune.

• Adults born in 1957 or later need a vaccine if they are not certain that they had measles or are not certain they had a measles shot.

• If you received a measles shot from 1963 through 1967, you should get another shot unless a blood test shows that you are immune.

• Anyone born in 1968 or later who is certain they had a measles vaccine is likely safe.

• If you are unsure if you are immune to measles you can either go ahead and get a shot or get a blood test first to test for immunity.

This is a fairly aggressive and pessimistic recommendation. And I think it’s justified. Adults can become quite ill with measles but the highest risk is to young children and pregnant people. If you need more information, contact your local health department.

Stay safe.

-pal