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Just 14 years after declaring measles had been eliminated from the U.S. through a successful vaccination program, government officials say the confirmed number of cases of the highly contagious and occasionally fatal disease has reached a 20-year high.

Unvaccinated Americans and foreign visitors who traveled from Europe, Africa and Asia are the main culprits in a growing spike of U.S. measles cases that began several years ago and exploded this year. Health officials are urging people to get vaccinated for measles, especially before international travel.

A viral respiratory disease that grows in cells at the back of the throat and in the lungs, measles is spread through the air by coughing, sneezing and even breathing. It can cause fever and coldlike symptoms, along with a stubborn, itchy rash.

As of last Friday, 288 cases had been reported in 18 states, the highest year-to-date total since 1994. Ninety-seven percent — 280 — of the 2014 U.S. cases were imported from other countries.

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New York City, California and Ohio — where Amish communities tend to have lower vaccination rates — lead the country in reported measles outbreaks.

This year, Washington, too, is trending toward an unusually high number of measles cases with 15 reported since January. The state’s last spike in measles cases was in 2008, when Grant County saw 19 cases — but that was for the whole year. There have been some measles cases in the state every year since then, with the exception of 2012.

“Our experience here in Washington is consistent to what’s being seen nationally,” said Chas DeBolt, senior epidemiologist for vaccine-preventable diseases for the Washington State Department of Health.

So far this year, a Whatcom County resident attending school in British Columbia infected five friends and family members. A man from San Juan County who traveled to Southeast Asia — an area prone to measles outbreaks — infected six others. One child from Skagit County was infected after her first immunization dose. Her source of measles is unknown.

The latest case of measles was in Snohomish County on May 17, contracted by an unimmunized man who traveled to Indonesia. There were no reports of anybody catching the disease from him.

“It’s the only case in the past six years” in the county, said Amy Blachard, communicable-disease program manager for Snohomish County, where 91 to 94 percent of children are vaccinated when they enter school.

Ten of the people who came down with measles in Washington had opted out of getting vaccinated for philosophical, medical or religious reasons, according to the state Department of Health. Four of the people’s immunization histories were unknown, and one had been vaccinated once outside of the U.S. Only one has been hospitalized.

The percentage of children whose families refuse vaccination because of personal beliefs is declining in King County, said Dr. Jeff Duchin, chief of communicable disease and immunization for Public Health Seattle — King County. He said 92 percent of children starting school in King County had been vaccinated in the 2012-13 school year.

“That’s enough to protect most people under most circumstances,” Duchin said of the county’s vaccination rate, “but that’s not enough for people who try to rely on other people in their communities being vaccinated.”

Nationwide, 195 of the people who came down with measles this year were unvaccinated. Of those, 165, or 85 percent, chose to go without vaccinations for personal, religious or philosophical reasons, “not because they were too young or had medical reasons that they couldn’t be vaccinated,” said Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the U.S. Centers for Disease Control and Prevention.

“Unfortunately, when we have larger communities of unimmunized people, it’s more likely that bigger outbreaks will occur, making it much more difficult to control the spread of disease and making us vulnerable to have the virus re-establish itself in our country again,” Schuchat said.

About 10 percent of children who get measles also get ear infections and about 5 percent develop pneumonia. About one in 1,000 measles patients contract encephalitis, and for every 1,000 cases, one or two people die.

Before the U.S. measles-vaccination program, which began in 1963, 3 million to 4 million people in the U.S. developed measles each year, leading to 48,000 hospitalizations and 400 to 500 deaths.

Material from Seattle Times reporter Colleen Wright and McClatchy Washington Bureau reporter Tony Pugh was used in this report.

Colleen Wright: 206-464-2240 or

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