"Forest fires start with sparks, but unless there is sufficient dry tinder, they won't roar out of control. The same is true of outbreaks. The occasional case is not an issue, but when it occurs in a community where a fair number of people are not vaccinated it can cause serious problems. This is why vaccination is important. We don't want to return to the days when measles and other vaccination-preventable diseases were rampant."

"The MMR vaccine is very safe and effective at preventing measles, and high coverage is critical for preventing outbreaks. Quick public health response limited the spread of the disease. But the more unvaccinated people there are in a community, the more difficult it is to control an outbreak."

The financial burden of a small measles outbreak

A measles outbreak earlier this year in Salt Lake County, Utah occurred when a local unvaccinated high school pupil returned from Europe with measles. The disease only spread to nine other people because local authorities responded rapidly. However, infection control measures carried out by two local hospitals, state and local health departments cost $300,000.

When an infected student or adult goes to school, every person there is exposed. According to Utah law, anybody who has been exposed to measles and has not been vaccinated or cannot prove they have been vaccinated has to stay at home (quatantined) for 21 days after being exposed. In this case 12,000 were told about possible exposure and 184 had to be quarantined, including 51 schoolchildren. The costs quoted did not include other actions, such as hiring substitute teachers.

Karyn Leniek, MD, MPH, deputy state epidemiologist for the Utah Department of Health, Salt Lake City, said:

"It is always a concern to have a large number of unvaccinated people in close proximity. Our goal is to have as many people vaccinated as possible to protect those who cannot receive the vaccine and who are not fully immunized."

Written by Christian Nordqvist