Measles is spreading across the US

Experts point to one reason for this year's large outbreak: the power of the anti-vaccination movement.

"It's just terribly sad that children in the US are having to suffer measles. This should not happen," said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and an adviser to the CDC on vaccines. "We'd previously eliminated this disease not just in the US but in the entire Western Hemisphere, and it appears that now we've profoundly and sadly turned back the clock."

The 20 states reporting measles this year are Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Texas and Washington.

Most of the cases have been in New York, site of an outbreak among ultra-Orthodox Jews that started in the fall.

Dr. Nancy Messonier, director of the CDC's National Center for Immunization and Respiratory Diseases, said the New York outbreak has been particularly difficult to control. "Most measles outbreaks in the US stop sooner than this," she said.

Health officials there announced last week that in the neighborhoods affected by the outbreak, anyone who has not had been vaccinated against measles or cannot show evidence of immunity could face a $1,000 fine.

On Monday, the New York City health department announced that one child-care program was closed "for repeatedly failing to provide access to medical and attendance records in violation of an Order of the Health Commissioner in response to the current measles outbreak." Schools and child-care programs are required to maintain records on-site, and unvaccinated students and staff are prohibited from attending.

In addition, the department said, "23 yeshivas and day care programs have received Notices of Violations (NOVs) for not following the school exclusion order."

Health officials in Rockland County, New York, tried to bar unvaccinated children from public places, but a judge prohibited the county from enforcing that rule.

Messonier said it's a matter of "correcting myths" about vaccination. Health authorities have worked with rabbis to explain that vaccination is safe, but that still hasn't turned the outbreak around.

"You have to just approach people where they are and answer their questions," Messonier said. "It's about the slow work of developing trust."

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