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http://www.jconline.com/apps/pbcs.dll/article?AID=/20061222/LIFE03/612220327/1152

CDC ties measles outbreak to Clinton County teenager

ATLANTA -- The biggest U.S. measles outbreak in a decade -- 34 people stricken in Indiana and Illinois last year -- was traced back to a Clinton County teenager who had traveled to Romania without first getting vaccinated, government health officials said Thursday.

The outbreak accounted for more than half of the 66 measles cases in the United States in 2005.

Widespread use of the measles vaccine has dramatically reduced the incidence of the disease over the past four decades; in 2004, there were just 37 cases, the smallest number in nearly 90 years of record-keeping.

The girl, who was not named to protect her privacy, unknowingly brought the viral disease back to her home state of Indiana, the Centers for Disease Control and Prevention reported.

Thirty-two other people in Indiana and one from Illinois became infected.

Three people were hospitalized, but no one died.

Only two of the 34 people had been vaccinated against measles.

According to Journal & Courier archives, on May 15, 2005, a 17-year-old, unvaccinated girl from Clinton County returned from a church mission trip to an orphanage in Romania.

She unknowingly carried a measles strain common in that country.

On May 16, 2005, about 500 people were with her at a gathering at West Lafayette's Upper Room Christian Fellowship.

About 50 of them lacked proof of measles immunity. Sixteen contracted measles at the gathering.

Over six weeks, a total of 34 cases were confirmed.

Ninety-seven percent were members of the church that held the gathering; 94 percent were unvaccinated; 88 percent were less than 20 years old, and 9 percent were hospitalized. All survived.

Of the 28 patients aged 5 to 19, 71 percent were home-schooled.

Indiana does not require home schooled children to be vaccinated against measles.

"The outbreak occurred because measles was imported into a population of children whose parents had chosen not to vaccinate their children because of safety concerns, despite evidence that measles-containing vaccine is safe and effective," the CDC said in its weekly journal.

"Certainly orphanages are known to be higher risk" for measles, said Dr. Philip Gould of the CDC's division of viral diseases.

"The main point is to ensure that people do get vaccinated, especially prior to leaving the country, ... going to a place that physicians suspect that measles is a risk."

The federal health agency said the girl should have been given two doses of a measles vaccine before leaving the country.

The CDC said the outbreak could have been prevented if everyone involved had been properly vaccinated.

However, the agency noted that a "major epidemic" was averted because the community surrounding the outbreak area had high vaccination rates.

Nearly all of the 32 other U.S. cases in 2005 originated abroad, including 16 cases involving U.S. residents infected while traveling overseas and seven involving foreigners who were infected before visiting the United States.

In the decade before a measles vaccine became available in 1963, about 450,000 measles cases and about 450 measles deaths were recorded in the U.S. each year.

The disease -- often known by its characteristic rash that begins on the face and spreads -- can cause ear infection, diarrhea, or pneumonia. It kills about one in 1,000 patients, according to the CDC.

The U.S. vaccination rate against measles is now more than 90 percent.