1991 — Jan-Dec, Measles resurgence, especially CA (8); NY (15); and PA (9) — 38
— 62 Hinman, et al. “Acute Measles Mortality…[US], 1987-2002.” JID, 189, 2004, S69-S77.[1]
— 38 Blanchard tally from State breakouts below.
— 36 Atkinson, William L., et al. “Measles Surveillance – US, 1991.” MMWR, 41/SS-6, p. 7.
— 35 Atkinson, William L., et al. “Measles Surveillance – US, 1991.” MMWR, 41/SS-6, p. 2
–~32 CDC NCHS[2] multiple-cause Mortality database (1987-1999), in Hinman Figure 3.[3]
— 30 CDC Nat. Immunization Pgm. Surveillance Database (1987-2002), in Hinman Figure 3.[4]
Arizona ( 1)
— 1 State. Atkinson, W. L., et al. “Measles Surveillance – US, 1991.” MMWR, 41/SS-6, p. 7.
California ( 8)
— 8 State. Atkinson, W. L., et al. “Measles Surveillance – US, 1991.” MMWR, 41/SS-6, p. 7.
— 2 Orange County, early March. Girl, 2, male, 32.[5]
Florida ( 1)
— 1 State. Atkinson, W. L., et al. “Measles Surveillance – US, 1991.” MMWR, 41/SS-6, p. 7.
Illinois ( ?)
— 0 11 cases by Mar 26. Daily Herald, IL. “Chicago staves off measles epidemic.” 3-26-1991, 4.[6]
New Jersey ( 3)
— 3 State. Atkinson, W. L., et al. “Measles Surveillance – US, 1991.” MMWR, 41/SS-6, p. 7.
New Mexico ( 1)
— 1 Navajo Reservation, late April. Infant, less than 6-months old.[7]
New York (15)
–15 State. Atkinson, W. L., et al. “Measles Surveillance – US, 1991.” MMWR, 41/SS-6, p. 7.
–14 New York Times, by Sep 28. “Immunizations are cost-effective” (Editorial). 9-28-1991.
–13 NYC. NYC Dept. of Health, in: Davis, et al. “Reporting Efficiency…” AJPH, July 1993, 1011.
–11 NYC, by April 4. Schanberg, Sidney. “Kinder, gentler…meaner and harder.” 4-4-1991.
— 9 NYC. CDC. “Measles Outbreak – New York City, 1990-1991.” MMWR, 40/18, 5-10-1991
Pennsylvania ( 9)
— 9 AP, Atlanta. “Measles make resurgence.” Daily Times, Farmington, NM, 5-29-1991, p. 2.
— 9 Offit, P. A. MD. The Philadelphia Measles Outbreak; Lessons From the Past.[8]
— 8 State. Atkinson, W. L., et al. “Measles Surveillance – US, 1991.” MMWR, 41/SS-6, p. 7.
— 5 State by Feb 13. AP. “State Rep. DeWeese calls for funding of child vaccinations.” 2-13-91.[9]
— 1 Chester Co. by Feb 13. Daily News, Huntingdon, PA. “Measles Epidemic.” 2-13-1991, 8.
— 6 Philadelphia. Offit, P. A. MD. The Philadelphia Measles Outbreak; Lessons From the Past.
–1 Feb 7. Girl, 9, member of Faith Tabernacle church, north Philadelphia.[10]
–1 Feb 10. Girl, 10, member of Faith Tabernacle church, north Philadelphia. Offit #15.[11]
–1 Feb 14. Girl, 14, member of Faith Tabernacle church, north Philadelphia. Offit #20.
–1 Feb 15. Girl, 5, north-central Philly, not a member of Faith Tabernacle church. #25.
–1 Feb 15. Girl, 13, sister of previous fatality; no doctor had seen either sister. #27.[12]
–1 March 8. Boy, 19-mo., “whose family belongs to a church that shuns medical care.”[13]
–1 March 9. Child, member of Faith Tabernacle church, north Philadelphia. Offit #62.[14]
— 5 Philadelphia. NYT. “Measles and Faith Combine in 5 Deaths in Philadelphia.” 2-16-1991.
— 1 Philadelphia, ~Jan 17. Boy, 18-months. Associated Press, Philadelphia, 1-17-1991.[15]
Narrative Information
CDC: “In March 1990, a large measles outbreak began in New York City. Through December 1990, approximately 2500 cases and eight measles-associated deaths were reported. However, since January 1991, transmission has increased; through May 7, more than 2000 cases and nine deaths were reported to the New York City Department of Health (NYCDH) in 1991.
“Preliminary data are available for the first 2084 cases reported in 1991. Of these patients, 1383 (66%) were less than 5 years of age, of whom 735 (53%) were less than 12 months of age. Most cases have occurred among black and Hispanic children; more than 70% of cases have been reported from the Bronx and Brooklyn. Transmission has also occurred among prisoners in the city jail system and among both patients and medical staff in some local hospitals.
“To control the outbreak, NYCDH officials have recommended an additional dose of measles vaccine for 6- to 11-month-old children, have made walk-in immunization services available, are vaccinating eligible children in emergency rooms, and have mounted a citywide multimedia “stop measles” education and information campaign. In addition, New York state health officials have implemented emergency regulations that require health-care workers to demonstrate proof of measles immunity, have integrated immunization services with certification for the Special Supplemental Program for Women, Infants, and Children, and are implementing requirements for hospitals and licensed health-care facilities to offer immunization to all children served. Reported by: K Ong, MD, S Friedman, MD, A Nazitto, D Hurley, New York City Dept of Health; LF Novick, MD, GS Birkhead, MD, DL Morse, MD, State Epidemiologist, New York State Dept of Health. Div of Immunization, Center for Prevention Svcs, CDC.
“Editorial Note: Characteristics of the current measles outbreak in New York City are similar to recent outbreaks in other large metropolitan areas of the United States, including Chicago, Houston, and Los Angeles.[16]
Sources
Associated Press, Philadelphia. “Child dies from measles.” Daily Times, Farmington, NM, 3-8-1991, p. 1. Accessed 5-6-2016 at: http://newspaperarchive.com/us/new-mexico/farmington/farmington-daily-times/1991/03-08?tag
Associated Press, Atlanta. “Measles make resurgence.” Daily Times, Farmington, NM, 5-29-1991, p. 2. Accessed 5-7-2016 at: http://newspaperarchive.com/us/new-mexico/farmington/farmington-daily-times/1991/05-29/page-2?tag
Associated Press, Philadelphia. “Measles on rise in state; child’s death upsets officials.” Indiana Gazette, Indiana, PA, 1-17-1991, p. 11. Accessed 5-6-2016 at: http://newspaperarchive.com/us/pennsylvania/indiana/indiana-gazette/1991/01-17/page-10?tag
Associated Press, Philadelphia. “Measles outbreak leaves five dead.” New Castle News, PA. 2-16-1991, p. 2. Accessed 5-6-2016 at: http://newspaperarchive.com/us/pennsylvania/new-castle/new-castle-news/1991/02-16/page-2?tag
Associated Press, Shiprock, NM. “Navajo infant dies from measles.” Roswell Daily Record, NM, 4-30-1991, 13. Accessed 5-7-2016 at: http://newspaperarchive.com/us/new-mexico/roswell/roswell-daily-record/1991/04-30/page-13?tag
Associated Press, Philadelphia. “School closed after 2 kids die of measles.” Chronicle-Telegram, Elyria, OH. 2-12-1991, p. 3. Accessed 5-6-2016 at: http://newspaperarchive.com/us/ohio/elyria/elyria-chronicle-telegram/1991/02-12/page-3?tag
Associated Press (Anne McGraw). “State Rep. DeWeese calls for funding of child vaccinations.” Leader-Times, Kittanning, PA, 2-13-1991, p. 3. Accessed 5-6-2016 at: http://newspaperarchive.com/us/pennsylvania/kittanning/kittanning-leader-times/1991/02-13/page-3?tag
Atkinson, William L., et al. “Measles Surveillance – United States, 1991.” MMWR (Morbidity and Mortality Weekly Report) CDC Surveillance Summaries, Vol. 41, No. SS-6, pp. 1-12. Atlanta, GA: Centers for Disease Control and Prevention, 11-20-1992. Accessed 5-5-2016 at: https://books.google.com/books?id=lnCt01e4gKcC&printsec=frontcover#v=onepage&q&f=false
Centers for Disease Control and Prevention. “Measles Outbreak – New York City, 1990-1991.” MMWR (Morbidity and Mortality Weekly Report), Vol. 40, No. 18, 5-10-1991, pp. 305-306. Accessed 5-2-2016 at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00001980.htm
Daily News, Huntingdon, PA. “Measles Death” (con’t from p.1), 2-13-1991, p. 8. Accessed 5-6-2016 at: http://newspaperarchive.com/us/pennsylvania/huntingdon/huntingdon-daily-news/1991/02-13/page-15?tag
Daily News, Huntingdon, PA. “Measles Epidemic” (con’t from p.1), 2-13-1991, p. 8. Accessed 5-6-2016 at: http://newspaperarchive.com/us/pennsylvania/huntingdon/huntingdon-daily-news/1991/02-13/page-15?tag
Davis, Susan F., et al. “Reporting Efficiency during a Measles Outbreak in New York City, 1991.” American Journal of Public Health, July 1993, pp. 1011-1015. Accessed 5-9-2016 at: http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.83.7.1011
Farmington Daily Times, NM “Measles claims first life.” 4-29-1991. Accessed 5-7-2016 at: http://newspaperarchive.com/tags/measles?
Hinman, Alan R., et al. “Acute Measles Mortality in the United States, 1987-2002.” Journal of Infectious Diseases, Vol. 189 (Supplement 1), 2004, pp. S69-S77. Accessed 5-2-2016 at: http://jid.oxfordjournals.org/content/189/Supplement_1/S69.long
New York Times. “Immunizations are cost-effective” (Editorial). Reprinted in Leader-Telegram, Eau Claire, WI. 9-28-1991. 8A. Accessed 5-7-2016 at: http://newspaperarchive.com/us/wisconsin/eau-claire/eau-claire-leader-telegram/1991/09-28/page-8?tag
New York Times. “Measles and Faith Combine in 5 Deaths in Philadelphia.” 2-16-1991. Accessed 5-3-2016 at: http://www.nytimes.com/1991/02/16/us/measles-and-faith-combine-in-5-deaths-in-philadelphia.html?pagewanted=all
Orange Country Register (Susan Peterson), Santa Ana, CA. “Resurgent measles fatal for two in OC.” 3-15-1991, p. 1. Accessed 5-6-2016 at: http://newspaperarchive.com/us/california/santa-ana/santa-ana-orange-county-register/1991/03-15/
Schanberg, Sidney. “Kinder, gentler…meaner and harder.” Cedar Rapids Gazette, IA, 4-4-1991, 4A. Accessed 5-7-2016 at: http://newspaperarchive.com/us/iowa/cedar-rapids/cedar-rapids-gazette/1991/07-04/page-4?tag
Additional Reading
Dales, Loring G., et al. “Measles Epidemic From Failure to Immunize.” Western Journal of Medicine, Vol. 159, No. 4, October 1993, pp. 455-464. Accessed 5-9-2016 at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1022280/pdf/westjmed00074-0031.pdf
[1] Hinman, et al., utilize a “capture-recapture” methodology, they view as necessary in order to correct for inefficiencies in data collection employed by the NCHS and NIP which understate measles fatalities. This methodology is briefly discussed and sources referenced in their article. We do not use this number as our estimate in that it is based on a methodology, and we choose to use the number of reported deaths we have seen in sources.
[2] National Center for Health Statistics.
[3] “Acute measles deaths, by reporting source, United States, 1987-2001.” Notes: data derived from the National Center for Health Statistics underlying-cause mortality database. We write “approximately” in that the “number of deaths” is represented by a bar – in this case extending slightly above the line representing 30 deaths.
[4] “Acute measles deaths, by reporting source, United States, 1987-2001.” Notes: data derived from the National Center for Health Statistics underlying-cause mortality database.
[5] Orange Country Register (Susan Peterson), CA. “Resurgent measles fatal for two in OC.” 3-15-1991, p. 1.
[6] “During the first nine weeks of this year, 529 cases of measles were reported to the…[CDC] from 18 different regions across the country. But only 11 cases have been reported in Illinois so far, state health officials said.”
[7] Associated Press, Shiprock, NM. “Navajo infant dies from measles.” Roswell Daily Record, NM, 4-30-1991, 13. Notes: “In the past two weeks, the number of measles cases on the reservation has increased from 236 to 309, Milligan said [Carol Milligan, Indian Health Service consultant]. Of the 309 cases, 266 have been in Arizona and 43 have been in New Mexico, Milligan said.”
[8] Dr. Offit writes that as of December 3, 1992. “Among church members [Faith Tabernacle], 486 people infected and six died. Among non-church members, 938 people infected and three died. All nine deaths were in children. Attack rate in church members about 1,000-fold greater than in the surrounding community.” Slide 67.
[9] Cites State House Majority Leader H. William DeWeese to effect that “So far this year, there have been five deaths from measles, four in Philadelphia.”
[10] Offit, Paul A. (Children’s Hosp. of Philly). The Philadelphia Measles Outbreak; Lessons From the Past. Slide 15.
[11] A news article notes that after this second death “The city closed a school run by a religious group that rejects medical care after an outbreak of measles that has hilled two girls and may have infected 90 other students.” (AP, Philadelphia. “School closed after 2 kids die of measles.” Chronicle-Telegram, Elyria, OH. 2-12-1991, p. 3.) Another quotes the father, the day after his daughter’s death, to effect that immunization would have been “Interference with God’s will.” (Daily News, Huntingdon, PA. “Measles Death” (con’t from p.1), 2-13-1991, p. 8.
[12] Offit: “In the U.S., about 1 in 1,000 infected children die from measles. In some developing world countries, can reach as high as 1 in 300. In Philadelphia, 4 of 150 children with measles who attend Faith Tabernacle are dead, a rate of about 1 in 35.” (slide 28) Next slide: the CDC sent team to investigate: “The CDC’s Bill Atkinson finds that the measles deaths nave nothing to do with the circulating strain and everything to do with the parents. Children are dying because they aren’t getting intravenous fluids for severe dehydration or oxygen for pneumonia.” (slide 29)
[13] AP, Philly. “Child dies from measles.” Daily Times, Farmington, NM, 3-8-1991, p. 1. Writes child “died today after being brought to the hospital as many as 10 days after contracting measles, a hospital spokeswoman said.”
[14] We believe this refers to March 8 death.
[15] AP. “Measles on rise in state; child’s death upsets officials.” Indiana Gazette, Indiana, PA, 1-17-1991, p. 11.
[16] CDC. Update: measles outbreak-Chicago, 1989. MMWR 1990;39:317-9,325-6; CDC. Measles-United States, 1989 and first 20 weeks 1990. MMWR 1990;39:353-5,361-3; and, CDC. Measles-Los Angeles County, California, 1988. MMWR 1989;38:49-52,57.