On Aug. 9, the Louisiana Department of Health confirmed a measles case in New Orleans. The patient was an international visitor who was not fully vaccinated and contracted measles from outside the United States. 

Measles is a highly contagious viral airborne disease that can cause serious complications and even death. Measles infects the respiratory tract and spreads throughout the body. Symptoms include a high fever, cough, runny nose and rash all over the body.  

This case marks the third measles case in Louisiana in 2024. 

The case can be placed in the context of a national uptick in measles. In 2000, the Center for Disease Control declared measles eliminated from the U.S., meaning that the disease did not spread within the country. In 2019, measles cases in the U.S. saw a dramatic increase that threatened its status as a measles-eliminated country. 

Currently, 236 cases in the U.S. have been reported this year, up from 59 cases in 2023.  

The resurgence of measles can be attributed to several factors, including changing public attitudes, declining vaccination rates, increased immunization exemptions and an increase in homeschooled children. 

According to Dr. Laura Rachal, an assistant professor of medicine at Tulane University Medical School, public attitudes toward healthcare have changed since the COVID-19 pandemic. 

“I think COVID [-19] made everyone question the public health system and ask, ‘why are they making us do this stuff,’” Rachal said. “Unfortunately, the focus on science and the scientific process isn't really one that I think a lot of people still buy into.” 

Additionally, declining measles vaccination rates in the U.S. have contributed to the recent surge in cases. During the 2022-2023 school year, the vaccination rate for measles, mumps and rubella was 93.1%, a 2% drop from 95% in the 2019-2020 school year.  

Increased immunization exemptions partly contribute to declining vaccination rates. Immunization exemptions include medical, religious and philosophical exemptions. In Louisiana, children are required to be vaccinated before entering school or daycare. However, the law dictates that the vaccination requirements can be waived at the parent’s request for any reason.  

“One of the other data points that I would like to present is there are more and more exemptions for vaccines,” Rachal said. “But there are now philosophical exemptions, like ‘I don’t want my child to get this.’ That has created a few extra exceptions.” 

Additionally, an increase in homeschooling has made it more difficult for healthcare providers to identify children who are behind on their immunizations, according to Rachal.  

“We're probably not catching as many kids not being vaccinated...because of a larger movement in the homeschool system,” Rachal said. “Sometimes we’re not catching people who are behind on their vaccines until they hit the college circuit, which is kind of scary.” 

While measles is preventable through vaccination, the disease can have long-term detrimental effects. In extreme cases, subacute sclerosing panencephalitis, or SSPE, can develop seven to 10 years after a measles infection. SSPE is a fatal disease that causes the deterioration of the central nervous system. 

Vaccination is the most effective way to prevent the spread of measles. One dose of the vaccine is 93% effective at preventing measles, while two doses are 97% effective. Creating herd immunity is essential to prevent the spread of disease and protect those who cannot safely receive the vaccine.  

“Every personal decision we make has a great impact on the entire public health system, and our system still is not great after COVID [-19],” Rachal said. “The one case of measles that popped up here in New Orleans could take down an entire school district just because of how far behind we are in public health across the country.”