Pennsylvania has not had a death from measles for 35 years, but in less than one month, 4 have died. According to a Sept. 26 release from the Pennsylvania Department of Health, the commonwealth also has 173 hospitalizations, and 890 confirmed cases. The epicenter is in Lancaster County, home of a large Amish community and other sects which refuse vaccinations on religious grounds. This single county has 359 confirmed cases. State and local health officials responded with 165 “pop-up” vaccination clinics in the county where 5,300 people were vaccinated. Healthcare providers report a “surge of interest” in the vaccine across the state.

Measles is one of the hardest diseases to contain. For 30 years U.S. health officials assumed that if caught early, a measles outbreak could be contained and extinguished. However, in Texas, Utah, South Carolina, and now in Pennsylvania, each outbreak is larger and longer. In a 4 day period last week, Pennsylvania reported 55 new confirmed cases. Outbreaks are so large and numerous that health officials have to choose which outbreak should be prioritized. On Sept. 13 an infected passenger spent 5 hours in the Philadelphia Airport exposing untold numbers of fellow travelers and airport employees to the disease, but officials were unable to complete traditional contact tracing. According to the U.S. Centers for Disease Control and Prevention (CDC) there are 3,659 confirmed measles cases in the U.S. For 25 years measles was considered “eliminated” in the U.S., but last year there were 2,289 cases. The average cost of a response to a measles outbreak is over $750,000, according to the Association of State and Territorial Health Officials, and this does not include related costs of lost time at work and other social costs.