Blame the Amish

Julia Belluz has the measles figures for 2014:

In 2000, the federal government declared that the United States had eliminated the disease: enough people were immunized that outbreaks were uncommon, and deaths from measles were scarcely heard of.

But in the first half of 2014 alone, there were 288 cases. And nearly all of them, the CDC researchers wrote in findings published last June, stemmed from Americans traveling abroad and returning with the disease.

"Of the 288 cases, 280 (97 percent) were associated with importations from at least 18 countries," they wrote. Many of these travelers were coming back from the Philippines, which has been dealing with a massive outbreak since fall 2013.

But all of a sudden, Amish people in Ohio started getting measles:

In the Ohio case, "patient zero" had traveled to the Philippines on a missionary trip. (In case you were wondering, he took a plane. Miller explained, "Some Amish fly. Some don't.") At the time, the Philippines happened to be facing a massive measles outbreak, with tens of thousands of cases.



When he returned to Ohio, and fell ill, a doctor misdiagnosed him with Dengue fever, so he continued to pass his disease along to friends and neighbors, many of whom had refused the vaccine out of those concerns over adverse effects.

Fletcher describes it as a "perfect storm:" an unimmunized traveler going to a place with an outbreak and bringing an infectious disease back to an unprotected community.

Measles is one of the most contagious viruses ever discovered. In most cases, it's not deadly, but it's almost always debilitating, bringing on a weeks-long fever, rash, and painful, watery eyes. Up to forty percent of people experience serious complications, such as pneumonia and encephalitis (or swelling of the brain). One or two children in 1,000 die.

"Measles is very contagious, so once [the Ohio missionary] felt better, he went to church, and the church was in somebody's house," Fletcher says. "The majority of those first cases, we linked back to him. They had all attended church in that house."

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